| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
36,179 |
30,004 |
$6.04M |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
26,483 |
22,059 |
$4.57M |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
14,355 |
12,109 |
$2.44M |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
6,877 |
6,001 |
$1.64M |
| 70450 |
Computed tomography, head or brain; without contrast material |
7,163 |
6,000 |
$1.24M |
| G0378 |
Hospital observation service, per hour |
8,939 |
5,660 |
$990K |
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
8,455 |
5,357 |
$946K |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
23,202 |
6,520 |
$888K |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
6,167 |
5,130 |
$811K |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
5,320 |
3,051 |
$664K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
7,454 |
5,043 |
$638K |
| 97530 |
Therapeutic activities, direct patient contact, each 15 minutes |
15,941 |
4,892 |
$505K |
| 59025 |
Fetal non-stress test |
2,470 |
1,891 |
$491K |
| 93306 |
Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete |
1,648 |
1,467 |
$482K |
| 96366 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour |
1,841 |
1,168 |
$481K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
1,947 |
1,659 |
$370K |
| 71275 |
Computed tomographic angiography, chest, with contrast material |
1,529 |
1,350 |
$356K |
| 76700 |
Ultrasound, abdominal, real time with image documentation; complete |
2,907 |
2,600 |
$320K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
8,550 |
7,363 |
$300K |
| 97112 |
Therapeutic procedure, each 15 minutes; neuromuscular reeducation of movement, balance, coordination |
17,191 |
4,778 |
$297K |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
7,514 |
5,699 |
$235K |
| 43239 |
Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple |
682 |
613 |
$234K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
2,326 |
2,110 |
$214K |
| 11042 |
Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm |
1,165 |
642 |
$211K |
| 97162 |
|
2,724 |
2,343 |
$209K |
| 87636 |
Infectious agent detection by nucleic acid; SARS-CoV-2 and influenza virus types A and B |
11,563 |
10,727 |
$195K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,058 |
1,722 |
$177K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
2,092 |
1,888 |
$173K |
| 76818 |
|
1,745 |
739 |
$171K |
| 0241U |
Neonatal screening for hereditary disorders, genomic sequence analysis panel |
1,768 |
1,692 |
$162K |
| 80053 |
Comprehensive metabolic panel |
46,782 |
35,899 |
$161K |
| 45385 |
Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) |
239 |
220 |
$147K |
| 45378 |
Colonoscopy, flexible; diagnostic, including collection of specimen(s) |
182 |
171 |
$143K |
| 70496 |
|
602 |
543 |
$141K |
| 76830 |
Ultrasound, transvaginal |
1,594 |
1,440 |
$135K |
| 97163 |
|
1,286 |
1,141 |
$129K |
| 97140 |
Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) |
11,817 |
3,844 |
$124K |
| 90853 |
Group psychotherapy (other than of a multiple-family group) |
694 |
145 |
$115K |
| 93971 |
|
1,557 |
1,337 |
$111K |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
2,463 |
1,411 |
$111K |
| 99281 |
Emergency department visit for the evaluation and management, self-limited or minor |
967 |
846 |
$103K |
| 93976 |
|
1,782 |
1,611 |
$102K |
| 71260 |
Computed tomography, thorax, diagnostic; with contrast material |
1,169 |
1,001 |
$101K |
| 76819 |
Fetal biophysical profile; without non-stress testing |
1,811 |
1,639 |
$98K |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
2,651 |
2,476 |
$94K |
| 45380 |
Colonoscopy, flexible; with biopsy, single or multiple |
145 |
132 |
$92K |
| 72148 |
Magnetic resonance imaging, lumbar spine; without contrast material |
670 |
566 |
$92K |
| 76811 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, detailed |
789 |
746 |
$91K |
| 71046 |
Radiologic examination, chest; 2 views |
7,512 |
6,601 |
$87K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
2,391 |
2,073 |
$80K |
| 87633 |
Infectious agent detection by nucleic acid, respiratory virus, 12-25 targets |
1,445 |
1,344 |
$77K |
| 76801 |
|
1,425 |
1,229 |
$73K |
| 76770 |
|
651 |
579 |
$70K |
| 97161 |
|
636 |
531 |
$67K |
| 72125 |
Computed tomography, cervical spine; without contrast material |
1,756 |
1,522 |
$63K |
| 85027 |
|
56,217 |
39,979 |
$63K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
3,454 |
3,197 |
$61K |
| 97535 |
Self-care/home management training, each 15 minutes |
2,676 |
1,604 |
$61K |
| 97166 |
|
1,160 |
990 |
$60K |
| 97116 |
|
2,567 |
1,229 |
$53K |
| 99291 |
Critical care, evaluation and management of the critically ill patient, first 30-74 minutes |
270 |
249 |
$52K |
| 70553 |
Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences |
178 |
155 |
$51K |
| 36415 |
Collection of venous blood by venipuncture |
38,633 |
27,040 |
$49K |
| 90715 |
|
1,489 |
1,377 |
$47K |
| 71250 |
|
896 |
770 |
$46K |
| 93970 |
|
433 |
372 |
$44K |
| 66984 |
Extracapsular cataract removal with insertion of intraocular lens prosthesis |
73 |
49 |
$42K |
| 87502 |
Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets |
2,485 |
2,234 |
$42K |
| 77080 |
|
880 |
818 |
$40K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
9,793 |
6,899 |
$39K |
| 71045 |
Radiologic examination, chest; single view |
13,506 |
11,203 |
$38K |
| 87651 |
Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe |
5,270 |
4,948 |
$36K |
| 81003 |
|
10,658 |
8,930 |
$35K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
3,012 |
2,767 |
$33K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
3,107 |
2,849 |
$33K |
| 70551 |
Magnetic resonance imaging, brain; without contrast material |
212 |
193 |
$32K |
| 87040 |
|
3,724 |
3,082 |
$31K |
| 86850 |
|
6,213 |
5,264 |
$30K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
28,916 |
22,467 |
$29K |
| 83880 |
|
3,633 |
3,000 |
$28K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
353 |
332 |
$27K |
| 36430 |
|
142 |
106 |
$26K |
| 12001 |
|
127 |
117 |
$23K |
| 78452 |
Myocardial perfusion imaging, tomographic (SPECT); multiple studies at rest and/or stress |
43 |
32 |
$21K |
| 93017 |
|
390 |
331 |
$20K |
| 73562 |
|
2,899 |
2,146 |
$20K |
| 84484 |
|
17,171 |
12,441 |
$19K |
| 76642 |
|
214 |
182 |
$19K |
| 70486 |
|
554 |
499 |
$19K |
| 76536 |
|
204 |
182 |
$19K |
| 72131 |
|
446 |
391 |
$18K |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
19,515 |
16,241 |
$18K |
| U0004 |
2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc, making use of high throughput technologies as described by cms-2020-01-r |
796 |
647 |
$18K |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
7,858 |
6,694 |
$17K |
| 29125 |
|
310 |
280 |
$17K |
| 0002A |
|
477 |
469 |
$17K |
| 0001A |
|
486 |
473 |
$15K |
| 73630 |
|
2,351 |
1,921 |
$15K |
| 73610 |
|
1,986 |
1,677 |
$14K |
| 73030 |
|
1,879 |
1,516 |
$13K |
| 85610 |
|
8,599 |
6,778 |
$13K |
| 83605 |
|
6,670 |
5,267 |
$13K |
| 85379 |
|
3,136 |
2,762 |
$12K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
151 |
67 |
$12K |
| 73130 |
|
1,886 |
1,530 |
$11K |
| 73721 |
Magnetic resonance imaging, any joint of lower extremity; without contrast material |
57 |
52 |
$11K |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
3,373 |
2,946 |
$11K |
| 97150 |
Therapeutic procedure(s), group (2 or more individuals) |
769 |
347 |
$10K |
| 84443 |
Thyroid stimulating hormone (TSH) |
3,163 |
2,780 |
$10K |
| 86592 |
|
1,329 |
1,283 |
$10K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
9,371 |
5,599 |
$10K |
| 99153 |
Mod sedat endo service >5yrs |
300 |
246 |
$10K |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
130 |
123 |
$9K |
| 81001 |
|
15,961 |
13,495 |
$9K |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
12,175 |
10,427 |
$8K |
| 87486 |
|
1,743 |
1,566 |
$8K |
| 90686 |
|
433 |
409 |
$8K |
| 76813 |
|
150 |
138 |
$8K |
| 94762 |
|
2,019 |
1,062 |
$8K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
4,021 |
3,523 |
$7K |
| P9016 |
Red blood cells, leukocytes reduced, each unit |
83 |
61 |
$7K |
| 77336 |
|
116 |
42 |
$7K |
| 96361 |
Intravenous infusion, hydration; each additional hour |
12 |
12 |
$7K |
| 82962 |
|
16,504 |
8,362 |
$7K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
122 |
80 |
$6K |
| 29515 |
|
70 |
66 |
$6K |
| 86762 |
|
404 |
396 |
$6K |
| 12011 |
|
43 |
42 |
$6K |
| 86803 |
|
431 |
411 |
$6K |
| 87798 |
Infectious agent detection by nucleic acid; not otherwise specified, amplified probe, each organism |
1,815 |
1,620 |
$6K |
| 94664 |
|
472 |
419 |
$6K |
| 72197 |
|
16 |
13 |
$6K |
| 86900 |
|
6,512 |
5,430 |
$5K |
| 84702 |
|
1,725 |
1,406 |
$5K |
| 88342 |
|
1,213 |
1,053 |
$5K |
| 84145 |
|
1,004 |
855 |
$5K |
| 86901 |
|
6,513 |
5,432 |
$5K |
| J7030 |
Infusion, normal saline solution , 1000 cc |
18,688 |
14,782 |
$5K |
| 87581 |
|
1,758 |
1,578 |
$5K |
| 97165 |
|
178 |
124 |
$5K |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
8,548 |
6,211 |
$5K |
| 70498 |
|
575 |
517 |
$5K |
| 29240 |
|
29 |
24 |
$5K |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
16,012 |
12,548 |
$5K |
| 87070 |
|
2,456 |
2,066 |
$5K |
| 97597 |
|
317 |
173 |
$5K |
| U0003 |
Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, making use of high throughput technologies as described by cms-2020-01-r |
136 |
119 |
$4K |
| 73110 |
|
1,010 |
843 |
$4K |
| 74018 |
|
290 |
261 |
$4K |
| 80061 |
Lipid panel |
2,372 |
2,088 |
$4K |
| J7120 |
Ringers lactate infusion, up to 1000 cc |
6,277 |
4,870 |
$4K |
| J2270 |
Injection, morphine sulfate, up to 10 mg |
6,304 |
4,394 |
$4K |
| 73502 |
|
496 |
422 |
$4K |
| 76870 |
|
39 |
38 |
$4K |
| 87653 |
|
38 |
36 |
$4K |
| J2704 |
Injection, propofol, 10 mg |
7,274 |
6,161 |
$4K |
| 82950 |
|
743 |
719 |
$4K |
| 77066 |
Tomosynthesis, mammo |
192 |
178 |
$4K |
| 96375 |
Therapeutic injection; each additional sequential IV push |
13,369 |
10,330 |
$4K |
| 82565 |
|
2,335 |
1,935 |
$3K |
| J1170 |
Injection, hydromorphone, up to 4 mg |
4,265 |
2,396 |
$3K |
| 85730 |
|
6,825 |
5,613 |
$3K |
| 72100 |
|
298 |
260 |
$3K |
| 84703 |
|
4,559 |
4,032 |
$3K |
| 84439 |
|
1,478 |
1,297 |
$3K |
| C8929 |
Transthoracic echocardiography with contrast, or without contrast followed by with contrast, real-time with image documentation (2d), includes m-mode recording, when performed, complete, with spectral doppler echocardiography, and with color flow doppler echocardiography |
15 |
12 |
$3K |
| 94799 |
|
695 |
591 |
$3K |
| 81025 |
|
4,739 |
4,202 |
$3K |
| 73080 |
|
342 |
296 |
$3K |
| A9585 |
Injection, gadobutrol, 0.1 ml |
1,475 |
1,273 |
$3K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
2,364 |
2,095 |
$3K |
| U0005 |
Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, cdc or non-cdc, making use of high throughput technologies, completed within 2 calendar days from date of specimen collection (list separately in addition to either hcpcs code u0003 or u0004) as described by cms-2020-01-r2 |
597 |
518 |
$3K |
| 82247 |
|
308 |
239 |
$2K |
| 72110 |
|
87 |
78 |
$2K |
| 83690 |
|
11,350 |
9,500 |
$2K |
| J2370 |
Injection, phenylephrine hcl, up to 1 ml |
880 |
711 |
$2K |
| 96376 |
|
5,872 |
3,536 |
$2K |
| 84156 |
|
519 |
449 |
$2K |
| 77065 |
Tomosynthesis, mammo |
62 |
48 |
$2K |
| 83735 |
|
6,580 |
4,670 |
$2K |
| J1650 |
Injection, enoxaparin sodium, 10 mg |
3,402 |
1,553 |
$2K |
| J2001 |
Injection, lidocaine hcl for intravenous infusion, 10 mg |
6,059 |
5,043 |
$2K |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
10,876 |
8,874 |
$2K |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
582 |
518 |
$2K |
| 0352U |
|
202 |
193 |
$2K |
| J0690 |
Injection, cefazolin sodium, 500 mg |
3,900 |
2,789 |
$1K |
| 86923 |
|
76 |
63 |
$1K |
| J3490 |
Unclassified drugs |
2,850 |
1,546 |
$1K |
| 76820 |
|
24 |
12 |
$1K |
| 87186 |
|
3,088 |
2,607 |
$1K |
| 70491 |
|
12 |
12 |
$1K |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
825 |
763 |
$1K |
| 97167 |
|
34 |
27 |
$1K |
| 82803 |
|
939 |
776 |
$1K |
| 87420 |
|
122 |
113 |
$1K |
| 82248 |
|
1,072 |
811 |
$1K |
| 82951 |
|
70 |
62 |
$1K |
| J2272 |
Injection, morphine sulfate (fresenius kabi), not therapeutically equivalent to j2270, up to 10 mg |
1,188 |
896 |
$1K |
| 99215 |
Prolong outpt/office vis |
18 |
12 |
$1K |
| Q0162 |
Ondansetron 1 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at the time of chemotherapy treatment, not to exceed a 48 hour dosage regimen |
1,887 |
1,602 |
$1K |
| 96367 |
|
102 |
84 |
$1K |
| 80306 |
|
753 |
662 |
$1K |
| 10060 |
|
13 |
12 |
$1K |
| 99152 |
|
924 |
766 |
$928.67 |
| J1644 |
Injection, heparin sodium, per 1000 units |
2,845 |
1,489 |
$861.09 |
| 82728 |
|
468 |
429 |
$857.78 |
| 82607 |
|
415 |
376 |
$843.17 |
| 73590 |
|
240 |
200 |
$840.82 |
| 72128 |
|
63 |
59 |
$803.06 |
| 86140 |
|
1,026 |
874 |
$772.77 |
| 87015 |
|
245 |
227 |
$737.12 |
| 87340 |
|
346 |
327 |
$734.95 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
5,370 |
4,469 |
$679.11 |
| 77062 |
|
12 |
12 |
$590.61 |
| 88313 |
|
634 |
563 |
$585.60 |
| 82550 |
|
1,378 |
1,097 |
$559.82 |
| 72132 |
|
12 |
12 |
$545.78 |
| 83550 |
|
522 |
473 |
$524.07 |
| J0171 |
Injection, adrenalin, epinephrine, 0.1 mg |
578 |
415 |
$510.77 |
| 73090 |
|
109 |
98 |
$498.29 |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
6,137 |
5,104 |
$485.58 |
| 87205 |
|
1,504 |
1,280 |
$476.33 |
| 87430 |
|
662 |
611 |
$474.00 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
3,010 |
2,059 |
$473.68 |
| 88304 |
|
211 |
191 |
$465.71 |
| J7050 |
Infusion, normal saline solution, 250 cc |
2,118 |
1,213 |
$460.55 |
| 83540 |
|
556 |
502 |
$414.20 |
| 84100 |
|
2,226 |
1,682 |
$410.46 |
| 87081 |
|
705 |
638 |
$396.27 |
| J2060 |
Injection, lorazepam, 2 mg |
1,712 |
1,193 |
$371.69 |
| J3475 |
Injection, magnesium sulfate, per 500 mg |
841 |
519 |
$371.26 |
| G0008 |
Administration of influenza virus vaccine |
162 |
156 |
$363.45 |
| 82570 |
|
490 |
430 |
$350.82 |
| G1004 |
Clinical decision support mechanism national decision support company, as defined by the medicare appropriate use criteria program |
8,665 |
5,963 |
$344.99 |
| 85652 |
|
1,189 |
994 |
$336.68 |
| J7040 |
Infusion, normal saline solution, sterile (500 ml = 1 unit) |
1,409 |
1,254 |
$282.87 |
| 72170 |
|
82 |
78 |
$281.41 |
| J2550 |
Injection, promethazine hcl, up to 50 mg |
1,030 |
587 |
$270.27 |
| 88142 |
|
13 |
13 |
$265.50 |
| 82952 |
|
71 |
63 |
$256.93 |
| J1200 |
Injection, diphenhydramine hcl, up to 50 mg |
2,188 |
1,666 |
$233.93 |
| 88112 |
|
13 |
12 |
$227.90 |
| 87075 |
|
183 |
156 |
$209.69 |
| J2930 |
Injection, methylprednisolone sodium succinate, up to 125 mg |
364 |
325 |
$184.36 |
| J2765 |
Injection, metoclopramide hcl, up to 10 mg |
1,147 |
979 |
$181.36 |
| 85018 |
|
307 |
229 |
$170.58 |
| 94760 |
|
798 |
529 |
$162.21 |
| C9113 |
Injection, pantoprazole sodium, per vial |
2,034 |
1,435 |
$159.44 |
| J3411 |
Injection, thiamine hcl, 100 mg |
296 |
175 |
$146.75 |
| J7512 |
Prednisone, immediate release or delayed release, oral, 1 mg |
1,564 |
1,182 |
$136.02 |
| 83970 |
|
38 |
36 |
$123.15 |
| C9803 |
Hospital outpatient clinic visit specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source |
53 |
51 |
$120.68 |
| J2543 |
Injection, piperacillin sodium/tazobactam sodium, 1 gram/0.125 grams (1.125 grams) |
202 |
69 |
$114.75 |
| J0360 |
Injection, hydralazine hcl, up to 20 mg |
224 |
154 |
$94.00 |
| 94644 |
|
14 |
12 |
$74.27 |
| 84550 |
|
162 |
134 |
$73.29 |
| J1596 |
Injection, glycopyrrolate, 0.1 mg |
702 |
630 |
$57.00 |
| 82010 |
|
380 |
312 |
$45.61 |
| 86706 |
|
12 |
12 |
$45.20 |
| 84153 |
|
13 |
12 |
$44.94 |
| J0330 |
Injection, succinylcholine chloride, up to 20 mg |
339 |
258 |
$39.58 |
| 83615 |
|
70 |
51 |
$32.21 |
| 82043 |
|
30 |
28 |
$28.95 |
| J1953 |
Injection, levetiracetam, 10 mg |
30 |
13 |
$26.78 |
| Q9957 |
Injection, perflutren lipid microspheres, per ml |
18 |
14 |
$26.13 |
| J1790 |
Injection, droperidol, up to 5 mg |
75 |
65 |
$23.66 |
| 82040 |
|
30 |
30 |
$20.96 |
| 87899 |
|
34 |
27 |
$18.88 |
| 87808 |
|
258 |
235 |
$17.85 |
| Q0163 |
Diphenhydramine hydrochloride, 50 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at time of chemotherapy treatment not to exceed a 48 hour dosage regimen |
112 |
94 |
$13.66 |
| J1940 |
Injection, furosemide, up to 20 mg |
159 |
103 |
$12.38 |
| 85014 |
|
155 |
130 |
$11.67 |
| 99001 |
|
309 |
257 |
$11.29 |
| 85347 |
|
20 |
13 |
$10.34 |
| 87210 |
|
235 |
212 |
$9.19 |
| 82746 |
|
26 |
24 |
$8.75 |
| 84460 |
|
29 |
29 |
$8.09 |
| 84450 |
|
28 |
28 |
$8.09 |
| 84075 |
|
29 |
29 |
$8.09 |
| J7042 |
5% dextrose/normal saline (500 ml = 1 unit) |
20 |
15 |
$4.64 |
| J7060 |
5% dextrose/water (500 ml = 1 unit) |
51 |
26 |
$4.62 |
| C1769 |
Guide wire |
1,132 |
883 |
$3.37 |
| J2920 |
Injection, methylprednisolone sodium succinate, up to 40 mg |
17 |
13 |
$1.92 |
| G8979 |
Mobility: walking & moving around functional limitation, projected goal status, at therapy episode outset, at reporting intervals, and at discharge or to end reporting |
483 |
291 |
$0.00 |
| G8978 |
Mobility: walking & moving around functional limitation, current status, at therapy episode outset and at reporting intervals |
434 |
272 |
$0.00 |
| C1894 |
Introducer/sheath, other than guiding, other than intracardiac electrophysiological, non-laser |
543 |
467 |
$0.00 |
| J2004 |
Injection, lidocaine hcl with epinephrine, 1 mg |
12 |
12 |
$0.00 |
| J0780 |
Injection, prochlorperazine, up to 10 mg |
15 |
12 |
$0.00 |
| J0665 |
Injection, bupivicaine, not otherwise specified, 0.5 mg |
390 |
300 |
$0.00 |
| 86703 |
|
17 |
13 |
$0.00 |
| 88312 |
|
91 |
77 |
$0.00 |
| A9502 |
Technetium tc-99m tetrofosmin, diagnostic, per study dose |
45 |
33 |
$0.00 |
| J1171 |
Injection, hydromorphone, 0.1 mg |
113 |
76 |
$0.00 |
| C1713 |
Anchor/screw for opposing bone-to-bone or soft tissue-to-bone (implantable) |
13 |
12 |
$0.00 |
| 29505 |
|
24 |
24 |
$0.00 |
| C1887 |
Catheter, guiding (may include infusion/perfusion capability) |
31 |
24 |
$0.00 |
| J2919 |
Injection, methylprednisolone sodium succinate, 5 mg |
128 |
93 |
$0.00 |
| A6022 |
Collagen dressing, sterile, size more than 16 sq. in. but less than or equal to 48 sq. in., each |
35 |
13 |
$0.00 |
| 86308 |
|
51 |
50 |
$0.00 |
| G8988 |
Self care functional limitation, projected goal status, at therapy episode outset, at reporting intervals, and at discharge or to end reporting |
150 |
96 |
$0.00 |
| 36416 |
|
121 |
97 |
$0.00 |
| 88341 |
|
20 |
17 |
$0.00 |
| J2003 |
Injection, lidocaine hydrochloride, 1 mg |
228 |
222 |
$0.00 |
| C1725 |
Catheter, transluminal angioplasty, non-laser (may include guidance, infusion/perfusion capability) |
249 |
207 |
$0.00 |
| J2470 |
Injection, pantoprazole sodium, 40 mg |
33 |
30 |
$0.00 |
| V2632 |
Posterior chamber intraocular lens |
76 |
49 |
$0.00 |
| G8987 |
Self care functional limitation, current status, at therapy episode outset and at reporting intervals |
149 |
95 |
$0.00 |
| J2371 |
Injection, phenylephrine hydrochloride, 20 micrograms |
635 |
553 |
$0.00 |
| J2471 |
Injection, pantoprazole (hikma), not therapeutically equivalent to j2470, 40 mg |
111 |
91 |
$0.00 |
| J2785 |
Injection, regadenoson, 0.1 mg |
19 |
16 |
$0.00 |
| C9290 |
Injection, bupivacaine liposome, 1 mg |
33 |
28 |
$0.00 |
| J1836 |
Injection, metronidazole, 10 mg |
22 |
14 |
$0.00 |
| J1920 |
Injection, labetalol hydrochloride, 5 mg |
15 |
12 |
$0.00 |