| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99284 |
Emergency department visit for the evaluation and management, high severity |
20,949 |
19,351 |
$4.11M |
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
83,835 |
75,873 |
$3.62M |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
11,683 |
10,859 |
$3.53M |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
19,074 |
18,364 |
$2.27M |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
9,406 |
8,550 |
$839K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
10,985 |
10,739 |
$547K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
15,395 |
14,801 |
$501K |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
5,130 |
4,318 |
$445K |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
3,237 |
3,173 |
$426K |
| 97112 |
Therapeutic procedure, each 15 minutes; neuromuscular reeducation of movement, balance, coordination |
14,346 |
4,915 |
$399K |
| 71046 |
Radiologic examination, chest; 2 views |
10,181 |
9,869 |
$351K |
| J0585 |
Injection, onabotulinumtoxina, 1 unit |
1,141 |
580 |
$335K |
| 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 |
4,692 |
4,557 |
$289K |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
4,164 |
4,092 |
$288K |
| 96375 |
Therapeutic injection; each additional sequential IV push |
8,369 |
7,349 |
$233K |
| 96360 |
Intravenous infusion, hydration; initial, 31 minutes to 1 hour |
2,373 |
2,058 |
$219K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
3,075 |
3,034 |
$207K |
| 70450 |
Computed tomography, head or brain; without contrast material |
2,977 |
2,897 |
$200K |
| 96361 |
Intravenous infusion, hydration; each additional hour |
8,424 |
7,255 |
$195K |
| U0002 |
2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc |
5,930 |
5,617 |
$192K |
| 97530 |
Therapeutic activities, direct patient contact, each 15 minutes |
7,286 |
2,910 |
$188K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
1,408 |
1,389 |
$151K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
8,279 |
7,979 |
$131K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
8,358 |
8,067 |
$131K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
6,841 |
6,675 |
$128K |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
2,208 |
2,175 |
$127K |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
5,998 |
2,012 |
$126K |
| 80061 |
Lipid panel |
8,490 |
8,417 |
$126K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
1,655 |
1,647 |
$111K |
| 97161 |
|
2,405 |
2,359 |
$106K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
2,429 |
2,412 |
$105K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
1,540 |
1,536 |
$102K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
1,452 |
1,440 |
$93K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
1,892 |
1,887 |
$89K |
| 86900 |
|
3,563 |
3,448 |
$83K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
1,266 |
1,260 |
$80K |
| 71045 |
Radiologic examination, chest; single view |
2,163 |
2,061 |
$79K |
| 36415 |
Collection of venous blood by venipuncture |
54,731 |
46,525 |
$75K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
1,151 |
1,149 |
$73K |
| 80053 |
Comprehensive metabolic panel |
33,376 |
30,389 |
$73K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
1,081 |
1,077 |
$69K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
1,072 |
1,058 |
$69K |
| 84443 |
Thyroid stimulating hormone (TSH) |
11,107 |
10,884 |
$69K |
| 82947 |
|
6,750 |
4,503 |
$66K |
| 71275 |
Computed tomographic angiography, chest, with contrast material |
728 |
717 |
$64K |
| 93975 |
|
481 |
476 |
$59K |
| 76830 |
Ultrasound, transvaginal |
957 |
947 |
$56K |
| 99215 |
Prolong outpt/office vis |
543 |
532 |
$50K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
5,363 |
5,269 |
$49K |
| 97140 |
Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) |
3,485 |
1,252 |
$46K |
| 70553 |
Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences |
206 |
206 |
$46K |
| 64615 |
|
486 |
486 |
$45K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
11,141 |
9,849 |
$43K |
| 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 |
630 |
603 |
$42K |
| 87624 |
Infectious agent detection by nucleic acid; human papillomavirus (HPV), high-risk types |
1,949 |
1,947 |
$39K |
| 41899 |
Unlisted procedure, dentoalveolar structures |
312 |
306 |
$38K |
| 71260 |
Computed tomography, thorax, diagnostic; with contrast material |
338 |
337 |
$36K |
| 87653 |
|
1,873 |
1,864 |
$36K |
| G0145 |
Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, with screening by automated system and manual rescreening under physician supervision |
2,480 |
2,464 |
$36K |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
3,439 |
3,408 |
$36K |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
4,121 |
4,093 |
$35K |
| 72148 |
Magnetic resonance imaging, lumbar spine; without contrast material |
338 |
338 |
$34K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
29,074 |
26,360 |
$33K |
| 43239 |
Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple |
108 |
107 |
$33K |
| 76982 |
|
597 |
594 |
$33K |
| 86780 |
|
4,043 |
3,980 |
$30K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
1,095 |
1,085 |
$28K |
| M0243 |
Intravenous infusion or subcutaneous injection, casirivimab and imdevimab includes infusion or injection, and post administration monitoring |
108 |
107 |
$28K |
| G0378 |
Hospital observation service, per hour |
1,501 |
1,255 |
$26K |
| 88342 |
|
1,341 |
897 |
$24K |
| 45380 |
Colonoscopy, flexible; with biopsy, single or multiple |
56 |
56 |
$24K |
| 85027 |
|
11,865 |
10,462 |
$24K |
| 59025 |
Fetal non-stress test |
272 |
123 |
$23K |
| 74018 |
|
925 |
857 |
$23K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
6,609 |
6,499 |
$23K |
| 76770 |
|
427 |
422 |
$22K |
| 96366 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour |
687 |
439 |
$22K |
| 73564 |
|
1,680 |
1,656 |
$21K |
| 93971 |
|
406 |
399 |
$21K |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
5,803 |
5,448 |
$21K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
427 |
426 |
$21K |
| 90686 |
|
2,343 |
2,328 |
$21K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
1,382 |
1,376 |
$21K |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
1,687 |
1,687 |
$21K |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
4,189 |
3,015 |
$20K |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
11,536 |
10,898 |
$20K |
| 73721 |
Magnetic resonance imaging, any joint of lower extremity; without contrast material |
156 |
156 |
$19K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
16,075 |
8,028 |
$18K |
| 87070 |
|
8,469 |
8,179 |
$18K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
8,391 |
6,904 |
$17K |
| 70496 |
|
101 |
101 |
$16K |
| 84702 |
|
2,960 |
2,151 |
$15K |
| 96413 |
Chemotherapy administration, intravenous infusion; up to 1 hour, single or initial substance |
110 |
106 |
$15K |
| 10060 |
|
195 |
147 |
$15K |
| 82607 |
|
2,364 |
2,345 |
$15K |
| 87428 |
|
690 |
680 |
$14K |
| 92557 |
|
387 |
383 |
$14K |
| 82728 |
|
1,943 |
1,926 |
$13K |
| 88175 |
Cytopathology, cervical or vaginal, any reporting system; collected in preservative fluid, automated thin layer |
703 |
701 |
$13K |
| 97162 |
|
307 |
307 |
$12K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
9,093 |
8,927 |
$12K |
| 12001 |
|
920 |
704 |
$12K |
| 86141 |
|
3,262 |
3,113 |
$12K |
| 87340 |
|
3,429 |
3,384 |
$11K |
| 76801 |
|
199 |
196 |
$11K |
| 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 |
4,064 |
3,593 |
$11K |
| 45385 |
Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) |
25 |
25 |
$11K |
| 74019 |
|
1,672 |
1,640 |
$10K |
| 73630 |
|
1,705 |
1,682 |
$10K |
| 86803 |
|
1,489 |
1,484 |
$10K |
| 86481 |
|
241 |
241 |
$10K |
| 87186 |
|
4,194 |
3,899 |
$10K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
177 |
169 |
$9K |
| 84466 |
|
1,521 |
1,508 |
$9K |
| 72110 |
|
271 |
271 |
$9K |
| 93306 |
Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete |
56 |
56 |
$9K |
| 76641 |
|
761 |
761 |
$8K |
| M0245 |
Intravenous infusion, bamlanivimab and etesevimab, includes infusion and post administration monitoring |
29 |
29 |
$8K |
| L4350 |
Ankle control orthosis, stirrup style, rigid, includes any type interface (e.g., pneumatic, gel), prefabricated, off-the-shelf |
157 |
156 |
$8K |
| 73610 |
|
1,514 |
1,465 |
$7K |
| 84403 |
|
524 |
512 |
$7K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
11,692 |
10,112 |
$7K |
| 81025 |
|
13,536 |
12,793 |
$7K |
| 84439 |
|
1,616 |
1,587 |
$6K |
| 73030 |
|
825 |
790 |
$6K |
| 87081 |
|
1,804 |
1,789 |
$6K |
| 87088 |
|
3,366 |
3,161 |
$6K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
107 |
107 |
$6K |
| 92551 |
|
939 |
935 |
$6K |
| 72141 |
|
53 |
53 |
$6K |
| 91320 |
|
59 |
59 |
$6K |
| 77066 |
Tomosynthesis, mammo |
104 |
104 |
$6K |
| 81001 |
|
8,679 |
8,257 |
$6K |
| 97802 |
|
83 |
83 |
$5K |
| G0279 |
Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066) |
488 |
486 |
$5K |
| M0247 |
Intravenous infusion, sotrovimab, includes infusion and post administration monitoring |
21 |
21 |
$5K |
| 84146 |
|
536 |
517 |
$5K |
| 83540 |
|
1,641 |
1,623 |
$5K |
| 76536 |
|
114 |
112 |
$5K |
| 70551 |
Magnetic resonance imaging, brain; without contrast material |
40 |
40 |
$5K |
| 86762 |
|
1,750 |
1,742 |
$5K |
| 90670 |
|
308 |
307 |
$5K |
| 73110 |
|
898 |
882 |
$5K |
| 87633 |
Infectious agent detection by nucleic acid, respiratory virus, 12-25 targets |
527 |
523 |
$4K |
| 73130 |
|
903 |
890 |
$4K |
| 82570 |
|
2,040 |
1,934 |
$4K |
| 86480 |
|
217 |
217 |
$4K |
| 72100 |
|
252 |
249 |
$4K |
| 86850 |
|
3,483 |
3,367 |
$4K |
| 85610 |
|
7,014 |
6,104 |
$4K |
| 82746 |
|
545 |
541 |
$4K |
| 83735 |
|
2,716 |
1,973 |
$4K |
| 87205 |
|
2,511 |
2,370 |
$4K |
| 83880 |
|
919 |
883 |
$4K |
| 96367 |
|
146 |
122 |
$4K |
| 73140 |
|
826 |
803 |
$4K |
| 12011 |
|
209 |
162 |
$3K |
| 82950 |
|
1,165 |
1,163 |
$3K |
| G0103 |
Prostate cancer screening; prostate specific antigen test (psa) |
302 |
302 |
$3K |
| 95806 |
|
40 |
39 |
$3K |
| 86003 |
|
106 |
55 |
$3K |
| 85018 |
|
3,240 |
2,947 |
$3K |
| 72125 |
Computed tomography, cervical spine; without contrast material |
236 |
232 |
$3K |
| 0124A |
|
120 |
118 |
$3K |
| 0003A |
|
71 |
70 |
$3K |
| 85652 |
|
2,664 |
2,560 |
$3K |
| 83001 |
|
252 |
251 |
$3K |
| 86225 |
|
398 |
394 |
$3K |
| 82043 |
|
832 |
828 |
$2K |
| 83655 |
|
400 |
394 |
$2K |
| 81003 |
|
18,481 |
17,608 |
$2K |
| 80076 |
|
544 |
529 |
$2K |
| 86235 |
|
97 |
49 |
$2K |
| 83690 |
|
6,740 |
6,305 |
$2K |
| 84484 |
|
7,864 |
5,983 |
$2K |
| 77065 |
Tomosynthesis, mammo |
56 |
51 |
$2K |
| 88304 |
|
334 |
309 |
$2K |
| 87632 |
|
186 |
184 |
$2K |
| 87807 |
|
3,121 |
3,066 |
$2K |
| 51798 |
|
462 |
429 |
$2K |
| 90480 |
|
59 |
59 |
$2K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
221 |
207 |
$2K |
| 86200 |
|
285 |
284 |
$2K |
| 85730 |
|
5,447 |
5,083 |
$2K |
| 82670 |
|
98 |
97 |
$2K |
| 0002A |
|
40 |
40 |
$2K |
| 70491 |
|
13 |
13 |
$2K |
| 87529 |
|
167 |
84 |
$1K |
| 71101 |
|
172 |
171 |
$1K |
| 93017 |
|
61 |
61 |
$1K |
| 80074 |
|
62 |
62 |
$1K |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
3,278 |
2,585 |
$1K |
| 86901 |
|
3,975 |
3,807 |
$1K |
| 96127 |
|
513 |
483 |
$1K |
| 73502 |
|
142 |
142 |
$1K |
| 84550 |
|
559 |
556 |
$1K |
| 83970 |
|
59 |
59 |
$1K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
12 |
12 |
$1K |
| 84156 |
|
989 |
901 |
$1K |
| 90656 |
|
59 |
59 |
$1K |
| 85007 |
|
1,952 |
1,825 |
$1K |
| 86431 |
|
377 |
376 |
$987.09 |
| 87210 |
|
1,971 |
1,922 |
$961.24 |
| 86038 |
|
158 |
155 |
$892.64 |
| 82784 |
|
164 |
139 |
$868.79 |
| 0001A |
|
22 |
22 |
$832.70 |
| 80164 |
|
189 |
166 |
$813.70 |
| 97535 |
Self-care/home management training, each 15 minutes |
30 |
24 |
$805.04 |
| 87040 |
|
2,141 |
1,198 |
$784.32 |
| 86039 |
|
139 |
139 |
$743.87 |
| 73080 |
|
189 |
185 |
$732.98 |
| 83516 |
|
137 |
105 |
$719.96 |
| 85379 |
|
2,068 |
2,031 |
$696.52 |
| 83605 |
|
2,991 |
2,444 |
$689.05 |
| 90651 |
|
40 |
40 |
$688.02 |
| 86160 |
|
156 |
79 |
$673.80 |
| 71271 |
|
12 |
12 |
$656.04 |
| 29125 |
|
41 |
25 |
$654.87 |
| 93246 |
|
51 |
51 |
$650.42 |
| 72050 |
|
12 |
12 |
$648.40 |
| 87661 |
Infectious agent detection by nucleic acid; Trichomonas vaginalis, amplified probe |
46 |
46 |
$632.93 |
| 77080 |
|
12 |
12 |
$630.30 |
| 73590 |
|
131 |
129 |
$624.70 |
| 90672 |
|
40 |
40 |
$618.24 |
| 99459 |
|
77 |
45 |
$496.38 |
| 84145 |
|
603 |
569 |
$468.50 |
| G0008 |
Administration of influenza virus vaccine |
123 |
123 |
$446.21 |
| 84703 |
|
702 |
695 |
$434.27 |
| 84207 |
|
28 |
27 |
$418.50 |
| 86706 |
|
97 |
96 |
$416.69 |
| 86308 |
|
534 |
526 |
$413.25 |
| 83002 |
|
39 |
39 |
$395.88 |
| 92567 |
|
692 |
684 |
$300.84 |
| 82805 |
|
98 |
84 |
$294.30 |
| 72040 |
|
25 |
25 |
$241.95 |
| 90473 |
|
26 |
26 |
$228.64 |
| 84100 |
|
225 |
131 |
$226.95 |
| 82550 |
|
147 |
138 |
$208.40 |
| 82565 |
|
447 |
428 |
$199.39 |
| 87493 |
|
13 |
13 |
$198.59 |
| 86665 |
|
46 |
26 |
$196.71 |
| 84144 |
|
25 |
24 |
$189.44 |
| 76870 |
|
12 |
12 |
$178.92 |
| 81002 |
|
849 |
787 |
$174.50 |
| 73090 |
|
125 |
119 |
$161.79 |
| 88341 |
|
41 |
25 |
$146.40 |
| 69210 |
|
25 |
25 |
$145.85 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
10,430 |
9,564 |
$132.81 |
| 84460 |
|
54 |
54 |
$130.03 |
| 88313 |
|
47 |
41 |
$108.75 |
| 82247 |
|
30 |
24 |
$97.62 |
| 69209 |
|
64 |
64 |
$95.37 |
| 84425 |
|
13 |
13 |
$89.26 |
| 80178 |
|
32 |
29 |
$84.93 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
7,681 |
7,433 |
$84.49 |
| 86664 |
|
26 |
26 |
$82.97 |
| 85014 |
|
491 |
454 |
$77.12 |
| 86376 |
|
12 |
12 |
$71.64 |
| 12002 |
|
27 |
26 |
$66.17 |
| 90837 |
Psychotherapy, 53 minutes with patient |
19 |
12 |
$65.04 |
| 84165 |
|
12 |
12 |
$61.63 |
| 80051 |
|
430 |
409 |
$55.63 |
| J0665 |
Injection, bupivicaine, not otherwise specified, 0.5 mg |
677 |
477 |
$50.31 |
| 73660 |
|
37 |
36 |
$49.10 |
| L3908 |
Wrist hand orthosis, wrist extension control cock-up, non molded, prefabricated, off-the-shelf |
311 |
303 |
$47.08 |
| 82375 |
|
98 |
84 |
$46.02 |
| A9577 |
Injection, gadobenate dimeglumine (multihance), per ml |
1,273 |
1,256 |
$44.00 |
| 90474 |
|
14 |
14 |
$42.00 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
1,943 |
1,696 |
$40.56 |
| J0131 |
Injection, acetaminophen, not otherwise specified,10 mg |
2,022 |
1,880 |
$40.46 |
| 82140 |
|
13 |
13 |
$36.22 |
| J0689 |
Injection, cefazolin sodium (baxter), not therapeutically equivalent to j0690, 500 mg |
653 |
588 |
$35.67 |
| 96376 |
|
2,517 |
1,794 |
$35.11 |
| J2550 |
Injection, promethazine hcl, up to 50 mg |
2,669 |
2,310 |
$33.97 |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
6,950 |
6,433 |
$33.25 |
| J2930 |
Injection, methylprednisolone sodium succinate, up to 125 mg |
298 |
278 |
$33.11 |
| J0137 |
Injection, acetaminophen (hikma), not therapeutically equivalent to j0131, 10 mg |
17 |
16 |
$31.11 |
| 99173 |
|
892 |
888 |
$28.00 |
| J2270 |
Injection, morphine sulfate, up to 10 mg |
2,222 |
1,893 |
$24.74 |
| 84155 |
|
13 |
13 |
$21.07 |
| 83050 |
|
68 |
60 |
$18.98 |
| 84520 |
|
315 |
302 |
$16.62 |
| J1170 |
Injection, hydromorphone, up to 4 mg |
2,863 |
1,949 |
$15.29 |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
10,650 |
9,268 |
$15.02 |
| J2360 |
Injection, orphenadrine citrate, up to 60 mg |
522 |
501 |
$9.75 |
| J1200 |
Injection, diphenhydramine hcl, up to 50 mg |
4,273 |
4,028 |
$9.44 |
| 85048 |
|
154 |
148 |
$8.87 |
| 36416 |
|
6,040 |
5,363 |
$7.75 |
| A9270 |
Non-covered item or service |
62,811 |
28,354 |
$3.28 |
| J7512 |
Prednisone, immediate release or delayed release, oral, 1 mg |
990 |
886 |
$3.00 |
| 94760 |
|
477 |
450 |
$2.16 |
| G1004 |
Clinical decision support mechanism national decision support company, as defined by the medicare appropriate use criteria program |
1,657 |
1,628 |
$0.00 |
| G8979 |
Mobility: walking & moving around functional limitation, projected goal status, at therapy episode outset, at reporting intervals, and at discharge or to end reporting |
639 |
543 |
$0.00 |
| J1644 |
Injection, heparin sodium, per 1000 units |
514 |
264 |
$0.00 |
| 91300 |
|
224 |
209 |
$0.00 |
| J0136 |
Injection, acetaminophen (b braun), not therapeutically equivalent to j0131, 10 mg |
568 |
539 |
$0.00 |
| 90715 |
|
1,558 |
1,551 |
$0.00 |
| J0780 |
Injection, prochlorperazine, up to 10 mg |
64 |
62 |
$0.00 |
| G8984 |
Carrying, moving & handling objects functional limitation, current status, at therapy episode outset and at reporting intervals |
168 |
145 |
$0.00 |
| 91312 |
|
118 |
116 |
$0.00 |
| J7120 |
Ringers lactate infusion, up to 1000 cc |
123 |
117 |
$0.00 |
| J2919 |
Injection, methylprednisolone sodium succinate, 5 mg |
90 |
86 |
$0.00 |
| 76942 |
|
66 |
65 |
$0.00 |
| C9113 |
Injection, pantoprazole sodium, per vial |
135 |
122 |
$0.00 |
| J2272 |
Injection, morphine sulfate (fresenius kabi), not therapeutically equivalent to j2270, up to 10 mg |
390 |
346 |
$0.00 |
| G8978 |
Mobility: walking & moving around functional limitation, current status, at therapy episode outset and at reporting intervals |
487 |
437 |
$0.00 |
| G8985 |
Carrying, moving and handling objects, projected goal status, at therapy episode outset, at reporting intervals, and at discharge or to end reporting |
262 |
213 |
$0.00 |
| C1713 |
Anchor/screw for opposing bone-to-bone or soft tissue-to-bone (implantable) |
171 |
168 |
$0.00 |
| 99152 |
|
72 |
69 |
$0.00 |
| J2710 |
Injection, neostigmine methylsulfate, up to 0.5 mg |
43 |
42 |
$0.00 |
| S0119 |
Ondansetron, oral, 4 mg (for circumstances falling under the medicare statute, use hcpcs q code) |
15 |
15 |
$0.00 |
| J7510 |
Prednisolone oral, per 5 mg |
28 |
26 |
$0.00 |
| J3260 |
Injection, tobramycin sulfate, up to 80 mg |
12 |
12 |
$0.00 |
| 90734 |
|
26 |
26 |
$0.00 |
| J3475 |
Injection, magnesium sulfate, per 500 mg |
16 |
14 |
$0.00 |
| J0134 |
Injection, acetaminophen (fresenius kabi), not therapeutically equivalent to j0131, 10 mg |
31 |
31 |
$0.00 |
| J2704 |
Injection, propofol, 10 mg |
6,996 |
6,715 |
$0.00 |
| J2370 |
Injection, phenylephrine hcl, up to 1 ml |
146 |
143 |
$0.00 |
| 76820 |
|
131 |
79 |
$0.00 |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
6,742 |
5,569 |
$0.00 |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
7,149 |
6,000 |
$0.00 |
| J2003 |
Injection, lidocaine hydrochloride, 1 mg |
90 |
72 |
$0.00 |
| J1815 |
Injection, insulin, per 5 units |
438 |
261 |
$0.00 |
| 97010 |
|
897 |
409 |
$0.00 |
| 90647 |
|
130 |
129 |
$0.00 |
| J1790 |
Injection, droperidol, up to 5 mg |
249 |
233 |
$0.00 |
| J0690 |
Injection, cefazolin sodium, 500 mg |
1,535 |
1,403 |
$0.00 |
| G8980 |
Mobility: walking & moving around functional limitation, discharge status, at discharge from therapy or to end reporting |
145 |
137 |
$0.00 |
| 91307 |
|
36 |
32 |
$0.00 |
| J2060 |
Injection, lorazepam, 2 mg |
1,353 |
1,191 |
$0.00 |
| J2765 |
Injection, metoclopramide hcl, up to 10 mg |
290 |
277 |
$0.00 |
| J0330 |
Injection, succinylcholine chloride, up to 20 mg |
71 |
70 |
$0.00 |
| 91305 |
|
60 |
60 |
$0.00 |
| J3411 |
Injection, thiamine hcl, 100 mg |
215 |
190 |
$0.00 |
| 70498 |
|
12 |
12 |
$0.00 |
| J2372 |
Injection, phenylephrine hydrochloride (biorphen), 20 micrograms |
58 |
54 |
$0.00 |
| J7620 |
Albuterol, up to 2.5 mg and ipratropium bromide, up to 0.5 mg, fda-approved final product, non-compounded, administered through dme |
15 |
15 |
$0.00 |
| 0346T |
|
59 |
59 |
$0.00 |
| J1010 |
Injection, methylprednisolone acetate, 1 mg |
13 |
13 |
$0.00 |
| J2371 |
Injection, phenylephrine hydrochloride, 20 micrograms |
12 |
12 |
$0.00 |
| 99153 |
Mod sedat endo service >5yrs |
14 |
13 |
$0.00 |
| 90723 |
|
56 |
56 |
$0.00 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
76 |
75 |
$0.00 |
| G0399 |
Home sleep test (hst) with type iii portable monitor, unattended; minimum of 4 channels: 2 respiratory movement/airflow, 1 ecg/heart rate and 1 oxygen saturation |
12 |
12 |
$0.00 |