| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99284 |
Emergency department visit for the evaluation and management, high severity |
26,194 |
24,025 |
$4.84M |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
37,971 |
35,396 |
$4.61M |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
12,660 |
11,668 |
$3.36M |
| G0378 |
Hospital observation service, per hour |
2,929 |
2,693 |
$2.04M |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
18,390 |
16,621 |
$1.56M |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
21,562 |
19,567 |
$1.07M |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
10,873 |
10,438 |
$837K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
10,762 |
10,076 |
$796K |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
5,074 |
4,931 |
$663K |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
6,455 |
5,377 |
$500K |
| 96360 |
Intravenous infusion, hydration; initial, 31 minutes to 1 hour |
5,182 |
4,643 |
$480K |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
17,180 |
5,071 |
$420K |
| 70450 |
Computed tomography, head or brain; without contrast material |
4,761 |
4,603 |
$397K |
| 90837 |
Psychotherapy, 53 minutes with patient |
5,461 |
4,108 |
$395K |
| 96361 |
Intravenous infusion, hydration; each additional hour |
15,879 |
13,013 |
$377K |
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
6,395 |
4,718 |
$365K |
| 93306 |
Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete |
1,752 |
1,743 |
$356K |
| 96375 |
Therapeutic injection; each additional sequential IV push |
14,020 |
12,006 |
$350K |
| 92507 |
Treatment of speech, language, voice, communication, and/or auditory processing disorder |
7,623 |
2,895 |
$310K |
| 71046 |
Radiologic examination, chest; 2 views |
8,734 |
8,501 |
$301K |
| 71045 |
Radiologic examination, chest; single view |
9,131 |
8,756 |
$290K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
2,811 |
2,756 |
$268K |
| 99291 |
Critical care, evaluation and management of the critically ill patient, first 30-74 minutes |
541 |
524 |
$214K |
| 90834 |
Psychotherapy, 45 minutes with patient |
3,879 |
3,016 |
$197K |
| 90791 |
Psychiatric diagnostic evaluation |
1,953 |
1,887 |
$177K |
| 43239 |
Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple |
441 |
440 |
$154K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
3,139 |
3,109 |
$149K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
1,432 |
1,427 |
$144K |
| 97530 |
Therapeutic activities, direct patient contact, each 15 minutes |
4,815 |
1,999 |
$144K |
| 80061 |
Lipid panel |
10,197 |
10,032 |
$131K |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
2,189 |
2,152 |
$126K |
| 86900 |
|
4,339 |
4,073 |
$105K |
| 84443 |
Thyroid stimulating hormone (TSH) |
17,877 |
17,237 |
$104K |
| 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 |
2,862 |
2,754 |
$97K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
1,828 |
1,799 |
$90K |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
6,294 |
6,194 |
$87K |
| 71275 |
Computed tomographic angiography, chest, with contrast material |
1,091 |
1,069 |
$84K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
22,960 |
20,838 |
$80K |
| 80053 |
Comprehensive metabolic panel |
32,586 |
28,398 |
$80K |
| 97162 |
|
1,696 |
1,666 |
$80K |
| 90792 |
Psychiatric diagnostic evaluation with medical services |
657 |
654 |
$78K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
1,174 |
1,169 |
$78K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
1,018 |
928 |
$76K |
| 96366 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour |
2,960 |
2,011 |
$66K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
2,284 |
2,226 |
$63K |
| 76830 |
Ultrasound, transvaginal |
1,164 |
1,147 |
$62K |
| 72148 |
Magnetic resonance imaging, lumbar spine; without contrast material |
679 |
677 |
$61K |
| U0002 |
2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc |
2,808 |
2,691 |
$60K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
52,039 |
44,117 |
$59K |
| 97140 |
Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) |
5,047 |
1,631 |
$59K |
| 93975 |
|
548 |
543 |
$56K |
| 97112 |
Therapeutic procedure, each 15 minutes; neuromuscular reeducation of movement, balance, coordination |
2,452 |
841 |
$51K |
| 58558 |
|
61 |
61 |
$50K |
| 90832 |
Psychotherapy, 30 minutes with patient |
1,427 |
1,112 |
$46K |
| 70553 |
Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences |
227 |
224 |
$46K |
| 99232 |
Subsequent hospital care, per day, moderate complexity |
1,240 |
318 |
$43K |
| 72100 |
|
1,892 |
1,882 |
$42K |
| 45380 |
Colonoscopy, flexible; with biopsy, single or multiple |
77 |
77 |
$41K |
| 84439 |
|
13,560 |
13,082 |
$40K |
| 36415 |
Collection of venous blood by venipuncture |
30,967 |
27,417 |
$39K |
| 96413 |
Chemotherapy administration, intravenous infusion; up to 1 hour, single or initial substance |
229 |
128 |
$38K |
| 72141 |
|
274 |
273 |
$37K |
| 73721 |
Magnetic resonance imaging, any joint of lower extremity; without contrast material |
327 |
320 |
$37K |
| 76536 |
|
708 |
705 |
$37K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
7,823 |
7,692 |
$36K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
2,729 |
2,674 |
$35K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
2,730 |
2,675 |
$35K |
| 82607 |
|
4,827 |
4,762 |
$34K |
| 71260 |
Computed tomography, thorax, diagnostic; with contrast material |
304 |
295 |
$34K |
| 76801 |
|
620 |
572 |
$34K |
| 59025 |
Fetal non-stress test |
524 |
227 |
$33K |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
2,489 |
2,470 |
$31K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
367 |
367 |
$30K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
13,954 |
11,662 |
$29K |
| 99281 |
Emergency department visit for the evaluation and management, self-limited or minor |
660 |
605 |
$28K |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
7,493 |
6,961 |
$28K |
| 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 |
2,658 |
2,553 |
$28K |
| 74018 |
|
2,220 |
2,165 |
$27K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
2,769 |
2,698 |
$25K |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
2,834 |
2,768 |
$22K |
| 10060 |
|
275 |
271 |
$22K |
| 76642 |
|
641 |
583 |
$21K |
| 70551 |
Magnetic resonance imaging, brain; without contrast material |
155 |
154 |
$19K |
| 97166 |
|
515 |
508 |
$19K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
19,313 |
17,628 |
$19K |
| 82746 |
|
2,611 |
2,585 |
$18K |
| 86780 |
|
2,548 |
2,481 |
$18K |
| 96367 |
|
892 |
777 |
$18K |
| 87633 |
Infectious agent detection by nucleic acid, respiratory virus, 12-25 targets |
275 |
267 |
$17K |
| 72125 |
Computed tomography, cervical spine; without contrast material |
1,685 |
1,633 |
$16K |
| 87428 |
|
452 |
439 |
$15K |
| 81514 |
|
95 |
93 |
$15K |
| M0245 |
Intravenous infusion, bamlanivimab and etesevimab, includes infusion and post administration monitoring |
59 |
59 |
$15K |
| 73030 |
|
1,753 |
1,653 |
$14K |
| 76700 |
Ultrasound, abdominal, real time with image documentation; complete |
217 |
215 |
$14K |
| 78452 |
Myocardial perfusion imaging, tomographic (SPECT); multiple studies at rest and/or stress |
24 |
24 |
$14K |
| 84481 |
|
1,589 |
1,548 |
$14K |
| 97161 |
|
263 |
260 |
$13K |
| 82947 |
|
2,323 |
1,982 |
$13K |
| 73130 |
|
2,210 |
1,974 |
$13K |
| 73630 |
|
2,434 |
2,258 |
$13K |
| 85027 |
|
5,549 |
5,106 |
$12K |
| 73610 |
|
2,207 |
2,093 |
$12K |
| 70486 |
|
343 |
339 |
$11K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
144 |
144 |
$11K |
| 90686 |
|
1,119 |
1,113 |
$11K |
| 77066 |
Tomosynthesis, mammo |
214 |
209 |
$11K |
| 84702 |
|
3,967 |
3,337 |
$11K |
| 86696 |
|
1,883 |
1,841 |
$11K |
| 73562 |
|
2,075 |
1,879 |
$11K |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
4,420 |
3,959 |
$11K |
| 82728 |
|
1,797 |
1,773 |
$11K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
122 |
121 |
$10K |
| 84403 |
|
749 |
725 |
$10K |
| 93971 |
|
194 |
188 |
$10K |
| 80074 |
|
448 |
441 |
$10K |
| 83735 |
|
14,992 |
12,471 |
$10K |
| 83550 |
|
2,318 |
2,293 |
$9K |
| 93017 |
|
310 |
303 |
$9K |
| 80076 |
|
6,942 |
6,579 |
$9K |
| 72040 |
|
655 |
650 |
$8K |
| 83540 |
|
2,606 |
2,571 |
$8K |
| 99222 |
Initial hospital care, per day, moderate complexity |
114 |
109 |
$8K |
| 92523 |
|
62 |
62 |
$8K |
| 73502 |
|
732 |
711 |
$8K |
| 85610 |
|
9,825 |
7,617 |
$7K |
| 86803 |
|
1,475 |
1,460 |
$7K |
| M0243 |
Intravenous infusion or subcutaneous injection, casirivimab and imdevimab includes infusion or injection, and post administration monitoring |
26 |
26 |
$7K |
| 86003 |
|
103 |
101 |
$7K |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
6,531 |
6,241 |
$7K |
| 83001 |
|
700 |
690 |
$7K |
| G0279 |
Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066) |
619 |
617 |
$7K |
| 73110 |
|
1,127 |
1,051 |
$7K |
| 90715 |
|
1,586 |
1,579 |
$6K |
| 76770 |
|
125 |
122 |
$6K |
| 74021 |
|
125 |
113 |
$6K |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
2,028 |
2,004 |
$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 |
2,270 |
2,037 |
$6K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
193 |
181 |
$6K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
68 |
68 |
$6K |
| 93970 |
|
56 |
55 |
$6K |
| 83525 |
|
873 |
865 |
$5K |
| 72110 |
|
132 |
132 |
$5K |
| 97165 |
|
102 |
101 |
$5K |
| 72072 |
|
215 |
213 |
$5K |
| 82670 |
|
339 |
334 |
$5K |
| 87340 |
|
1,875 |
1,831 |
$5K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
2,747 |
2,716 |
$5K |
| 84146 |
|
588 |
576 |
$5K |
| 82570 |
|
2,086 |
1,985 |
$5K |
| 99215 |
Prolong outpt/office vis |
41 |
40 |
$5K |
| 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 |
119 |
118 |
$5K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
230 |
226 |
$5K |
| 87522 |
Neg quan hep c or qual rna |
248 |
242 |
$5K |
| 0241U |
Neonatal screening for hereditary disorders, genomic sequence analysis panel |
640 |
611 |
$5K |
| 82043 |
|
1,563 |
1,541 |
$5K |
| M0247 |
Intravenous infusion, sotrovimab, includes infusion and post administration monitoring |
19 |
19 |
$4K |
| 88175 |
Cytopathology, cervical or vaginal, any reporting system; collected in preservative fluid, automated thin layer |
265 |
264 |
$4K |
| 0012A |
|
122 |
122 |
$4K |
| 86038 |
|
865 |
853 |
$4K |
| 99238 |
Hospital discharge day management, 30 minutes or less |
126 |
120 |
$4K |
| 81025 |
|
14,187 |
13,255 |
$4K |
| 97535 |
Self-care/home management training, each 15 minutes |
407 |
285 |
$4K |
| 86695 |
|
552 |
544 |
$4K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
139 |
132 |
$4K |
| 83880 |
|
2,198 |
2,099 |
$4K |
| 82784 |
|
449 |
441 |
$3K |
| 86140 |
|
2,393 |
2,316 |
$3K |
| 99239 |
Hospital discharge day management, more than 30 minutes |
64 |
62 |
$3K |
| 90677 |
|
167 |
166 |
$3K |
| 81001 |
|
12,023 |
11,280 |
$3K |
| 0011A |
|
126 |
125 |
$3K |
| 71271 |
|
53 |
53 |
$3K |
| 82565 |
|
1,220 |
1,141 |
$3K |
| C9803 |
Hospital outpatient clinic visit specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source |
530 |
501 |
$3K |
| 85730 |
|
5,661 |
5,337 |
$2K |
| 87631 |
|
1,666 |
1,642 |
$2K |
| 84460 |
|
974 |
958 |
$2K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
28 |
28 |
$2K |
| 87624 |
Infectious agent detection by nucleic acid; human papillomavirus (HPV), high-risk types |
99 |
99 |
$2K |
| 73564 |
|
64 |
51 |
$2K |
| 83970 |
|
92 |
91 |
$2K |
| 84484 |
|
12,646 |
11,286 |
$2K |
| 99231 |
Subsequent hospital care, per day, straightforward or low complexity |
111 |
46 |
$2K |
| 87798 |
Infectious agent detection by nucleic acid; not otherwise specified, amplified probe, each organism |
326 |
317 |
$2K |
| 83655 |
|
289 |
283 |
$2K |
| 90670 |
|
355 |
355 |
$2K |
| 0001A |
|
68 |
68 |
$2K |
| 82550 |
|
1,973 |
1,865 |
$2K |
| 81003 |
|
16,105 |
14,645 |
$2K |
| 82105 |
|
224 |
215 |
$2K |
| 84450 |
|
799 |
789 |
$2K |
| 72050 |
|
39 |
39 |
$2K |
| 97116 |
|
337 |
189 |
$2K |
| 86762 |
|
1,049 |
1,018 |
$2K |
| 86850 |
|
4,017 |
3,798 |
$2K |
| 87581 |
|
277 |
269 |
$2K |
| 87486 |
|
276 |
268 |
$2K |
| J3475 |
Injection, magnesium sulfate, per 500 mg |
688 |
514 |
$2K |
| 0064A |
|
43 |
43 |
$2K |
| 72131 |
|
52 |
50 |
$2K |
| 83002 |
|
180 |
176 |
$2K |
| 87077 |
|
1,529 |
1,490 |
$2K |
| 99309 |
Subsequent nursing facility care, per day, low to moderate complexity |
22 |
17 |
$1K |
| 92526 |
|
32 |
14 |
$1K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
96 |
96 |
$1K |
| 82950 |
|
549 |
544 |
$1K |
| 71250 |
|
24 |
24 |
$1K |
| 71101 |
|
171 |
170 |
$1K |
| 83615 |
|
582 |
547 |
$1K |
| 77065 |
Tomosynthesis, mammo |
41 |
38 |
$1K |
| 94726 |
|
28 |
27 |
$1K |
| 74019 |
|
202 |
201 |
$1K |
| 90651 |
|
25 |
25 |
$1K |
| 0002A |
|
33 |
33 |
$1K |
| 87502 |
Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets |
97 |
97 |
$1K |
| 85651 |
|
862 |
825 |
$1K |
| 83690 |
|
9,490 |
8,784 |
$1K |
| 99442 |
|
79 |
68 |
$1K |
| 0004A |
|
33 |
32 |
$1K |
| 85652 |
|
1,104 |
1,082 |
$1K |
| 90833 |
Psychotherapy, 30 minutes with patient when performed with an E&M service (add-on) |
37 |
36 |
$1K |
| 73080 |
|
307 |
295 |
$1K |
| 94060 |
|
12 |
12 |
$1K |
| 87186 |
|
932 |
911 |
$1K |
| 36591 |
|
173 |
79 |
$1K |
| 86376 |
|
118 |
117 |
$996.63 |
| 73590 |
|
284 |
263 |
$988.58 |
| 84144 |
|
79 |
77 |
$903.62 |
| 0202U |
Oncology (prostate), multianalyte, gene expression profiling |
57 |
57 |
$900.24 |
| 80051 |
|
330 |
316 |
$798.77 |
| 82248 |
|
459 |
416 |
$788.22 |
| 83516 |
|
108 |
104 |
$781.23 |
| G0108 |
Diabetes outpatient self-management training services, individual, per 30 minutes |
12 |
12 |
$779.06 |
| 86706 |
|
146 |
145 |
$778.10 |
| 0134A |
|
25 |
25 |
$754.47 |
| 82274 |
|
168 |
159 |
$725.44 |
| 85018 |
|
1,404 |
1,182 |
$697.95 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
274 |
255 |
$679.14 |
| 90656 |
|
70 |
70 |
$672.88 |
| 87150 |
|
40 |
40 |
$620.28 |
| 99308 |
Subsequent nursing facility care, per day, straightforward |
13 |
12 |
$596.76 |
| 85379 |
|
3,108 |
3,046 |
$595.41 |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
14 |
12 |
$590.04 |
| 86364 |
|
47 |
47 |
$572.32 |
| 0071A |
|
15 |
15 |
$570.78 |
| 84153 |
|
54 |
54 |
$568.85 |
| 84550 |
|
324 |
308 |
$568.56 |
| 84520 |
|
363 |
333 |
$543.70 |
| 87661 |
Infectious agent detection by nucleic acid; Trichomonas vaginalis, amplified probe |
120 |
119 |
$534.58 |
| 0072A |
|
14 |
14 |
$529.90 |
| 86901 |
|
4,340 |
4,074 |
$523.65 |
| 77080 |
|
14 |
13 |
$522.89 |
| 96158 |
|
17 |
16 |
$521.19 |
| 87070 |
|
351 |
333 |
$498.88 |
| 73090 |
|
163 |
157 |
$485.68 |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
363 |
341 |
$475.91 |
| 0124A |
|
15 |
14 |
$473.11 |
| 12001 |
|
512 |
508 |
$446.06 |
| 80305 |
|
43 |
37 |
$408.91 |
| G2211 |
Visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and/or with medical care services that are part of ongoing care related to a patient's single, serious condition or a complex condition. (add-on code, list separately in addition to office/outpatient evaluation and management visit, new or established) |
363 |
359 |
$396.48 |
| 84156 |
|
250 |
211 |
$326.66 |
| 84100 |
|
444 |
352 |
$315.37 |
| 82785 |
|
39 |
37 |
$312.35 |
| 87040 |
|
1,961 |
1,864 |
$300.93 |
| 82533 |
|
38 |
37 |
$291.66 |
| 86431 |
|
129 |
127 |
$276.58 |
| 87184 |
|
328 |
319 |
$273.63 |
| 84132 |
|
378 |
284 |
$246.31 |
| 87503 |
|
55 |
55 |
$245.90 |
| 86708 |
|
41 |
40 |
$243.18 |
| 86704 |
|
43 |
42 |
$223.66 |
| 93000 |
|
25 |
25 |
$219.30 |
| 73140 |
|
48 |
48 |
$213.47 |
| 87480 |
|
134 |
131 |
$200.31 |
| 87088 |
|
208 |
205 |
$198.81 |
| 87510 |
|
134 |
131 |
$196.51 |
| 82977 |
|
72 |
67 |
$195.01 |
| 84145 |
|
45 |
41 |
$194.00 |
| 87660 |
|
134 |
131 |
$188.38 |
| 82150 |
|
440 |
422 |
$186.29 |
| 80069 |
|
28 |
28 |
$147.25 |
| G0103 |
Prostate cancer screening; prostate specific antigen test (psa) |
16 |
15 |
$138.72 |
| J0665 |
Injection, bupivicaine, not otherwise specified, 0.5 mg |
879 |
729 |
$137.35 |
| 80164 |
|
26 |
24 |
$128.24 |
| 74022 |
|
197 |
192 |
$122.35 |
| 82310 |
|
38 |
38 |
$116.98 |
| 83605 |
|
3,296 |
3,030 |
$116.69 |
| 70498 |
|
13 |
13 |
$103.42 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
1,914 |
1,735 |
$103.28 |
| 99188 |
|
14 |
13 |
$96.73 |
| 84165 |
|
15 |
14 |
$89.40 |
| 87081 |
|
25 |
25 |
$88.16 |
| 90707 |
|
28 |
28 |
$81.01 |
| 87205 |
|
135 |
131 |
$75.97 |
| 86308 |
|
47 |
46 |
$68.25 |
| 72170 |
|
28 |
28 |
$57.04 |
| 83721 |
|
15 |
14 |
$56.08 |
| 82803 |
|
1,523 |
1,410 |
$54.21 |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
5,220 |
4,972 |
$53.71 |
| 85014 |
|
113 |
94 |
$53.60 |
| 86225 |
|
14 |
12 |
$51.84 |
| J0137 |
Injection, acetaminophen (hikma), not therapeutically equivalent to j0131, 10 mg |
66 |
63 |
$50.36 |
| 96127 |
|
12 |
12 |
$43.52 |
| J0136 |
Injection, acetaminophen (b braun), not therapeutically equivalent to j0131, 10 mg |
16 |
15 |
$38.28 |
| 94664 |
|
1,690 |
1,483 |
$35.51 |
| 82040 |
|
13 |
13 |
$34.21 |
| J1010 |
Injection, methylprednisolone acetate, 1 mg |
26 |
25 |
$32.67 |
| 87147 |
|
28 |
27 |
$32.54 |
| 86787 |
|
54 |
54 |
$31.09 |
| 90744 |
|
28 |
27 |
$28.23 |
| J2930 |
Injection, methylprednisolone sodium succinate, up to 125 mg |
140 |
129 |
$24.25 |
| 82140 |
|
27 |
26 |
$8.52 |
| Q0245 |
Injection, bamlanivimab and etesevimab, 2100 mg |
36 |
29 |
$8.51 |
| 85049 |
|
154 |
98 |
$6.81 |
| A9579 |
Injection, gadolinium-based magnetic resonance contrast agent, not otherwise specified (nos), per ml |
1,303 |
1,281 |
$3.99 |
| J0134 |
Injection, acetaminophen (fresenius kabi), not therapeutically equivalent to j0131, 10 mg |
142 |
128 |
$2.78 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
1,381 |
1,269 |
$2.72 |
| Q0247 |
Injection, sotrovimab, 500 mg |
19 |
19 |
$1.45 |
| J3420 |
Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg |
16 |
13 |
$1.31 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
341 |
301 |
$1.31 |
| Q0244 |
Injection, casirivimab and imdevimab, 1200 mg |
26 |
26 |
$0.25 |
| 90723 |
|
226 |
226 |
$0.00 |
| J1170 |
Injection, hydromorphone, up to 4 mg |
379 |
275 |
$0.00 |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
678 |
653 |
$0.00 |
| 82077 |
|
2,579 |
2,355 |
$0.00 |
| 96376 |
|
4,459 |
2,962 |
$0.00 |
| 91307 |
|
28 |
28 |
$0.00 |
| 90680 |
|
178 |
178 |
$0.00 |
| J2765 |
Injection, metoclopramide hcl, up to 10 mg |
285 |
238 |
$0.00 |
| J0690 |
Injection, cefazolin sodium, 500 mg |
248 |
200 |
$0.00 |
| J2060 |
Injection, lorazepam, 2 mg |
411 |
330 |
$0.00 |
| 91301 |
|
274 |
274 |
$0.00 |
| J2360 |
Injection, orphenadrine citrate, up to 60 mg |
51 |
49 |
$0.00 |
| 94761 |
|
274 |
188 |
$0.00 |
| J1630 |
Injection, haloperidol, up to 5 mg |
201 |
177 |
$0.00 |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
894 |
797 |
$0.00 |
| J7050 |
Infusion, normal saline solution, 250 cc |
761 |
425 |
$0.00 |
| A9270 |
Non-covered item or service |
526 |
367 |
$0.00 |
| J2704 |
Injection, propofol, 10 mg |
1,013 |
977 |
$0.00 |
| J2001 |
Injection, lidocaine hcl for intravenous infusion, 10 mg |
202 |
198 |
$0.00 |
| J3490 |
Unclassified drugs |
257 |
253 |
$0.00 |
| 94760 |
|
438 |
425 |
$0.00 |
| 90698 |
|
79 |
79 |
$0.00 |
| 90716 |
|
28 |
28 |
$0.00 |
| J3480 |
Injection, potassium chloride, per 2 meq |
42 |
26 |
$0.00 |
| J2003 |
Injection, lidocaine hydrochloride, 1 mg |
200 |
196 |
$0.00 |
| 12002 |
|
12 |
12 |
$0.00 |
| 91306 |
|
42 |
42 |
$0.00 |
| 70496 |
|
12 |
12 |
$0.00 |
| G0283 |
Electrical stimulation (unattended), to one or more areas for indication(s) other than wound care, as part of a therapy plan of care |
30 |
12 |
$0.00 |
| J1642 |
Injection, heparin sodium, (heparin lock flush), per 10 units |
78 |
25 |
$0.00 |
| 97802 |
|
12 |
12 |
$0.00 |
| J7999 |
Compounded drug, not otherwise classified |
14 |
14 |
$0.00 |
| 95886 |
|
12 |
12 |
$0.00 |
| J1580 |
Injection, garamycin, gentamicin, up to 80 mg |
12 |
12 |
$0.00 |
| J2919 |
Injection, methylprednisolone sodium succinate, 5 mg |
135 |
105 |
$0.00 |
| J0780 |
Injection, prochlorperazine, up to 10 mg |
243 |
220 |
$0.00 |
| 80143 |
|
1,678 |
1,564 |
$0.00 |
| A9577 |
Injection, gadobenate dimeglumine (multihance), per ml |
303 |
292 |
$0.00 |
| 80179 |
|
1,666 |
1,557 |
$0.00 |
| 90648 |
|
339 |
338 |
$0.00 |
| J1596 |
Injection, glycopyrrolate, 0.1 mg |
80 |
80 |
$0.00 |
| 82010 |
|
191 |
179 |
$0.00 |
| J1200 |
Injection, diphenhydramine hcl, up to 50 mg |
1,332 |
1,168 |
$0.00 |
| 12011 |
|
26 |
25 |
$0.00 |
| 94729 |
|
161 |
159 |
$0.00 |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
1,867 |
1,584 |
$0.00 |
| J3370 |
Injection, vancomycin hcl, 500 mg |
27 |
15 |
$0.00 |
| J1171 |
Injection, hydromorphone, 0.1 mg |
78 |
60 |
$0.00 |
| J1644 |
Injection, heparin sodium, per 1000 units |
346 |
207 |
$0.00 |
| 90633 |
|
41 |
41 |
$0.00 |
| G1004 |
Clinical decision support mechanism national decision support company, as defined by the medicare appropriate use criteria program |
52 |
43 |
$0.00 |
| J7040 |
Infusion, normal saline solution, sterile (500 ml = 1 unit) |
60 |
28 |
$0.00 |
| 99152 |
|
160 |
157 |
$0.00 |
| L1830 |
Knee orthosis, immobilizer, canvas longitudinal, prefabricated, off-the-shelf |
12 |
12 |
$0.00 |
| 91312 |
|
14 |
14 |
$0.00 |
| 91300 |
|
145 |
134 |
$0.00 |
| J0171 |
Injection, adrenalin, epinephrine, 0.1 mg |
13 |
12 |
$0.00 |
| 29125 |
|
27 |
26 |
$0.00 |
| C1713 |
Anchor/screw for opposing bone-to-bone or soft tissue-to-bone (implantable) |
16 |
16 |
$0.00 |
| 90681 |
|
25 |
25 |
$0.00 |
| J2004 |
Injection, lidocaine hcl with epinephrine, 1 mg |
15 |
15 |
$0.00 |
| 90461 |
|
13 |
13 |
$0.00 |
| 90734 |
|
24 |
24 |
$0.00 |
| J1756 |
Injection, iron sucrose, 1 mg |
41 |
15 |
$0.00 |
| 91313 |
|
14 |
14 |
$0.00 |