| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
51,637 |
45,498 |
$8.63M |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
52,968 |
48,288 |
$8.25M |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
41,517 |
38,179 |
$6.46M |
| 96361 |
Intravenous infusion, hydration; each additional hour |
12,534 |
10,920 |
$4.26M |
| 70450 |
Computed tomography, head or brain; without contrast material |
19,212 |
17,447 |
$2.39M |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
13,619 |
12,588 |
$2.06M |
| 43239 |
Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple |
1,978 |
1,910 |
$1.48M |
| S9485 |
Crisis intervention mental health services, per diem |
1,872 |
1,691 |
$1.14M |
| 45378 |
Colonoscopy, flexible; diagnostic, including collection of specimen(s) |
1,886 |
1,696 |
$1.10M |
| 93306 |
Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete |
5,630 |
5,218 |
$988K |
| 45385 |
Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) |
1,455 |
1,334 |
$955K |
| 59025 |
Fetal non-stress test |
3,728 |
2,845 |
$946K |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
5,971 |
5,604 |
$819K |
| 62323 |
|
1,820 |
1,788 |
$809K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
7,431 |
7,163 |
$788K |
| 99281 |
Emergency department visit for the evaluation and management, self-limited or minor |
4,713 |
4,359 |
$747K |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
19,910 |
16,972 |
$680K |
| 71046 |
Radiologic examination, chest; 2 views |
36,028 |
33,457 |
$675K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
11,959 |
11,819 |
$664K |
| 70551 |
Magnetic resonance imaging, brain; without contrast material |
2,240 |
2,084 |
$661K |
| 76830 |
Ultrasound, transvaginal |
6,714 |
6,487 |
$649K |
| 78452 |
Myocardial perfusion imaging, tomographic (SPECT); multiple studies at rest and/or stress |
1,650 |
1,556 |
$631K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
3,688 |
3,375 |
$610K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
3,534 |
3,347 |
$576K |
| G0378 |
Hospital observation service, per hour |
20,042 |
7,753 |
$566K |
| 71275 |
Computed tomographic angiography, chest, with contrast material |
2,911 |
2,691 |
$534K |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
5,083 |
4,525 |
$526K |
| 96360 |
Intravenous infusion, hydration; initial, 31 minutes to 1 hour |
4,026 |
3,733 |
$494K |
| 64493 |
|
891 |
842 |
$492K |
| 93971 |
|
2,699 |
2,535 |
$477K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
3,088 |
2,267 |
$467K |
| 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 |
8,762 |
7,873 |
$463K |
| 45380 |
Colonoscopy, flexible; with biopsy, single or multiple |
649 |
601 |
$444K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
90,727 |
71,191 |
$418K |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
5,490 |
4,928 |
$411K |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
3,895 |
3,694 |
$355K |
| 76642 |
|
4,520 |
3,731 |
$323K |
| 76801 |
|
3,102 |
2,779 |
$314K |
| 76700 |
Ultrasound, abdominal, real time with image documentation; complete |
2,269 |
2,219 |
$313K |
| 72148 |
Magnetic resonance imaging, lumbar spine; without contrast material |
1,360 |
1,299 |
$287K |
| 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 |
10,517 |
9,165 |
$277K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
6,130 |
5,647 |
$272K |
| 62321 |
|
616 |
601 |
$266K |
| 93017 |
|
2,424 |
2,302 |
$238K |
| 99291 |
Critical care, evaluation and management of the critically ill patient, first 30-74 minutes |
2,243 |
2,065 |
$226K |
| 84484 |
|
38,363 |
23,131 |
$225K |
| ATP14 |
|
22,356 |
17,957 |
$203K |
| 76536 |
|
2,086 |
2,033 |
$194K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
3,248 |
2,908 |
$191K |
| 11042 |
Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm |
1,866 |
943 |
$182K |
| 71250 |
|
2,712 |
2,595 |
$172K |
| 73562 |
|
6,975 |
6,018 |
$169K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
6,793 |
6,305 |
$167K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
16,193 |
7,962 |
$165K |
| 96366 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour |
648 |
580 |
$163K |
| 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 |
9,398 |
8,503 |
$160K |
| 70553 |
Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences |
445 |
408 |
$155K |
| 71260 |
Computed tomography, thorax, diagnostic; with contrast material |
2,716 |
2,502 |
$141K |
| 94060 |
|
1,442 |
1,347 |
$134K |
| 76819 |
Fetal biophysical profile; without non-stress testing |
1,134 |
886 |
$133K |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
1,769 |
656 |
$129K |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
1,768 |
1,744 |
$128K |
| 12001 |
|
613 |
591 |
$127K |
| 76770 |
|
886 |
853 |
$124K |
| 73030 |
|
5,577 |
5,088 |
$124K |
| 80053 |
Comprehensive metabolic panel |
47,604 |
40,864 |
$123K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
42,098 |
36,348 |
$117K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
742 |
612 |
$116K |
| 72141 |
|
432 |
413 |
$110K |
| 0241U |
Neonatal screening for hereditary disorders, genomic sequence analysis panel |
3,439 |
3,205 |
$108K |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
23,524 |
21,053 |
$105K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
540 |
363 |
$104K |
| ATP08 |
|
14,646 |
11,129 |
$103K |
| 43235 |
|
187 |
172 |
$98K |
| 72110 |
|
2,368 |
2,317 |
$98K |
| 76811 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, detailed |
429 |
409 |
$95K |
| 73721 |
Magnetic resonance imaging, any joint of lower extremity; without contrast material |
283 |
262 |
$94K |
| 81025 |
|
17,130 |
15,579 |
$92K |
| 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 |
1,531 |
1,397 |
$88K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
372 |
356 |
$85K |
| 77065 |
Tomosynthesis, mammo |
2,408 |
2,202 |
$83K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
48,560 |
37,406 |
$82K |
| 73630 |
|
3,646 |
3,311 |
$79K |
| 77062 |
|
1,444 |
1,409 |
$79K |
| 83690 |
|
16,698 |
14,946 |
$79K |
| 70486 |
|
1,857 |
1,768 |
$78K |
| 73610 |
|
4,235 |
3,959 |
$77K |
| 72100 |
|
2,638 |
2,547 |
$77K |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
14,325 |
13,125 |
$77K |
| 84702 |
|
6,381 |
5,683 |
$77K |
| 73130 |
|
3,952 |
3,493 |
$75K |
| 71045 |
Radiologic examination, chest; single view |
12,469 |
11,023 |
$73K |
| 77061 |
|
1,104 |
1,078 |
$72K |
| 77080 |
|
1,270 |
1,246 |
$71K |
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
2,983 |
2,006 |
$70K |
| ATP15 |
|
7,679 |
6,317 |
$68K |
| 81001 |
|
30,360 |
27,393 |
$66K |
| 82947 |
|
23,544 |
11,826 |
$65K |
| 87428 |
|
1,328 |
1,246 |
$65K |
| 83880 |
|
4,418 |
3,913 |
$64K |
| 87651 |
Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe |
2,148 |
2,069 |
$60K |
| 70498 |
|
476 |
426 |
$59K |
| 93970 |
|
369 |
329 |
$58K |
| 19083 |
|
82 |
72 |
$58K |
| 84600 |
|
5,311 |
4,473 |
$57K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
373 |
318 |
$57K |
| 87631 |
|
600 |
564 |
$56K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
2,284 |
2,103 |
$55K |
| 72125 |
Computed tomography, cervical spine; without contrast material |
7,864 |
7,271 |
$54K |
| 86850 |
|
8,379 |
7,623 |
$53K |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
7,831 |
7,223 |
$53K |
| 90715 |
|
2,276 |
2,169 |
$53K |
| 94726 |
|
1,196 |
1,120 |
$51K |
| 64494 |
|
741 |
544 |
$51K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
2,090 |
1,922 |
$50K |
| 76818 |
|
607 |
426 |
$49K |
| 93975 |
|
873 |
813 |
$47K |
| 72131 |
|
1,842 |
1,717 |
$46K |
| 64721 |
|
108 |
108 |
$46K |
| 83735 |
|
13,268 |
9,281 |
$45K |
| 73110 |
|
2,301 |
2,104 |
$44K |
| 87502 |
Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets |
744 |
704 |
$43K |
| 73502 |
|
1,944 |
1,829 |
$43K |
| 94729 |
|
1,232 |
1,155 |
$42K |
| 74018 |
|
1,511 |
1,376 |
$41K |
| 83605 |
|
7,054 |
5,402 |
$40K |
| 87040 |
|
5,599 |
3,433 |
$40K |
| 76870 |
|
436 |
419 |
$39K |
| 76813 |
|
184 |
181 |
$36K |
| 82805 |
|
1,385 |
1,138 |
$36K |
| 74183 |
|
78 |
77 |
$36K |
| 77066 |
Tomosynthesis, mammo |
1,909 |
1,841 |
$34K |
| 84703 |
|
6,063 |
5,688 |
$34K |
| 12011 |
|
157 |
153 |
$30K |
| 84443 |
Thyroid stimulating hormone (TSH) |
4,383 |
3,866 |
$30K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
2,833 |
2,717 |
$28K |
| 72050 |
|
314 |
311 |
$27K |
| 73221 |
|
64 |
59 |
$27K |
| 81003 |
|
17,644 |
16,208 |
$26K |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
21,284 |
16,586 |
$25K |
| 86900 |
|
8,528 |
7,758 |
$25K |
| 80050 |
General health panel |
1,815 |
1,620 |
$24K |
| 73080 |
|
1,361 |
1,246 |
$23K |
| 96375 |
Therapeutic injection; each additional sequential IV push |
15,288 |
13,198 |
$22K |
| 87081 |
|
4,341 |
4,165 |
$22K |
| 85027 |
|
6,556 |
5,133 |
$21K |
| 64483 |
|
42 |
41 |
$21K |
| 70491 |
|
238 |
209 |
$21K |
| 85379 |
|
3,068 |
2,858 |
$20K |
| J2704 |
Injection, propofol, 10 mg |
17,955 |
13,596 |
$20K |
| 99219 |
|
75 |
40 |
$20K |
| 71271 |
|
402 |
398 |
$20K |
| 36415 |
Collection of venous blood by venipuncture |
33,827 |
24,160 |
$19K |
| 97161 |
|
543 |
436 |
$18K |
| G0297 |
Low dose ct scan (ldct) for lung cancer screening |
101 |
95 |
$18K |
| 73140 |
|
890 |
840 |
$18K |
| 12002 |
|
96 |
91 |
$18K |
| 86901 |
|
8,491 |
7,722 |
$18K |
| 72070 |
|
472 |
457 |
$18K |
| 72052 |
|
352 |
347 |
$18K |
| 87186 |
|
3,283 |
2,973 |
$17K |
| 80076 |
|
13,624 |
12,073 |
$17K |
| 85610 |
|
9,331 |
7,452 |
$17K |
| 88304 |
|
1,719 |
1,613 |
$17K |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
15,313 |
9,890 |
$17K |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
5,117 |
3,615 |
$16K |
| 70544 |
|
28 |
25 |
$16K |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
15,671 |
12,728 |
$16K |
| J7030 |
Infusion, normal saline solution , 1000 cc |
14,666 |
10,539 |
$16K |
| 10060 |
|
100 |
91 |
$15K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
11,507 |
9,392 |
$14K |
| 87807 |
|
1,283 |
1,258 |
$14K |
| J1650 |
Injection, enoxaparin sodium, 10 mg |
1,508 |
549 |
$12K |
| J2270 |
Injection, morphine sulfate, up to 10 mg |
9,997 |
6,367 |
$12K |
| 88342 |
|
2,902 |
2,742 |
$12K |
| 74019 |
|
273 |
261 |
$12K |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
11,851 |
11,080 |
$12K |
| J1644 |
Injection, heparin sodium, per 1000 units |
4,371 |
1,740 |
$12K |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
7,136 |
6,307 |
$10K |
| 87077 |
|
2,205 |
2,017 |
$10K |
| 87070 |
|
2,051 |
1,782 |
$10K |
| J7120 |
Ringers lactate infusion, up to 1000 cc |
2,551 |
1,952 |
$9K |
| 85730 |
|
3,073 |
2,778 |
$9K |
| J0690 |
Injection, cefazolin sodium, 500 mg |
7,285 |
5,077 |
$9K |
| J3490 |
Unclassified drugs |
416 |
368 |
$9K |
| 76882 |
|
93 |
79 |
$9K |
| 73590 |
|
584 |
528 |
$8K |
| J1040 |
Injection, methylprednisolone acetate, 80 mg |
6,200 |
5,987 |
$8K |
| 36430 |
|
27 |
24 |
$8K |
| 93225 |
|
137 |
134 |
$8K |
| 71100 |
|
133 |
129 |
$8K |
| 70496 |
|
327 |
288 |
$8K |
| 80179 |
|
1,482 |
1,413 |
$7K |
| 87430 |
|
715 |
680 |
$7K |
| 72040 |
|
150 |
147 |
$7K |
| J2060 |
Injection, lorazepam, 2 mg |
8,049 |
5,237 |
$7K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
1,800 |
1,452 |
$7K |
| 82553 |
|
1,814 |
1,224 |
$7K |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
7,028 |
6,172 |
$6K |
| 85007 |
|
3,330 |
2,637 |
$6K |
| ATP02 |
|
2,131 |
1,502 |
$6K |
| 80143 |
|
1,498 |
1,406 |
$6K |
| J1170 |
Injection, hydromorphone, up to 4 mg |
5,991 |
2,844 |
$5K |
| 84112 |
|
69 |
63 |
$5K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
3,153 |
2,904 |
$5K |
| 58340 |
|
28 |
28 |
$5K |
| 87205 |
|
1,855 |
1,608 |
$5K |
| 73620 |
|
185 |
171 |
$5K |
| 87486 |
|
176 |
161 |
$5K |
| 87147 |
|
761 |
667 |
$4K |
| 88341 |
|
537 |
485 |
$4K |
| J1630 |
Injection, haloperidol, up to 5 mg |
4,491 |
3,031 |
$4K |
| 73564 |
|
198 |
169 |
$4K |
| 74740 |
|
30 |
28 |
$4K |
| 31500 |
|
15 |
13 |
$4K |
| ATP09 |
|
649 |
429 |
$4K |
| J2001 |
Injection, lidocaine hcl for intravenous infusion, 10 mg |
5,889 |
5,303 |
$4K |
| J3370 |
Injection, vancomycin hcl, 500 mg |
1,501 |
696 |
$4K |
| 86140 |
|
1,308 |
1,082 |
$4K |
| J7512 |
Prednisone, immediate release or delayed release, oral, 1 mg |
2,754 |
2,091 |
$4K |
| U0002 |
2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc |
1,221 |
1,132 |
$4K |
| J3475 |
Injection, magnesium sulfate, per 500 mg |
1,088 |
758 |
$4K |
| 82550 |
|
3,647 |
2,660 |
$3K |
| 87088 |
|
571 |
533 |
$3K |
| 87798 |
Infectious agent detection by nucleic acid; not otherwise specified, amplified probe, each organism |
94 |
53 |
$3K |
| 85652 |
|
1,682 |
1,394 |
$2K |
| 88307 |
|
64 |
52 |
$2K |
| J0574 |
Buprenorphine/naloxone, oral, greater than 6 mg, but less than or equal to 10 mg buprenorphine |
43 |
24 |
$2K |
| 82607 |
|
411 |
330 |
$2K |
| 73090 |
|
229 |
223 |
$2K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
12 |
12 |
$2K |
| 87661 |
Infectious agent detection by nucleic acid; Trichomonas vaginalis, amplified probe |
97 |
86 |
$2K |
| 97530 |
Therapeutic activities, direct patient contact, each 15 minutes |
67 |
39 |
$2K |
| 93880 |
|
12 |
12 |
$2K |
| 72072 |
|
60 |
57 |
$2K |
| 17250 |
|
43 |
24 |
$2K |
| J1200 |
Injection, diphenhydramine hcl, up to 50 mg |
2,873 |
2,166 |
$2K |
| 73560 |
|
141 |
120 |
$2K |
| 87801 |
Infectious agent detection by nucleic acid; amplified probe, multiple organisms |
41 |
38 |
$2K |
| J0131 |
Injection, acetaminophen, not otherwise specified,10 mg |
1,097 |
985 |
$2K |
| 82746 |
|
296 |
238 |
$2K |
| G0279 |
Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066) |
94 |
94 |
$1K |
| 82565 |
|
3,353 |
2,970 |
$1K |
| 97597 |
|
123 |
80 |
$1K |
| 85049 |
|
495 |
473 |
$1K |
| 76775 |
|
25 |
24 |
$1K |
| 73700 |
|
32 |
29 |
$1K |
| J7050 |
Infusion, normal saline solution, 250 cc |
957 |
513 |
$1K |
| 85014 |
|
900 |
758 |
$994.12 |
| 82010 |
|
233 |
183 |
$964.17 |
| 85018 |
|
827 |
714 |
$913.85 |
| 73565 |
|
30 |
29 |
$854.39 |
| ATP16 |
|
104 |
76 |
$827.64 |
| 96367 |
|
117 |
94 |
$821.38 |
| 73020 |
|
22 |
20 |
$814.19 |
| 73521 |
|
25 |
24 |
$809.28 |
| 84145 |
|
133 |
108 |
$805.52 |
| 82728 |
|
142 |
114 |
$795.52 |
| 87808 |
|
93 |
87 |
$781.58 |
| 70360 |
|
12 |
12 |
$760.70 |
| 90674 |
|
96 |
80 |
$758.61 |
| 80061 |
Lipid panel |
1,441 |
1,236 |
$734.45 |
| 90686 |
|
166 |
143 |
$694.00 |
| J0171 |
Injection, adrenalin, epinephrine, 0.1 mg |
30 |
28 |
$687.32 |
| 84100 |
|
2,267 |
1,226 |
$669.44 |
| 71101 |
|
52 |
52 |
$627.23 |
| ATP06 |
|
89 |
80 |
$618.48 |
| A9502 |
Technetium tc-99m tetrofosmin, diagnostic, per study dose |
2,514 |
1,578 |
$616.14 |
| 76376 |
|
2,877 |
2,673 |
$574.71 |
| 97162 |
|
39 |
29 |
$569.87 |
| 74220 |
|
12 |
12 |
$529.77 |
| 93226 |
|
40 |
39 |
$515.70 |
| 88312 |
|
108 |
101 |
$495.64 |
| 72128 |
|
117 |
105 |
$488.04 |
| ATP03 |
|
302 |
236 |
$472.65 |
| J2543 |
Injection, piperacillin sodium/tazobactam sodium, 1 gram/0.125 grams (1.125 grams) |
64 |
38 |
$411.91 |
| 84520 |
|
2,789 |
2,607 |
$398.57 |
| J2765 |
Injection, metoclopramide hcl, up to 10 mg |
2,186 |
1,810 |
$338.50 |
| J7613 |
Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg |
979 |
585 |
$326.98 |
| 73552 |
|
12 |
12 |
$241.08 |
| Q3014 |
Telehealth originating site facility fee |
113 |
100 |
$210.34 |
| 87480 |
|
12 |
12 |
$190.48 |
| 86618 |
|
18 |
14 |
$186.36 |
| 73060 |
|
21 |
15 |
$144.28 |
| J2930 |
Injection, methylprednisolone sodium succinate, up to 125 mg |
801 |
525 |
$140.78 |
| 80164 |
|
29 |
25 |
$137.41 |
| 84439 |
|
30 |
26 |
$123.30 |
| 87899 |
|
14 |
12 |
$106.29 |
| 86592 |
|
24 |
24 |
$101.20 |
| J7040 |
Infusion, normal saline solution, sterile (500 ml = 1 unit) |
90 |
55 |
$97.30 |
| ATP04 |
|
18 |
13 |
$86.88 |
| J0780 |
Injection, prochlorperazine, up to 10 mg |
230 |
201 |
$81.06 |
| 96376 |
|
3,319 |
2,858 |
$62.02 |
| J1956 |
Injection, levofloxacin, 250 mg |
106 |
71 |
$54.04 |
| 89051 |
|
16 |
12 |
$45.44 |
| 85651 |
|
18 |
13 |
$36.50 |
| J7070 |
Infusion, d5w, 1000 cc |
36 |
24 |
$27.02 |
| 83615 |
|
134 |
108 |
$16.50 |
| 99406 |
|
431 |
306 |
$15.93 |
| A9585 |
Injection, gadobutrol, 0.1 ml |
1,184 |
962 |
$13.96 |
| 84550 |
|
107 |
90 |
$13.95 |
| 82248 |
|
90 |
73 |
$9.00 |
| 82247 |
|
19 |
15 |
$8.86 |
| 80320 |
|
1,004 |
908 |
$5.00 |
| J7644 |
Ipratropium bromide, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose form, per milligram |
310 |
216 |
$2.11 |
| 80051 |
|
511 |
487 |
$0.00 |
| J2370 |
Injection, phenylephrine hcl, up to 1 ml |
641 |
541 |
$0.00 |
| G0008 |
Administration of influenza virus vaccine |
158 |
152 |
$0.00 |
| A4648 |
Tissue marker, implantable, any type, each |
150 |
139 |
$0.00 |
| 80329 |
|
439 |
400 |
$0.00 |
| J2785 |
Injection, regadenoson, 0.1 mg |
223 |
188 |
$0.00 |
| J1940 |
Injection, furosemide, up to 20 mg |
41 |
25 |
$0.00 |
| C1769 |
Guide wire |
58 |
53 |
$0.00 |
| J3480 |
Injection, potassium chloride, per 2 meq |
180 |
90 |
$0.00 |
| 36416 |
|
128 |
117 |
$0.00 |
| J1010 |
Injection, methylprednisolone acetate, 1 mg |
287 |
269 |
$0.00 |
| 96368 |
|
33 |
28 |
$0.00 |
| 88311 |
|
13 |
12 |
$0.00 |
| J2710 |
Injection, neostigmine methylsulfate, up to 0.5 mg |
499 |
427 |
$0.00 |
| C9113 |
Injection, pantoprazole sodium, per vial |
414 |
197 |
$0.00 |
| 84450 |
|
31 |
24 |
$0.00 |
| J2919 |
Injection, methylprednisolone sodium succinate, 5 mg |
18 |
16 |
$0.00 |
| J1953 |
Injection, levetiracetam, 10 mg |
131 |
118 |
$0.00 |
| 84460 |
|
16 |
12 |
$0.00 |
| C1713 |
Anchor/screw for opposing bone-to-bone or soft tissue-to-bone (implantable) |
71 |
66 |
$0.00 |
| J7606 |
Formoterol fumarate, inhalation solution, fda approved final product, non-compounded, administered through dme, unit dose form, 20 micrograms |
34 |
12 |
$0.00 |
| G1004 |
Clinical decision support mechanism national decision support company, as defined by the medicare appropriate use criteria program |
15 |
12 |
$0.00 |
| J2550 |
Injection, promethazine hcl, up to 50 mg |
19 |
12 |
$0.00 |