| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 90378 |
|
3,931 |
2,543 |
$11.75M |
| J1745 |
Injection, infliximab, excludes biosimilar, 10 mg |
2,081 |
1,574 |
$4.69M |
| 0450 |
Emergency room services |
323,737 |
297,210 |
$3.81M |
| J1950 |
Injection, leuprolide acetate (for depot suspension), per 3.75 mg |
399 |
287 |
$2.99M |
| 87633 |
Infectious agent detection by nucleic acid, respiratory virus, 12-25 targets |
13,895 |
13,558 |
$2.06M |
| J3262 |
Injection, tocilizumab, 1 mg |
801 |
476 |
$1.73M |
| J1569 |
Injection, immune globulin, (gammagard liquid), non-lyophilized, (e.g., liquid), 500 mg |
1,194 |
613 |
$1.48M |
| Z7500 |
|
27,623 |
26,702 |
$941K |
| A0429 |
Ambulance service, basic life support, emergency transport (bls-emergency) |
76,126 |
62,060 |
$930K |
| Z7502 |
|
23,850 |
23,700 |
$882K |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
9,087 |
8,480 |
$730K |
| 70553 |
Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences |
6,029 |
5,839 |
$687K |
| 93975 |
|
10,941 |
10,489 |
$663K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
27,766 |
25,854 |
$604K |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
17,601 |
14,922 |
$532K |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
23,522 |
22,321 |
$519K |
| 92507 |
Treatment of speech, language, voice, communication, and/or auditory processing disorder |
17,026 |
5,150 |
$494K |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
4,410 |
4,131 |
$470K |
| J3490 |
Unclassified drugs |
82,465 |
58,503 |
$450K |
| 87502 |
Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets |
15,472 |
15,228 |
$442K |
| 80053 |
Comprehensive metabolic panel |
79,443 |
67,309 |
$436K |
| 0123 |
|
103 |
103 |
$402K |
| 99199 |
Unlisted special service, procedure or report |
27,141 |
23,046 |
$395K |
| 95810 |
Polysomnography; sleep staging with 4 or more additional parameters |
3,512 |
3,490 |
$384K |
| 0760 |
|
131,623 |
120,831 |
$378K |
| 0510 |
|
52,310 |
48,505 |
$366K |
| 95782 |
|
854 |
851 |
$350K |
| 96360 |
Intravenous infusion, hydration; initial, 31 minutes to 1 hour |
12,503 |
11,880 |
$346K |
| 70450 |
Computed tomography, head or brain; without contrast material |
7,795 |
7,492 |
$346K |
| 71046 |
Radiologic examination, chest; 2 views |
34,176 |
32,737 |
$337K |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
14,202 |
13,395 |
$316K |
| 96361 |
Intravenous infusion, hydration; each additional hour |
17,607 |
15,528 |
$271K |
| 76770 |
|
13,315 |
12,981 |
$269K |
| 87634 |
|
9,710 |
9,536 |
$245K |
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
4,822 |
4,642 |
$239K |
| 87798 |
Infectious agent detection by nucleic acid; not otherwise specified, amplified probe, each organism |
14,006 |
13,678 |
$224K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
20,916 |
20,116 |
$206K |
| 99221 |
|
815 |
807 |
$201K |
| 0360 |
|
26,827 |
17,630 |
$201K |
| 97530 |
Therapeutic activities, direct patient contact, each 15 minutes |
3,649 |
1,119 |
$192K |
| 87428 |
|
5,752 |
5,687 |
$190K |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
18,116 |
15,128 |
$189K |
| 96450 |
|
1,803 |
1,444 |
$188K |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
48,585 |
46,805 |
$185K |
| P9040 |
Red blood cells, leukocytes reduced, irradiated, each unit |
687 |
488 |
$179K |
| 87581 |
|
14,138 |
13,810 |
$178K |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
39,907 |
32,288 |
$178K |
| 87486 |
|
14,138 |
13,811 |
$178K |
| 99215 |
Prolong outpt/office vis |
2,885 |
2,610 |
$166K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
44,093 |
39,151 |
$164K |
| J2704 |
Injection, propofol, 10 mg |
23,253 |
22,116 |
$164K |
| 96375 |
Therapeutic injection; each additional sequential IV push |
16,398 |
12,175 |
$158K |
| J0558 |
Injection, penicillin g benzathine and penicillin g procaine, 100,000 units |
861 |
719 |
$149K |
| Z4300 |
|
1,429 |
1,429 |
$148K |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
50,585 |
8,953 |
$145K |
| 96112 |
|
4,960 |
2,693 |
$144K |
| 99244 |
Office or other outpatient consultation, moderate to high complexity |
1,516 |
1,439 |
$139K |
| 0361 |
|
5,113 |
3,639 |
$138K |
| J1642 |
Injection, heparin sodium, (heparin lock flush), per 10 units |
22,544 |
8,272 |
$125K |
| 96366 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour |
5,762 |
4,691 |
$123K |
| 93306 |
Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete |
1,463 |
1,433 |
$117K |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
24,063 |
22,834 |
$113K |
| 0710 |
|
25,853 |
25,199 |
$101K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
6,526 |
6,455 |
$101K |
| J2175 |
Injection, meperidine hydrochloride, per 100 mg |
8,200 |
7,585 |
$96K |
| 92508 |
Group treatment of speech, language, voice, communication, and/or auditory processing disorder |
2,567 |
594 |
$95K |
| Z7610 |
|
8,697 |
4,104 |
$89K |
| 86140 |
|
40,860 |
38,474 |
$88K |
| 87040 |
|
14,471 |
13,779 |
$87K |
| 97750 |
|
11,436 |
6,846 |
$85K |
| 41899 |
Unlisted procedure, dentoalveolar structures |
1,844 |
1,814 |
$84K |
| J2270 |
Injection, morphine sulfate, up to 10 mg |
10,700 |
8,833 |
$76K |
| J8499 |
Prescription drug, oral, non chemotherapeutic, nos |
22,123 |
19,154 |
$76K |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
16,543 |
15,037 |
$74K |
| 74018 |
|
9,076 |
8,516 |
$73K |
| Z7506 |
|
529 |
507 |
$72K |
| 99070 |
|
4,716 |
3,370 |
$72K |
| 81001 |
|
50,607 |
48,257 |
$71K |
| 99238 |
Hospital discharge day management, 30 minutes or less |
1,446 |
1,424 |
$71K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
8,613 |
8,130 |
$68K |
| 97165 |
|
4,048 |
2,756 |
$68K |
| 95819 |
|
5,619 |
5,539 |
$67K |
| 85027 |
|
24,710 |
20,786 |
$67K |
| 96409 |
|
5,433 |
2,882 |
$67K |
| G0378 |
Hospital observation service, per hour |
547 |
538 |
$67K |
| J2001 |
Injection, lidocaine hcl for intravenous infusion, 10 mg |
20,489 |
17,611 |
$66K |
| J9370 |
Vincristine sulfate, 1 mg |
4,816 |
3,044 |
$66K |
| 80306 |
|
8,140 |
7,723 |
$65K |
| 92521 |
|
906 |
573 |
$63K |
| 71045 |
Radiologic examination, chest; single view |
6,800 |
6,289 |
$63K |
| 73610 |
|
11,496 |
10,746 |
$63K |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
4,919 |
4,731 |
$61K |
| J0131 |
Injection, acetaminophen, not otherwise specified,10 mg |
1,977 |
1,797 |
$61K |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
10,833 |
10,014 |
$60K |
| 76536 |
|
3,517 |
3,431 |
$59K |
| 76870 |
|
4,593 |
4,390 |
$58K |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
12,505 |
10,012 |
$57K |
| 94375 |
|
11,682 |
11,500 |
$57K |
| 44970 |
|
774 |
745 |
$55K |
| 73080 |
|
8,681 |
7,584 |
$55K |
| 99222 |
Initial hospital care, per day, moderate complexity |
436 |
427 |
$54K |
| 73521 |
|
6,624 |
6,501 |
$54K |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
7,128 |
5,749 |
$52K |
| 73630 |
|
9,162 |
8,785 |
$52K |
| 99245 |
|
548 |
546 |
$51K |
| 96413 |
Chemotherapy administration, intravenous infusion; up to 1 hour, single or initial substance |
4,097 |
2,986 |
$51K |
| 99499 |
|
873 |
714 |
$51K |
| 0160 |
|
5,908 |
5,636 |
$50K |
| 83690 |
|
16,112 |
15,369 |
$50K |
| Z4307 |
|
2,055 |
2,054 |
$50K |
| 85007 |
|
32,308 |
27,126 |
$49K |
| 83615 |
|
17,928 |
12,950 |
$49K |
| Z4301 |
|
1,934 |
1,929 |
$49K |
| 73110 |
|
8,403 |
7,844 |
$48K |
| 96111 |
|
458 |
446 |
$48K |
| 73562 |
|
8,701 |
8,446 |
$48K |
| 96379 |
|
8,881 |
6,422 |
$47K |
| 72082 |
|
5,466 |
5,397 |
$46K |
| J0690 |
Injection, cefazolin sodium, 500 mg |
6,535 |
5,394 |
$45K |
| 92570 |
|
943 |
939 |
$44K |
| 74022 |
|
2,656 |
2,560 |
$43K |
| 97533 |
|
821 |
279 |
$43K |
| 99281 |
Emergency department visit for the evaluation and management, self-limited or minor |
1,361 |
1,239 |
$42K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
873 |
847 |
$42K |
| T1024 |
Evaluation and treatment by an integrated, specialty team contracted to provide coordinated care to multiple or severely handicapped children, per encounter |
16,237 |
10,518 |
$42K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
12,527 |
12,300 |
$42K |
| 70486 |
|
1,160 |
1,125 |
$42K |
| 84100 |
|
17,916 |
12,892 |
$41K |
| 97139 |
|
15,296 |
2,279 |
$40K |
| 73130 |
|
6,898 |
6,546 |
$40K |
| 70551 |
Magnetic resonance imaging, brain; without contrast material |
970 |
946 |
$39K |
| 73090 |
|
7,199 |
6,237 |
$38K |
| J2930 |
Injection, methylprednisolone sodium succinate, up to 125 mg |
985 |
731 |
$37K |
| Z4308 |
|
1,503 |
1,499 |
$36K |
| 0762 |
|
1,147 |
1,086 |
$36K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
5,588 |
5,343 |
$36K |
| 92587 |
|
559 |
558 |
$35K |
| 73590 |
|
5,754 |
5,268 |
$34K |
| J2920 |
Injection, methylprednisolone sodium succinate, up to 40 mg |
2,797 |
2,019 |
$34K |
| 84550 |
|
15,637 |
11,152 |
$33K |
| 76000 |
|
3,585 |
3,467 |
$32K |
| 97802 |
|
1,046 |
1,034 |
$32K |
| 76700 |
Ultrasound, abdominal, real time with image documentation; complete |
2,049 |
2,027 |
$32K |
| 0270 |
|
49,922 |
31,493 |
$31K |
| 42820 |
Tonsillectomy and adenoidectomy; younger than age 12 |
2,257 |
2,223 |
$31K |
| J1568 |
Injection, immune globulin, (octagam), intravenous, non-lyophilized (e.g., liquid), 500 mg |
28 |
15 |
$31K |
| 92558 |
|
668 |
633 |
$31K |
| 82803 |
|
4,592 |
4,342 |
$30K |
| 87430 |
|
7,782 |
7,665 |
$30K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
8,917 |
8,480 |
$29K |
| 99366 |
|
19,897 |
9,845 |
$28K |
| 99232 |
Subsequent hospital care, per day, moderate complexity |
519 |
250 |
$28K |
| 74183 |
|
294 |
286 |
$28K |
| 0300 |
|
1,988 |
921 |
$28K |
| 73552 |
|
3,074 |
2,870 |
$28K |
| 83605 |
|
5,058 |
4,584 |
$27K |
| 85055 |
|
2,508 |
1,358 |
$27K |
| 84443 |
Thyroid stimulating hormone (TSH) |
7,095 |
6,881 |
$27K |
| 82330 |
|
4,418 |
4,182 |
$26K |
| 0636 |
|
2,213 |
1,491 |
$26K |
| 83880 |
|
2,043 |
1,967 |
$26K |
| J1200 |
Injection, diphenhydramine hcl, up to 50 mg |
4,998 |
3,818 |
$26K |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
5,222 |
5,018 |
$25K |
| 87186 |
|
7,071 |
6,830 |
$25K |
| 87497 |
|
600 |
371 |
$25K |
| 81025 |
|
15,094 |
14,163 |
$25K |
| 86923 |
|
1,935 |
1,604 |
$25K |
| 93325 |
|
547 |
474 |
$25K |
| 97803 |
|
2,245 |
2,192 |
$25K |
| 83735 |
|
6,362 |
5,328 |
$24K |
| 95811 |
|
345 |
344 |
$24K |
| 0250 |
|
2,894 |
2,137 |
$23K |
| 99218 |
|
93 |
92 |
$23K |
| J0694 |
Injection, cefoxitin sodium, 1 gm |
830 |
610 |
$23K |
| 87081 |
|
10,109 |
9,983 |
$23K |
| 70491 |
|
344 |
330 |
$22K |
| 85652 |
|
16,319 |
15,391 |
$22K |
| 0301 |
|
1,245 |
649 |
$22K |
| G9002 |
Coordinated care fee, maintenance rate |
2,668 |
2,629 |
$22K |
| 72157 |
|
256 |
240 |
$22K |
| Z4311 |
|
1,811 |
1,810 |
$22K |
| 72158 |
|
401 |
387 |
$21K |
| 92588 |
|
286 |
286 |
$20K |
| 99231 |
Subsequent hospital care, per day, straightforward or low complexity |
350 |
342 |
$20K |
| 73721 |
Magnetic resonance imaging, any joint of lower extremity; without contrast material |
1,075 |
1,069 |
$20K |
| 96415 |
|
2,120 |
1,676 |
$19K |
| 85730 |
|
5,791 |
5,477 |
$19K |
| Z4309 |
|
730 |
730 |
$19K |
| 87077 |
|
5,754 |
5,551 |
$19K |
| J9260 |
Injection, methotrexate sodium, 50 mg |
2,005 |
1,183 |
$19K |
| 99243 |
|
210 |
207 |
$19K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
2,111 |
1,110 |
$18K |
| 12011 |
|
3,189 |
3,153 |
$18K |
| 84145 |
|
1,173 |
1,135 |
$18K |
| 88313 |
|
675 |
601 |
$17K |
| 43762 |
|
626 |
564 |
$17K |
| 85379 |
|
3,179 |
3,049 |
$17K |
| 73030 |
|
2,637 |
2,546 |
$17K |
| J1170 |
Injection, hydromorphone, up to 4 mg |
1,788 |
1,485 |
$16K |
| V5298 |
Hearing aid, not otherwise classified |
12 |
12 |
$16K |
| Z4302 |
|
1,143 |
1,143 |
$16K |
| Z4312 |
|
1,338 |
1,337 |
$16K |
| 95012 |
|
6,354 |
6,299 |
$16K |
| 86850 |
|
6,201 |
5,458 |
$16K |
| 54161 |
|
818 |
804 |
$15K |
| 85610 |
|
6,344 |
5,934 |
$15K |
| 73140 |
|
4,937 |
4,523 |
$15K |
| 85384 |
|
3,096 |
2,965 |
$15K |
| 70543 |
|
191 |
188 |
$14K |
| 72197 |
|
227 |
222 |
$14K |
| 76885 |
|
398 |
394 |
$14K |
| J2710 |
Injection, neostigmine methylsulfate, up to 0.5 mg |
2,681 |
2,528 |
$14K |
| 43239 |
Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple |
735 |
700 |
$14K |
| 72100 |
|
2,525 |
2,471 |
$14K |
| 94799 |
|
1,789 |
1,751 |
$14K |
| 72156 |
|
227 |
218 |
$14K |
| 99233 |
Prolong inpt eval add15 m |
327 |
150 |
$14K |
| 81002 |
|
19,049 |
18,509 |
$14K |
| J1720 |
Injection, hydrocortisone sodium succinate, up to 100 mg |
691 |
429 |
$14K |
| 73000 |
|
2,731 |
2,573 |
$14K |
| 84439 |
|
6,750 |
6,553 |
$13K |
| 82728 |
|
3,905 |
3,493 |
$13K |
| 96411 |
|
978 |
593 |
$13K |
| 97010 |
|
6,037 |
1,516 |
$13K |
| 72125 |
Computed tomography, cervical spine; without contrast material |
199 |
193 |
$12K |
| 84484 |
|
2,914 |
2,776 |
$12K |
| 82550 |
|
5,403 |
5,154 |
$12K |
| 70360 |
|
2,982 |
2,945 |
$12K |
| 74019 |
|
812 |
791 |
$12K |
| Z4310 |
|
985 |
982 |
$12K |
| S0020 |
Injection, bupivicaine hydrochloride, 30 ml |
2,546 |
2,282 |
$12K |
| 72148 |
Magnetic resonance imaging, lumbar spine; without contrast material |
367 |
365 |
$12K |
| 87070 |
|
3,320 |
3,170 |
$12K |
| Z7512 |
|
446 |
432 |
$12K |
| S0302 |
Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service) |
2,761 |
1,389 |
$12K |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
941 |
546 |
$12K |
| 84305 |
|
1,197 |
1,189 |
$11K |
| 0258 |
|
119 |
104 |
$11K |
| 97112 |
Therapeutic procedure, each 15 minutes; neuromuscular reeducation of movement, balance, coordination |
390 |
114 |
$11K |
| 76010 |
|
1,206 |
1,160 |
$10K |
| 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 |
11,732 |
11,299 |
$10K |
| 86900 |
|
6,316 |
5,538 |
$10K |
| 93303 |
Transthoracic echocardiography for congenital cardiac anomalies, follow-up or limited study |
120 |
104 |
$10K |
| Q9966 |
Low osmolar contrast material, 200-299 mg/ml iodine concentration, per ml |
515 |
476 |
$10K |
| 94770 |
|
1,167 |
1,121 |
$10K |
| 80299 |
|
1,453 |
1,310 |
$9K |
| 70480 |
|
201 |
197 |
$9K |
| 69436 |
Tympanostomy (requiring insertion of ventilating tube), general anesthesia |
703 |
690 |
$9K |
| 88312 |
|
2,294 |
2,228 |
$9K |
| 92060 |
|
185 |
183 |
$9K |
| J0780 |
Injection, prochlorperazine, up to 10 mg |
1,212 |
1,048 |
$9K |
| 86901 |
|
6,308 |
5,540 |
$9K |
| 73060 |
|
1,646 |
1,516 |
$9K |
| 0306 |
|
1,280 |
812 |
$9K |
| 73070 |
|
1,889 |
1,668 |
$9K |
| 73100 |
|
3,338 |
2,923 |
$9K |
| 83001 |
|
1,016 |
917 |
$9K |
| 82784 |
|
3,275 |
2,984 |
$9K |
| 12001 |
|
2,130 |
2,110 |
$9K |
| 83002 |
|
1,081 |
1,041 |
$9K |
| 86235 |
|
215 |
205 |
$8K |
| 87631 |
|
309 |
294 |
$8K |
| 88304 |
|
3,072 |
2,998 |
$8K |
| 97799 |
|
2,262 |
399 |
$8K |
| 84403 |
|
876 |
863 |
$8K |
| A9575 |
Injection, gadoterate meglumine, 0.1 ml |
2,054 |
1,924 |
$8K |
| 97166 |
|
780 |
758 |
$8K |
| 86160 |
|
1,490 |
1,348 |
$8K |
| 81003 |
|
5,065 |
4,961 |
$8K |
| 82465 |
|
3,041 |
2,313 |
$8K |
| 71260 |
Computed tomography, thorax, diagnostic; with contrast material |
171 |
166 |
$7K |
| A9577 |
Injection, gadobenate dimeglumine (multihance), per ml |
1,740 |
1,697 |
$7K |
| 77074 |
|
826 |
819 |
$7K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
1,138 |
1,106 |
$7K |
| X3920 |
|
146 |
146 |
$7K |
| 83519 |
|
1,117 |
1,101 |
$7K |
| J7030 |
Infusion, normal saline solution , 1000 cc |
1,641 |
902 |
$7K |
| 86003 |
|
441 |
355 |
$7K |
| 82947 |
|
5,099 |
4,740 |
$7K |
| 99080 |
|
916 |
900 |
$7K |
| A9150 |
Non-prescription drugs |
16,120 |
13,335 |
$7K |
| 80143 |
|
675 |
655 |
$7K |
| 72070 |
|
1,325 |
1,303 |
$7K |
| 76882 |
|
975 |
944 |
$7K |
| 51741 |
|
2,031 |
1,977 |
$7K |
| 10060 |
|
1,223 |
1,189 |
$6K |
| 85045 |
|
4,293 |
3,589 |
$6K |
| 93320 |
|
160 |
135 |
$6K |
| 94664 |
|
1,664 |
1,656 |
$6K |
| 87088 |
|
2,492 |
2,419 |
$6K |
| 88104 |
|
1,375 |
1,137 |
$6K |
| 29515 |
|
3,317 |
3,176 |
$6K |
| 92523 |
|
276 |
274 |
$6K |
| 80179 |
|
662 |
641 |
$6K |
| 83498 |
|
194 |
192 |
$6K |
| 29125 |
|
3,651 |
3,518 |
$6K |
| 73560 |
|
2,764 |
2,664 |
$6K |
| 72040 |
|
785 |
768 |
$6K |
| J2919 |
Injection, methylprednisolone sodium succinate, 5 mg |
494 |
449 |
$6K |
| 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 |
264 |
250 |
$6K |
| 82379 |
|
1,169 |
1,120 |
$6K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
237 |
234 |
$6K |
| J7799 |
Noc drugs, other than inhalation drugs, administered through dme |
5,957 |
4,778 |
$5K |
| 83516 |
|
1,357 |
1,304 |
$5K |
| 51798 |
|
1,834 |
1,779 |
$5K |
| 67311 |
|
195 |
191 |
$5K |
| 99217 |
|
118 |
116 |
$5K |
| 74230 |
|
305 |
303 |
$5K |
| 12051 |
|
630 |
616 |
$5K |
| 77072 |
|
3,124 |
3,095 |
$5K |
| 29105 |
|
2,315 |
2,201 |
$5K |
| Z4314 |
|
253 |
253 |
$5K |
| V5264 |
Ear mold/insert, not disposable, any type |
68 |
68 |
$5K |
| 54640 |
|
239 |
236 |
$5K |
| 83540 |
|
2,260 |
2,156 |
$5K |
| 0305 |
|
954 |
642 |
$4K |
| T1001 |
Nursing assessment / evaluation |
1,852 |
1,766 |
$4K |
| X3908 |
|
142 |
38 |
$4K |
| 82657 |
|
403 |
390 |
$4K |
| 83550 |
|
2,084 |
1,992 |
$4K |
| 80061 |
Lipid panel |
2,428 |
2,375 |
$4K |
| 76506 |
|
107 |
107 |
$4K |
| J7050 |
Infusion, normal saline solution, 250 cc |
2,255 |
1,368 |
$4K |
| 74240 |
|
164 |
164 |
$4K |
| 87045 |
|
727 |
704 |
$4K |
| P9037 |
Platelets, pheresis, leukocytes reduced, irradiated, each unit |
14 |
12 |
$4K |
| 72170 |
|
340 |
330 |
$4K |
| 74455 |
|
205 |
198 |
$4K |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
3,756 |
3,096 |
$4K |
| 88185 |
|
13 |
13 |
$4K |
| 84244 |
|
129 |
128 |
$4K |
| 87205 |
|
2,407 |
2,295 |
$4K |
| 0700 |
|
3,151 |
2,986 |
$4K |
| 99464 |
|
85 |
85 |
$4K |
| 72081 |
|
555 |
542 |
$4K |
| J9100 |
Injection, cytarabine, 100 mg |
311 |
50 |
$4K |
| 93971 |
|
49 |
49 |
$4K |
| 86038 |
|
552 |
540 |
$4K |
| 82139 |
|
509 |
481 |
$3K |
| 82670 |
|
342 |
331 |
$3K |
| 90686 |
|
682 |
648 |
$3K |
| 83970 |
|
386 |
360 |
$3K |
| 94060 |
|
554 |
550 |
$3K |
| 99460 |
|
44 |
43 |
$3K |
| 74270 |
|
244 |
232 |
$3K |
| A9554 |
Iodine i-125 sodium iothalamate, diagnostic, per study dose, up to 10 microcuries |
27 |
27 |
$3K |
| 87799 |
|
175 |
108 |
$3K |
| 99234 |
|
1,608 |
1,541 |
$3K |
| 80305 |
|
1,199 |
1,153 |
$3K |
| 92611 |
|
187 |
187 |
$3K |
| 86225 |
|
214 |
210 |
$3K |
| J8540 |
Dexamethasone, oral, 0.25 mg |
49 |
39 |
$3K |
| 80076 |
|
817 |
787 |
$3K |
| 96368 |
|
603 |
587 |
$3K |
| 86880 |
|
592 |
568 |
$3K |
| 72146 |
|
39 |
39 |
$3K |
| 82977 |
|
1,034 |
904 |
$3K |
| J7611 |
Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, concentrated form, 1 mg |
5,120 |
4,826 |
$3K |
| X4301 |
|
26 |
26 |
$2K |
| J2765 |
Injection, metoclopramide hcl, up to 10 mg |
531 |
457 |
$2K |
| 29505 |
|
1,052 |
1,024 |
$2K |
| 82247 |
|
601 |
469 |
$2K |
| 44500 |
|
96 |
89 |
$2K |
| 86308 |
|
827 |
822 |
$2K |
| V5266 |
Battery for use in hearing device |
64 |
63 |
$2K |
| 69210 |
|
387 |
380 |
$2K |
| 25605 |
|
210 |
202 |
$2K |
| 99368 |
|
1,943 |
1,271 |
$2K |
| 86376 |
|
596 |
583 |
$2K |
| 94621 |
|
100 |
99 |
$2K |
| 82533 |
|
538 |
519 |
$2K |
| 99152 |
|
544 |
486 |
$2K |
| 76857 |
|
174 |
173 |
$2K |
| V5010 |
Assessment for hearing aid |
27 |
27 |
$2K |
| S5012 |
5% dextrose with potassium chloride, 1000 ml |
3,115 |
2,540 |
$2K |
| 86360 |
|
263 |
247 |
$2K |
| 87300 |
|
845 |
828 |
$2K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
32 |
32 |
$2K |
| 89051 |
|
2,166 |
1,759 |
$2K |
| 87449 |
|
180 |
61 |
$2K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
1,645 |
1,569 |
$2K |
| 86359 |
|
263 |
246 |
$2K |
| 84703 |
|
861 |
849 |
$2K |
| V5267 |
Hearing aid or assistive listening device/supplies/accessories, not otherwise specified |
25 |
22 |
$2K |
| 86355 |
|
276 |
260 |
$2K |
| 86039 |
|
122 |
120 |
$2K |
| 82150 |
|
430 |
412 |
$2K |
| 86357 |
|
250 |
234 |
$2K |
| 85060 |
|
486 |
385 |
$2K |
| 73660 |
|
621 |
589 |
$2K |
| 82570 |
|
2,044 |
1,868 |
$2K |
| 94150 |
|
298 |
272 |
$2K |
| 80069 |
|
1,054 |
880 |
$2K |
| 84510 |
|
129 |
98 |
$2K |
| A9573 |
Injection, gadopiclenol, 1 ml |
24 |
24 |
$1K |
| S9470 |
Nutritional counseling, dietitian visit |
316 |
314 |
$1K |
| Z7508 |
|
25 |
25 |
$1K |
| J2060 |
Injection, lorazepam, 2 mg |
274 |
168 |
$1K |
| X3910 |
|
142 |
38 |
$1K |
| 87075 |
|
526 |
510 |
$1K |
| J0171 |
Injection, adrenalin, epinephrine, 0.1 mg |
127 |
113 |
$1K |
| 93010 |
Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only |
65 |
56 |
$1K |
| J2272 |
Injection, morphine sulfate (fresenius kabi), not therapeutically equivalent to j2270, up to 10 mg |
60 |
59 |
$1K |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
50 |
48 |
$1K |
| 29130 |
|
782 |
772 |
$1K |
| 84132 |
|
3,759 |
3,567 |
$1K |
| 84295 |
|
3,705 |
3,512 |
$1K |
| J0134 |
Injection, acetaminophen (fresenius kabi), not therapeutically equivalent to j0131, 10 mg |
71 |
70 |
$1K |
| 30140 |
|
81 |
78 |
$1K |
| 71020 |
|
40 |
39 |
$1K |
| 96367 |
|
177 |
169 |
$1K |
| 99239 |
Hospital discharge day management, more than 30 minutes |
39 |
39 |
$1K |
| 82105 |
|
145 |
116 |
$1K |
| 76937 |
|
180 |
178 |
$1K |
| 96151 |
|
48 |
48 |
$1K |
| 87046 |
|
728 |
704 |
$1K |
| 82785 |
|
804 |
775 |
$1K |
| 82010 |
|
472 |
418 |
$1K |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
24 |
24 |
$1K |
| 77076 |
|
38 |
36 |
$1K |
| 93000 |
|
26 |
26 |
$993.02 |
| J0561 |
Injection, penicillin g benzathine, 100,000 units |
71 |
71 |
$987.11 |
| 93308 |
|
30 |
26 |
$986.91 |
| 14040 |
|
42 |
42 |
$968.24 |
| 99205 |
Prolong outpt/office vis |
39 |
39 |
$953.38 |
| J7644 |
Ipratropium bromide, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose form, per milligram |
1,854 |
1,669 |
$952.50 |
| 51600 |
|
127 |
120 |
$914.47 |
| 87279 |
|
140 |
132 |
$913.14 |
| 88342 |
|
71 |
69 |
$894.36 |
| 86769 |
|
137 |
126 |
$893.95 |
| 92522 |
|
102 |
100 |
$857.58 |
| X4540 |
|
26 |
26 |
$855.66 |
| S9446 |
Patient education, not otherwise classified, non-physician provider, group, per session |
929 |
883 |
$854.05 |
| 93350 |
|
63 |
63 |
$836.59 |
| 84030 |
|
129 |
98 |
$788.19 |
| 86945 |
|
457 |
272 |
$764.10 |
| 80164 |
|
242 |
216 |
$755.34 |
| J0290 |
Injection, ampicillin sodium, 500 mg |
133 |
114 |
$750.05 |
| 82157 |
|
49 |
49 |
$750.00 |
| 82140 |
|
171 |
164 |
$700.74 |
| 92551 |
|
69 |
69 |
$684.32 |
| 84156 |
|
1,387 |
1,251 |
$683.00 |
| 90656 |
|
63 |
62 |
$672.57 |
| 11750 |
|
90 |
90 |
$652.53 |
| S5001 |
Prescription drug, brand name |
514 |
510 |
$651.89 |
| X4100 |
|
13 |
13 |
$649.61 |
| 72141 |
|
37 |
37 |
$647.01 |
| 80320 |
|
609 |
589 |
$642.60 |
| 0761 |
|
42 |
39 |
$627.16 |
| 24640 |
|
216 |
207 |
$621.39 |
| 86431 |
|
172 |
170 |
$591.70 |
| A9698 |
Non-radioactive contrast imaging material, not otherwise classified, per study |
335 |
323 |
$574.80 |
| 87299 |
|
137 |
132 |
$574.39 |
| 87260 |
|
137 |
132 |
$563.64 |
| 86256 |
|
163 |
158 |
$556.65 |
| 84480 |
|
152 |
144 |
$548.35 |
| 92015 |
Determination of refractive state |
47 |
47 |
$544.63 |
| 11730 |
|
138 |
137 |
$543.90 |
| 76942 |
|
27 |
24 |
$527.28 |
| Z4303 |
|
12 |
12 |
$516.36 |
| 87280 |
|
137 |
132 |
$509.48 |
| J7609 |
Albuterol, inhalation solution, compounded product, administered through dme, unit dose, 1 mg |
968 |
956 |
$494.17 |
| 12031 |
|
50 |
50 |
$485.99 |
| 88300 |
|
456 |
441 |
$460.09 |
| 80197 |
|
73 |
54 |
$448.48 |
| 93786 |
|
57 |
56 |
$438.28 |
| 83520 |
|
169 |
160 |
$426.26 |
| 86356 |
|
68 |
66 |
$423.62 |
| J1953 |
Injection, levetiracetam, 10 mg |
25 |
25 |
$411.61 |
| 83655 |
|
446 |
443 |
$411.58 |
| 86665 |
|
80 |
80 |
$402.03 |
| 82610 |
|
103 |
101 |
$388.80 |
| 0302 |
|
347 |
282 |
$381.93 |
| 88184 |
|
13 |
13 |
$370.22 |
| 84436 |
|
1,535 |
1,507 |
$361.10 |
| 93321 |
|
32 |
28 |
$355.57 |
| 88307 |
|
66 |
65 |
$352.82 |
| 74241 |
|
26 |
26 |
$343.25 |
| J1071 |
Injection, testosterone cypionate, 1 mg |
33 |
28 |
$339.21 |
| 94729 |
|
12 |
12 |
$337.40 |
| J1030 |
Injection, methylprednisolone acetate, 40 mg |
118 |
96 |
$335.29 |
| 82652 |
|
99 |
97 |
$330.00 |
| J7613 |
Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg |
1,285 |
925 |
$322.81 |
| 86329 |
|
101 |
97 |
$300.87 |
| J0295 |
Injection, ampicillin sodium/sulbactam sodium, per 1.5 gm |
94 |
72 |
$293.91 |
| 70250 |
|
24 |
24 |
$292.37 |
| 82248 |
|
220 |
187 |
$280.63 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
14 |
14 |
$276.50 |
| 30300 |
|
110 |
100 |
$270.50 |
| 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 |
1,998 |
1,637 |
$269.78 |
| J0330 |
Injection, succinylcholine chloride, up to 20 mg |
339 |
317 |
$250.98 |
| 86480 |
|
55 |
54 |
$248.80 |
| 71250 |
|
13 |
13 |
$235.21 |
| 87276 |
|
134 |
129 |
$233.55 |
| 94760 |
|
134 |
131 |
$217.03 |
| 80177 |
|
50 |
49 |
$211.85 |
| 87275 |
|
134 |
129 |
$211.33 |
| 85397 |
|
14 |
12 |
$208.70 |
| 88108 |
|
47 |
40 |
$202.45 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
47 |
47 |
$197.52 |
| 73600 |
|
56 |
52 |
$177.30 |
| 92585 |
|
19 |
19 |
$176.65 |
| 74000 |
|
13 |
12 |
$175.49 |
| 82043 |
|
510 |
501 |
$169.51 |
| J2274 |
Injection, morphine sulfate, preservative-free for epidural or intrathecal use, 10 mg |
41 |
41 |
$166.29 |
| J7042 |
5% dextrose/normal saline (500 ml = 1 unit) |
60 |
55 |
$156.63 |
| 84460 |
|
27 |
27 |
$152.99 |
| 84450 |
|
13 |
13 |
$141.74 |
| 86664 |
|
68 |
68 |
$141.55 |
| 87427 |
|
43 |
42 |
$140.29 |
| 86703 |
|
31 |
28 |
$139.71 |
| 82017 |
|
42 |
42 |
$137.15 |
| 85240 |
|
13 |
12 |
$133.26 |
| J7620 |
Albuterol, up to 2.5 mg and ipratropium bromide, up to 0.5 mg, fda-approved final product, non-compounded, administered through dme |
184 |
152 |
$132.43 |
| S0077 |
Injection, clindamycin phosphate, 300 mg |
26 |
25 |
$130.33 |
| 86592 |
|
80 |
77 |
$129.08 |
| 82962 |
|
74 |
61 |
$127.96 |
| J0136 |
Injection, acetaminophen (b braun), not therapeutically equivalent to j0131, 10 mg |
16 |
12 |
$120.86 |
| 29799 |
|
35 |
35 |
$120.00 |
| 92567 |
|
15 |
15 |
$116.04 |
| 87106 |
|
67 |
61 |
$115.85 |
| 84478 |
|
104 |
82 |
$107.93 |
| 75565 |
|
12 |
12 |
$101.78 |
| 87181 |
|
287 |
276 |
$101.63 |
| 86317 |
|
12 |
12 |
$92.25 |
| 96523 |
|
40 |
15 |
$90.64 |
| 88311 |
|
68 |
63 |
$88.80 |
| 24538 |
|
12 |
12 |
$85.77 |
| 12002 |
|
24 |
24 |
$80.04 |
| 70160 |
|
12 |
12 |
$78.76 |
| 86645 |
|
12 |
12 |
$75.67 |
| 85018 |
|
34 |
34 |
$74.10 |
| 0257 |
|
12 |
12 |
$73.48 |
| J3475 |
Injection, magnesium sulfate, per 500 mg |
16 |
13 |
$72.05 |
| S0028 |
Injection, famotidine, 20 mg |
1,164 |
859 |
$67.38 |
| 73620 |
|
15 |
14 |
$67.34 |
| J7610 |
Albuterol, inhalation solution, compounded product, administered through dme, concentrated form, 1 mg |
53 |
43 |
$61.36 |
| 95831 |
|
13 |
13 |
$56.71 |
| 86644 |
|
12 |
12 |
$52.18 |
| 42830 |
|
40 |
40 |
$50.00 |
| 87206 |
|
42 |
38 |
$49.32 |
| E0780 |
Ambulatory infusion pump, mechanical, reusable, for infusion less than 8 hours |
165 |
135 |
$48.38 |
| 96376 |
|
161 |
158 |
$48.30 |
| 87116 |
|
40 |
36 |
$47.66 |
| 0320 |
|
1,150 |
919 |
$45.20 |
| 80349 |
|
112 |
110 |
$43.05 |
| 84146 |
|
13 |
13 |
$42.26 |
| 82607 |
|
12 |
12 |
$41.26 |
| 82542 |
|
15 |
12 |
$37.91 |
| J7642 |
Glycopyrrolate, inhalation solution, compounded product, administered through dme, concentrated form, per milligram |
2,098 |
1,969 |
$35.70 |
| 85008 |
|
614 |
548 |
$33.68 |
| 85347 |
|
13 |
12 |
$22.35 |
| 83525 |
|
38 |
38 |
$22.00 |
| 36415 |
Collection of venous blood by venipuncture |
12 |
12 |
$20.85 |
| J7510 |
Prednisolone oral, per 5 mg |
28 |
26 |
$20.26 |
| J2251 |
Injection, midazolam in 0.9% sodium chloride, intravenous, not therapeutically equivalent to j2250, 1 mg |
126 |
120 |
$19.20 |
| 84630 |
|
12 |
12 |
$13.00 |
| 84702 |
|
17 |
12 |
$8.00 |
| J3370 |
Injection, vancomycin hcl, 500 mg |
15 |
14 |
$7.07 |
| S0119 |
Ondansetron, oral, 4 mg (for circumstances falling under the medicare statute, use hcpcs q code) |
87 |
85 |
$2.54 |
| 89050 |
|
15 |
13 |
$1.88 |
| 0272 |
|
191 |
169 |
$0.01 |
| 0351 |
|
90 |
85 |
$0.00 |
| 93041 |
|
69 |
69 |
$0.00 |
| 80339 |
|
57 |
52 |
$0.00 |
| 0261 |
|
158 |
119 |
$0.00 |
| 0402 |
|
642 |
492 |
$0.00 |
| 15853 |
|
36 |
35 |
$0.00 |
| 99001 |
|
55 |
52 |
$0.00 |
| 0483 |
|
23 |
14 |
$0.00 |
| 0260 |
|
423 |
319 |
$0.00 |
| 0460 |
|
51 |
44 |
$0.00 |
| 0940 |
|
62 |
60 |
$0.00 |
| 0444 |
|
22 |
22 |
$0.00 |
| 81205 |
|
15 |
15 |
$0.00 |
| 0920 |
|
18 |
12 |
$0.00 |
| A4216 |
Sterile water, saline and/or dextrose, diluent/flush, 10 ml |
59 |
34 |
$0.00 |
| S5010 |
5% dextrose and 0.45% normal saline, 1000 ml |
29 |
26 |
$0.00 |
| 94070 |
|
13 |
13 |
$0.00 |
| A4641 |
Radiopharmaceutical, diagnostic, not otherwise classified |
27 |
27 |
$0.00 |
| 0611 |
|
83 |
83 |
$0.00 |
| 0370 |
|
2,320 |
2,305 |
$0.00 |
| 80329 |
|
215 |
193 |
$0.00 |
| 0740 |
|
88 |
85 |
$0.00 |
| 0310 |
|
205 |
126 |
$0.00 |
| 99153 |
Mod sedat endo service >5yrs |
41 |
39 |
$0.00 |
| 0612 |
Calcium glucon (wg critical) |
39 |
23 |
$0.00 |
| 99291 |
Critical care, evaluation and management of the critically ill patient, first 30-74 minutes |
29 |
12 |
$0.00 |
| J1094 |
Injection, dexamethasone acetate, 1 mg |
84 |
82 |
$0.00 |
| 0410 |
|
60 |
53 |
$0.00 |
| 0331 |
|
122 |
53 |
$0.00 |
| S0074 |
Injection, cefotetan disodium, 500 mg |
20 |
15 |
$0.00 |
| 0610 |
|
44 |
32 |
$0.00 |
| 0352 |
|
51 |
48 |
$0.00 |
| Q4051 |
Splint supplies, miscellaneous (includes thermoplastics, strapping, fasteners, padding and other supplies) |
17 |
14 |
$0.00 |
| 94761 |
|
15 |
12 |
$0.00 |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
12 |
12 |
$0.00 |
| 0942 |
|
12 |
12 |
$0.00 |