| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
63,679 |
58,027 |
$7.00M |
| 96361 |
Intravenous infusion, hydration; each additional hour |
20,899 |
15,734 |
$6.03M |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
41,355 |
36,949 |
$4.96M |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
21,447 |
18,687 |
$2.66M |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
21,967 |
19,911 |
$2.05M |
| 70450 |
Computed tomography, head or brain; without contrast material |
7,769 |
6,724 |
$1.65M |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
6,860 |
5,808 |
$1.55M |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
15,784 |
4,411 |
$923K |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
5,161 |
3,343 |
$622K |
| 96360 |
Intravenous infusion, hydration; initial, 31 minutes to 1 hour |
3,342 |
2,531 |
$572K |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
4,158 |
3,096 |
$468K |
| G0378 |
Hospital observation service, per hour |
8,085 |
2,987 |
$457K |
| 43239 |
Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple |
1,287 |
1,105 |
$440K |
| 96366 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour |
2,250 |
1,167 |
$437K |
| 95810 |
Polysomnography; sleep staging with 4 or more additional parameters |
687 |
646 |
$391K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
1,812 |
1,486 |
$380K |
| 71275 |
Computed tomographic angiography, chest, with contrast material |
1,868 |
1,488 |
$356K |
| 59025 |
Fetal non-stress test |
2,393 |
1,854 |
$349K |
| 80053 |
Comprehensive metabolic panel |
35,589 |
28,134 |
$294K |
| 93306 |
Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete |
998 |
862 |
$210K |
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
3,430 |
2,366 |
$180K |
| 96413 |
Chemotherapy administration, intravenous infusion; up to 1 hour, single or initial substance |
1,968 |
1,052 |
$170K |
| 45385 |
Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) |
262 |
217 |
$140K |
| 36415 |
Collection of venous blood by venipuncture |
70,749 |
52,881 |
$134K |
| J9271 |
Injection, pembrolizumab, 1 mg |
21 |
12 |
$124K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
17,042 |
13,098 |
$122K |
| 69436 |
Tympanostomy (requiring insertion of ventilating tube), general anesthesia |
103 |
72 |
$115K |
| 93976 |
|
878 |
680 |
$107K |
| 87636 |
Infectious agent detection by nucleic acid; SARS-CoV-2 and influenza virus types A and B |
8,716 |
7,657 |
$102K |
| 11042 |
Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm |
1,293 |
640 |
$96K |
| 71260 |
Computed tomography, thorax, diagnostic; with contrast material |
647 |
548 |
$93K |
| 70553 |
Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences |
464 |
424 |
$92K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
12,025 |
7,670 |
$91K |
| 45378 |
Colonoscopy, flexible; diagnostic, including collection of specimen(s) |
266 |
175 |
$89K |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
8,925 |
7,654 |
$86K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
1,223 |
795 |
$85K |
| 96415 |
|
392 |
270 |
$80K |
| 84484 |
|
19,333 |
15,873 |
$75K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
68,757 |
53,944 |
$71K |
| 12001 |
|
449 |
388 |
$66K |
| 99281 |
Emergency department visit for the evaluation and management, self-limited or minor |
638 |
550 |
$65K |
| 97140 |
Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) |
2,382 |
883 |
$62K |
| 71271 |
|
365 |
329 |
$60K |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
894 |
730 |
$60K |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
1,289 |
1,160 |
$60K |
| 72148 |
Magnetic resonance imaging, lumbar spine; without contrast material |
539 |
502 |
$59K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
1,306 |
760 |
$57K |
| J3490 |
Unclassified drugs |
6,187 |
3,346 |
$57K |
| 97162 |
|
1,539 |
1,319 |
$56K |
| 71046 |
Radiologic examination, chest; 2 views |
5,552 |
4,993 |
$55K |
| 72100 |
|
1,292 |
1,142 |
$49K |
| 76536 |
|
504 |
472 |
$48K |
| 93798 |
|
943 |
143 |
$48K |
| 93971 |
|
642 |
553 |
$47K |
| 93017 |
|
611 |
555 |
$46K |
| 76642 |
|
425 |
373 |
$44K |
| 70498 |
|
524 |
388 |
$43K |
| 78815 |
Positron emission tomography (PET) for limited area imaging |
122 |
112 |
$42K |
| 71045 |
Radiologic examination, chest; single view |
21,969 |
19,313 |
$41K |
| 70496 |
|
181 |
143 |
$41K |
| 71250 |
|
770 |
680 |
$41K |
| 73610 |
|
1,646 |
1,461 |
$40K |
| 94060 |
|
458 |
391 |
$40K |
| 73721 |
Magnetic resonance imaging, any joint of lower extremity; without contrast material |
215 |
192 |
$40K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
555 |
435 |
$38K |
| 78452 |
Myocardial perfusion imaging, tomographic (SPECT); multiple studies at rest and/or stress |
107 |
99 |
$37K |
| 97161 |
|
818 |
730 |
$36K |
| 87502 |
Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets |
2,389 |
2,292 |
$36K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
343 |
177 |
$36K |
| 82805 |
|
1,497 |
1,149 |
$35K |
| 93922 |
|
555 |
508 |
$35K |
| 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 |
234 |
217 |
$34K |
| 72125 |
Computed tomography, cervical spine; without contrast material |
2,322 |
1,881 |
$33K |
| 72131 |
|
626 |
512 |
$33K |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
23,751 |
20,285 |
$32K |
| 70551 |
Magnetic resonance imaging, brain; without contrast material |
210 |
170 |
$32K |
| 96367 |
|
893 |
540 |
$31K |
| 70486 |
|
594 |
509 |
$30K |
| 72141 |
|
288 |
252 |
$30K |
| 97112 |
Therapeutic procedure, each 15 minutes; neuromuscular reeducation of movement, balance, coordination |
1,038 |
351 |
$30K |
| 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 |
177 |
172 |
$29K |
| 36591 |
|
2,423 |
1,392 |
$29K |
| 80320 |
|
2,704 |
2,374 |
$28K |
| 86900 |
|
1,489 |
1,123 |
$28K |
| 82565 |
|
12,446 |
10,860 |
$26K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
24,332 |
20,676 |
$26K |
| 73560 |
|
1,522 |
1,281 |
$25K |
| 45380 |
Colonoscopy, flexible; with biopsy, single or multiple |
51 |
40 |
$25K |
| 73630 |
|
1,831 |
1,632 |
$24K |
| 97802 |
|
278 |
252 |
$24K |
| 93296 |
|
1,872 |
1,755 |
$24K |
| 84443 |
Thyroid stimulating hormone (TSH) |
3,878 |
3,286 |
$23K |
| U0002 |
2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc |
9,101 |
8,411 |
$22K |
| 73030 |
|
1,115 |
953 |
$22K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
2,552 |
2,245 |
$20K |
| 70491 |
|
89 |
68 |
$20K |
| 74174 |
|
616 |
476 |
$20K |
| 83605 |
|
5,490 |
4,387 |
$19K |
| 73130 |
|
1,280 |
1,083 |
$18K |
| 94729 |
|
426 |
364 |
$17K |
| 81001 |
|
25,632 |
22,324 |
$17K |
| 73700 |
|
232 |
201 |
$17K |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
5,661 |
4,809 |
$16K |
| 87081 |
|
3,140 |
2,871 |
$16K |
| 94726 |
|
356 |
301 |
$16K |
| 84703 |
|
15,614 |
13,591 |
$15K |
| 92557 |
|
226 |
213 |
$15K |
| 80051 |
|
10,977 |
9,619 |
$14K |
| 85027 |
|
5,031 |
3,673 |
$13K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
1,314 |
1,184 |
$13K |
| 80061 |
Lipid panel |
2,192 |
1,964 |
$13K |
| 90715 |
|
871 |
708 |
$13K |
| 73502 |
|
742 |
631 |
$12K |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
849 |
786 |
$12K |
| 72050 |
|
286 |
258 |
$12K |
| 74018 |
|
710 |
589 |
$11K |
| J0131 |
Injection, acetaminophen, not otherwise specified,10 mg |
2,539 |
1,860 |
$11K |
| 97535 |
Self-care/home management training, each 15 minutes |
468 |
320 |
$11K |
| 97016 |
|
166 |
64 |
$11K |
| 93970 |
|
74 |
66 |
$10K |
| 12011 |
|
80 |
70 |
$10K |
| 80076 |
|
4,620 |
3,977 |
$10K |
| 72110 |
|
236 |
221 |
$10K |
| 86850 |
|
1,303 |
986 |
$10K |
| 36416 |
|
1,810 |
1,064 |
$10K |
| 97116 |
|
489 |
250 |
$10K |
| 73100 |
|
183 |
127 |
$10K |
| 73590 |
|
541 |
452 |
$10K |
| 88307 |
|
81 |
55 |
$9K |
| 80047 |
|
4,936 |
4,130 |
$9K |
| 97166 |
|
134 |
107 |
$9K |
| 87651 |
Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe |
2,635 |
2,255 |
$9K |
| 73110 |
|
747 |
655 |
$9K |
| 97530 |
Therapeutic activities, direct patient contact, each 15 minutes |
393 |
183 |
$9K |
| 85610 |
|
9,859 |
7,803 |
$8K |
| 97803 |
|
101 |
94 |
$8K |
| 73120 |
|
180 |
140 |
$8K |
| 93880 |
|
158 |
148 |
$8K |
| A9552 |
Fluorodeoxyglucose f-18 fdg, diagnostic, per study dose, up to 45 millicuries |
131 |
123 |
$8K |
| 84439 |
|
1,139 |
1,010 |
$8K |
| 83735 |
|
4,089 |
2,657 |
$8K |
| 96376 |
|
3,038 |
1,524 |
$7K |
| 95811 |
|
27 |
27 |
$7K |
| 76770 |
|
50 |
43 |
$7K |
| 82077 |
|
6,528 |
5,344 |
$7K |
| 86140 |
|
1,042 |
779 |
$7K |
| 82607 |
|
601 |
542 |
$7K |
| 81003 |
|
10,650 |
9,540 |
$7K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
57 |
49 |
$6K |
| 10060 |
|
41 |
36 |
$6K |
| 77336 |
|
60 |
27 |
$6K |
| 73090 |
|
370 |
262 |
$6K |
| 87070 |
|
899 |
702 |
$6K |
| 73080 |
|
404 |
341 |
$6K |
| 78451 |
|
29 |
28 |
$6K |
| 72040 |
|
88 |
74 |
$6K |
| 96375 |
Therapeutic injection; each additional sequential IV push |
18,755 |
14,140 |
$6K |
| 76830 |
Ultrasound, transvaginal |
338 |
260 |
$6K |
| 83880 |
|
3,375 |
2,771 |
$6K |
| 87077 |
|
2,486 |
2,099 |
$5K |
| 72128 |
|
182 |
157 |
$5K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
3,470 |
3,018 |
$5K |
| 72072 |
|
174 |
155 |
$5K |
| 12002 |
|
43 |
36 |
$5K |
| 97113 |
|
96 |
24 |
$5K |
| 92567 |
|
255 |
246 |
$5K |
| J1756 |
Injection, iron sucrose, 1 mg |
95 |
54 |
$5K |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
7,120 |
5,540 |
$4K |
| 99152 |
|
677 |
529 |
$4K |
| 85379 |
|
3,117 |
2,627 |
$4K |
| 97165 |
|
105 |
78 |
$4K |
| J3535 |
Drug administered through a metered dose inhaler |
710 |
517 |
$4K |
| 86703 |
|
322 |
285 |
$4K |
| 75574 |
|
16 |
12 |
$4K |
| 87420 |
|
608 |
523 |
$4K |
| 82248 |
|
8,037 |
6,736 |
$4K |
| 82728 |
|
683 |
595 |
$4K |
| 96417 |
|
53 |
27 |
$4K |
| J1815 |
Injection, insulin, per 5 units |
1,357 |
577 |
$3K |
| 96368 |
|
244 |
144 |
$3K |
| 87661 |
Infectious agent detection by nucleic acid; Trichomonas vaginalis, amplified probe |
886 |
735 |
$3K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
868 |
698 |
$3K |
| 80164 |
|
263 |
217 |
$3K |
| 84702 |
|
1,791 |
1,384 |
$3K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
3,294 |
2,999 |
$3K |
| 83690 |
|
14,277 |
12,399 |
$3K |
| 82947 |
|
12,703 |
10,996 |
$3K |
| 73600 |
|
64 |
58 |
$3K |
| 87040 |
|
1,288 |
1,014 |
$3K |
| 73552 |
|
108 |
84 |
$3K |
| 72170 |
|
387 |
314 |
$3K |
| 82746 |
|
464 |
413 |
$3K |
| 71101 |
|
164 |
141 |
$3K |
| J1642 |
Injection, heparin sodium, (heparin lock flush), per 10 units |
3,543 |
1,756 |
$3K |
| 86803 |
|
275 |
238 |
$3K |
| G0108 |
Diabetes outpatient self-management training services, individual, per 30 minutes |
55 |
43 |
$3K |
| J3370 |
Injection, vancomycin hcl, 500 mg |
821 |
456 |
$3K |
| J7040 |
Infusion, normal saline solution, sterile (500 ml = 1 unit) |
3,319 |
2,504 |
$2K |
| 85007 |
|
1,188 |
821 |
$2K |
| 97035 |
|
69 |
25 |
$2K |
| 84520 |
|
11,599 |
10,112 |
$2K |
| 83540 |
|
657 |
571 |
$2K |
| 76377 |
|
113 |
99 |
$2K |
| 87186 |
|
1,362 |
1,150 |
$2K |
| 29581 |
|
35 |
13 |
$2K |
| 86901 |
|
1,492 |
1,126 |
$2K |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
2,645 |
2,145 |
$2K |
| 80069 |
|
350 |
290 |
$2K |
| 82570 |
|
779 |
661 |
$2K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
867 |
697 |
$2K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
240 |
189 |
$2K |
| 73221 |
|
14 |
12 |
$2K |
| 85652 |
|
960 |
724 |
$2K |
| 83550 |
|
612 |
529 |
$2K |
| J1170 |
Injection, hydromorphone, up to 4 mg |
3,975 |
2,439 |
$2K |
| G2066 |
Interrogation device evaluation(s), (remote) up to 30 days; implantable cardiovascular physiologic monitor system, implantable loop recorder system, or subcutaneous cardiac rhythm monitor system, remote data acquisition(s), receipt of transmissions and technician review, technical support and distribution of results |
65 |
62 |
$2K |
| 82330 |
|
1,458 |
1,150 |
$1K |
| 77062 |
|
27 |
24 |
$1K |
| 84153 |
|
221 |
205 |
$1K |
| 99153 |
Mod sedat endo service >5yrs |
353 |
286 |
$1K |
| 73060 |
|
89 |
69 |
$1K |
| 93299 |
|
57 |
52 |
$1K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
940 |
746 |
$1K |
| 76937 |
|
79 |
62 |
$1K |
| 87205 |
|
985 |
772 |
$1K |
| J7030 |
Infusion, normal saline solution , 1000 cc |
14,982 |
11,068 |
$1K |
| 74183 |
|
12 |
12 |
$1K |
| 97022 |
|
49 |
13 |
$986.61 |
| 84100 |
|
997 |
636 |
$983.12 |
| 82040 |
|
2,230 |
1,815 |
$975.51 |
| 83615 |
|
386 |
291 |
$965.40 |
| J1650 |
Injection, enoxaparin sodium, 10 mg |
1,717 |
762 |
$962.14 |
| 85018 |
|
2,142 |
1,552 |
$924.75 |
| 84550 |
|
505 |
388 |
$905.97 |
| 85730 |
|
2,174 |
1,752 |
$863.77 |
| 85014 |
|
707 |
457 |
$856.99 |
| 76819 |
Fetal biophysical profile; without non-stress testing |
21 |
12 |
$855.73 |
| 92523 |
|
17 |
12 |
$823.88 |
| J2469 |
Injection, palonosetron hcl, 25 mcg |
177 |
69 |
$792.28 |
| 87807 |
|
112 |
98 |
$780.25 |
| J2543 |
Injection, piperacillin sodium/tazobactam sodium, 1 gram/0.125 grams (1.125 grams) |
277 |
132 |
$755.61 |
| 87340 |
|
49 |
40 |
$736.10 |
| 80143 |
|
614 |
507 |
$684.08 |
| 82043 |
|
280 |
262 |
$651.32 |
| 87210 |
|
214 |
191 |
$632.81 |
| 91010 |
|
13 |
12 |
$602.11 |
| J7120 |
Ringers lactate infusion, up to 1000 cc |
8,040 |
6,072 |
$592.56 |
| 83970 |
|
70 |
64 |
$583.19 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
11,007 |
8,324 |
$542.16 |
| 84132 |
|
1,672 |
1,312 |
$538.84 |
| J2270 |
Injection, morphine sulfate, up to 10 mg |
1,434 |
1,007 |
$538.69 |
| 92579 |
|
12 |
12 |
$509.01 |
| J0690 |
Injection, cefazolin sodium, 500 mg |
3,174 |
1,949 |
$472.82 |
| 84156 |
|
422 |
320 |
$453.02 |
| 80179 |
|
590 |
486 |
$448.86 |
| 82140 |
|
78 |
59 |
$429.22 |
| 87147 |
|
371 |
289 |
$426.91 |
| 82550 |
|
346 |
260 |
$412.80 |
| 29125 |
|
209 |
183 |
$410.36 |
| 82977 |
|
2,217 |
1,794 |
$351.04 |
| 92587 |
|
24 |
13 |
$345.59 |
| 77066 |
Tomosynthesis, mammo |
42 |
39 |
$339.13 |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
17,281 |
13,118 |
$327.34 |
| 86780 |
|
35 |
31 |
$327.22 |
| 82150 |
|
2,245 |
1,815 |
$311.25 |
| 84450 |
|
2,308 |
1,883 |
$301.23 |
| 84436 |
|
12 |
12 |
$299.10 |
| 82247 |
|
2,219 |
1,791 |
$296.59 |
| 87801 |
Infectious agent detection by nucleic acid; amplified probe, multiple organisms |
16 |
12 |
$279.38 |
| 84460 |
|
2,337 |
1,909 |
$278.23 |
| C1887 |
Catheter, guiding (may include infusion/perfusion capability) |
176 |
144 |
$270.68 |
| J1953 |
Injection, levetiracetam, 10 mg |
48 |
26 |
$268.61 |
| C9113 |
Injection, pantoprazole sodium, per vial |
303 |
173 |
$252.09 |
| J1644 |
Injection, heparin sodium, per 1000 units |
1,570 |
617 |
$251.28 |
| 88304 |
|
613 |
440 |
$235.49 |
| 84155 |
|
2,210 |
1,796 |
$221.16 |
| 77061 |
|
17 |
15 |
$215.98 |
| J2704 |
Injection, propofol, 10 mg |
9,032 |
7,224 |
$209.72 |
| J2310 |
Injection, naloxone hydrochloride, per 1 mg |
15 |
12 |
$194.48 |
| 82803 |
|
636 |
507 |
$192.49 |
| 80177 |
|
13 |
12 |
$185.16 |
| 93280 |
|
12 |
12 |
$175.94 |
| J9045 |
Injection, carboplatin, 50 mg |
27 |
12 |
$175.30 |
| 82378 |
|
15 |
12 |
$169.83 |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
6,674 |
4,099 |
$165.61 |
| 86706 |
|
14 |
12 |
$161.23 |
| 84295 |
|
1,323 |
1,051 |
$158.94 |
| J0736 |
Injection, clindamycin phosphate, 300 mg |
197 |
130 |
$155.93 |
| Q9957 |
Injection, perflutren lipid microspheres, per ml |
386 |
342 |
$147.23 |
| 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 |
177 |
172 |
$145.27 |
| J3475 |
Injection, magnesium sulfate, per 500 mg |
576 |
385 |
$138.26 |
| G0480 |
Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not limited to gc/ms (any type, single or tandem) and lc/ms (any type, single or tandem and excluding immunoassays (e.g., ia, eia, elisa, emit, fpia) and enzymatic methods (e.g., alcohol dehydrogenase)), (2) stable isotope or other universally recognized internal standards in all samples (e.g., to control for matrix effects, interferences and variations in signal strength), and (3) method or drug-specific calibration and matrix-matched quality control material (e.g., to control for instrument variations and mass spectral drift); qualitative or quantitative, all sources, includes specimen validity testing, per day; 1-7 drug class(es), including metabolite(s) if performed |
15 |
14 |
$119.61 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
5,384 |
3,721 |
$118.53 |
| J2930 |
Injection, methylprednisolone sodium succinate, up to 125 mg |
794 |
560 |
$113.48 |
| 84075 |
|
2,186 |
1,776 |
$111.79 |
| 87430 |
|
343 |
325 |
$111.68 |
| 85049 |
|
133 |
113 |
$106.26 |
| J0780 |
Injection, prochlorperazine, up to 10 mg |
577 |
378 |
$104.31 |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
13,945 |
11,830 |
$103.19 |
| J1200 |
Injection, diphenhydramine hcl, up to 50 mg |
2,540 |
1,750 |
$102.51 |
| J2272 |
Injection, morphine sulfate (fresenius kabi), not therapeutically equivalent to j2270, up to 10 mg |
213 |
126 |
$90.21 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
1,595 |
1,053 |
$82.34 |
| 85045 |
|
68 |
54 |
$81.79 |
| 82435 |
|
1,280 |
1,022 |
$78.26 |
| J3480 |
Injection, potassium chloride, per 2 meq |
748 |
374 |
$73.90 |
| 51701 |
|
116 |
88 |
$69.40 |
| 76801 |
|
58 |
38 |
$65.31 |
| 87075 |
|
76 |
51 |
$63.67 |
| J7050 |
Infusion, normal saline solution, 250 cc |
3,947 |
1,786 |
$60.59 |
| A9575 |
Injection, gadoterate meglumine, 0.1 ml |
857 |
784 |
$55.90 |
| J2919 |
Injection, methylprednisolone sodium succinate, 5 mg |
366 |
285 |
$50.50 |
| J3360 |
Injection, diazepam, up to 5 mg |
280 |
184 |
$50.36 |
| J2060 |
Injection, lorazepam, 2 mg |
464 |
336 |
$48.87 |
| J2371 |
Injection, phenylephrine hydrochloride, 20 micrograms |
169 |
111 |
$47.20 |
| J7512 |
Prednisone, immediate release or delayed release, oral, 1 mg |
1,551 |
1,152 |
$46.86 |
| 85384 |
|
65 |
52 |
$45.87 |
| 86308 |
|
46 |
25 |
$45.54 |
| J2765 |
Injection, metoclopramide hcl, up to 10 mg |
1,338 |
943 |
$43.68 |
| J0665 |
Injection, bupivicaine, not otherwise specified, 0.5 mg |
1,241 |
803 |
$37.15 |
| J2360 |
Injection, orphenadrine citrate, up to 60 mg |
153 |
111 |
$32.40 |
| 82375 |
|
625 |
505 |
$27.94 |
| 88311 |
|
199 |
150 |
$20.48 |
| J3420 |
Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg |
37 |
25 |
$19.28 |
| J0295 |
Injection, ampicillin sodium/sulbactam sodium, per 1.5 gm |
20 |
13 |
$18.57 |
| 83050 |
|
613 |
493 |
$16.98 |
| J1630 |
Injection, haloperidol, up to 5 mg |
175 |
128 |
$15.56 |
| J1940 |
Injection, furosemide, up to 20 mg |
95 |
53 |
$15.05 |
| J0360 |
Injection, hydralazine hcl, up to 20 mg |
22 |
14 |
$13.52 |
| J7510 |
Prednisolone oral, per 5 mg |
171 |
134 |
$11.77 |
| J2470 |
Injection, pantoprazole sodium, 40 mg |
81 |
61 |
$5.93 |
| J1171 |
Injection, hydromorphone, 0.1 mg |
85 |
60 |
$5.65 |
| J2370 |
Injection, phenylephrine hcl, up to 1 ml |
343 |
223 |
$3.74 |
| C1894 |
Introducer/sheath, other than guiding, other than intracardiac electrophysiological, non-laser |
382 |
298 |
$0.00 |
| A9502 |
Technetium tc-99m tetrofosmin, diagnostic, per study dose |
438 |
386 |
$0.00 |
| V5266 |
Battery for use in hearing device |
37 |
37 |
$0.00 |
| 82010 |
|
105 |
78 |
$0.00 |
| J1580 |
Injection, garamycin, gentamicin, up to 80 mg |
82 |
63 |
$0.00 |
| J1596 |
Injection, glycopyrrolate, 0.1 mg |
79 |
70 |
$0.00 |
| Q9966 |
Low osmolar contrast material, 200-299 mg/ml iodine concentration, per ml |
12 |
12 |
$0.00 |
| 77065 |
Tomosynthesis, mammo |
17 |
15 |
$0.00 |
| C1769 |
Guide wire |
625 |
468 |
$0.00 |
| J7999 |
Compounded drug, not otherwise classified |
144 |
121 |
$0.00 |
| J0330 |
Injection, succinylcholine chloride, up to 20 mg |
148 |
92 |
$0.00 |
| J2785 |
Injection, regadenoson, 0.1 mg |
159 |
146 |
$0.00 |
| J2795 |
Injection, ropivacaine hydrochloride, 1 mg |
18 |
12 |
$0.00 |
| C9399 |
Unclassified drugs or biologicals |
80 |
75 |
$0.00 |
| J7060 |
5% dextrose/water (500 ml = 1 unit) |
56 |
24 |
$0.00 |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
19 |
14 |
$0.00 |