| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
98,417 |
81,790 |
$5.77M |
| 99233 |
Prolong inpt eval add15 m |
92,369 |
24,707 |
$4.57M |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
48,764 |
44,502 |
$4.48M |
| 99232 |
Subsequent hospital care, per day, moderate complexity |
120,086 |
29,720 |
$4.11M |
| 99215 |
Prolong outpt/office vis |
44,428 |
38,821 |
$3.67M |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
75,529 |
64,683 |
$3.08M |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
39,834 |
36,990 |
$2.51M |
| 99291 |
Critical care, evaluation and management of the critically ill patient, first 30-74 minutes |
18,554 |
8,336 |
$1.89M |
| 99244 |
Office or other outpatient consultation, moderate to high complexity |
16,091 |
15,101 |
$1.70M |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
22,726 |
20,415 |
$1.65M |
| 99223 |
Prolong inpt eval add15 m |
16,505 |
14,179 |
$1.61M |
| J0585 |
Injection, onabotulinumtoxina, 1 unit |
3,082 |
2,089 |
$1.54M |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
15,350 |
14,534 |
$1.25M |
| 99205 |
Prolong outpt/office vis |
10,591 |
9,862 |
$1.13M |
| 99231 |
Subsequent hospital care, per day, straightforward or low complexity |
54,522 |
16,713 |
$1.05M |
| 70553 |
Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences |
7,130 |
6,689 |
$1.02M |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
24,094 |
17,915 |
$1.01M |
| 99222 |
Initial hospital care, per day, moderate complexity |
14,193 |
11,914 |
$881K |
| 99239 |
Hospital discharge day management, more than 30 minutes |
14,218 |
13,234 |
$862K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
60,620 |
53,493 |
$857K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
16,212 |
15,451 |
$857K |
| 99243 |
|
12,364 |
11,730 |
$827K |
| 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 |
8,378 |
7,562 |
$676K |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
21,259 |
13,766 |
$676K |
| 99245 |
|
4,604 |
4,404 |
$652K |
| 36415 |
Collection of venous blood by venipuncture |
181,316 |
151,964 |
$629K |
| 93229 |
|
1,159 |
1,130 |
$555K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
23,621 |
20,181 |
$550K |
| 93306 |
Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete |
13,337 |
12,495 |
$460K |
| 96413 |
Chemotherapy administration, intravenous infusion; up to 1 hour, single or initial substance |
5,988 |
3,631 |
$459K |
| 93010 |
Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only |
107,955 |
72,013 |
$456K |
| 71046 |
Radiologic examination, chest; 2 views |
46,489 |
41,757 |
$451K |
| 99238 |
Hospital discharge day management, 30 minutes or less |
12,454 |
11,685 |
$448K |
| 71260 |
Computed tomography, thorax, diagnostic; with contrast material |
6,595 |
6,232 |
$428K |
| 01922 |
|
2,426 |
944 |
$410K |
| 88307 |
|
4,882 |
4,138 |
$393K |
| 99242 |
|
8,324 |
7,977 |
$393K |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
11,817 |
11,235 |
$389K |
| 00731 |
|
3,414 |
2,901 |
$377K |
| 90960 |
End-stage renal disease related services monthly, for patients 20 years and older, with 4 or more face-to-face visits |
4,379 |
4,236 |
$371K |
| 95812 |
|
2,018 |
1,977 |
$357K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
9,769 |
9,428 |
$352K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
5,068 |
4,326 |
$349K |
| 99253 |
|
4,712 |
3,786 |
$337K |
| 70450 |
Computed tomography, head or brain; without contrast material |
15,353 |
13,140 |
$336K |
| 71045 |
Radiologic examination, chest; single view |
68,861 |
33,339 |
$321K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
4,317 |
4,254 |
$309K |
| A9585 |
Injection, gadobutrol, 0.1 ml |
17,290 |
9,657 |
$276K |
| 71275 |
Computed tomographic angiography, chest, with contrast material |
4,902 |
4,574 |
$272K |
| 97530 |
Therapeutic activities, direct patient contact, each 15 minutes |
5,931 |
3,673 |
$269K |
| 71250 |
|
4,058 |
3,790 |
$263K |
| 99254 |
|
2,716 |
2,255 |
$261K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
4,075 |
3,925 |
$256K |
| 90961 |
|
3,885 |
3,784 |
$255K |
| 99221 |
|
6,773 |
5,639 |
$250K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
2,618 |
2,581 |
$234K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
45,330 |
37,766 |
$229K |
| 72197 |
|
1,088 |
1,025 |
$219K |
| 99443 |
|
3,051 |
2,913 |
$209K |
| 97161 |
|
3,967 |
3,844 |
$202K |
| 99442 |
|
4,023 |
3,814 |
$191K |
| 88331 |
|
2,258 |
1,545 |
$190K |
| 93000 |
|
22,316 |
21,501 |
$186K |
| 97112 |
Therapeutic procedure, each 15 minutes; neuromuscular reeducation of movement, balance, coordination |
5,038 |
3,255 |
$186K |
| 84443 |
Thyroid stimulating hormone (TSH) |
16,422 |
15,429 |
$172K |
| 99252 |
|
3,424 |
2,899 |
$164K |
| 67028 |
Intravitreal injection of a pharmacologic agent |
2,651 |
2,208 |
$157K |
| 74183 |
|
764 |
728 |
$148K |
| 99451 |
|
7,343 |
6,378 |
$147K |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
7,037 |
6,715 |
$146K |
| 97802 |
|
2,819 |
2,700 |
$143K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
3,235 |
3,083 |
$137K |
| T1013 |
Sign language or oral interpretive services, per 15 minutes |
5,461 |
4,261 |
$134K |
| 76830 |
Ultrasound, transvaginal |
2,633 |
2,497 |
$130K |
| 94729 |
|
4,055 |
3,911 |
$130K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
2,346 |
2,159 |
$128K |
| 43239 |
Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple |
2,149 |
2,064 |
$128K |
| 88342 |
|
3,699 |
3,226 |
$127K |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
4,155 |
4,104 |
$121K |
| 64615 |
|
1,708 |
1,643 |
$120K |
| 78815 |
Positron emission tomography (PET) for limited area imaging |
1,796 |
1,729 |
$119K |
| 76819 |
Fetal biophysical profile; without non-stress testing |
2,157 |
1,398 |
$117K |
| 90870 |
|
1,716 |
1,145 |
$115K |
| 76770 |
|
2,466 |
2,359 |
$114K |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
11,685 |
8,995 |
$112K |
| 88341 |
|
1,393 |
1,091 |
$110K |
| 70551 |
Magnetic resonance imaging, brain; without contrast material |
1,561 |
1,467 |
$109K |
| 92015 |
Determination of refractive state |
9,685 |
9,478 |
$109K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
9,076 |
8,776 |
$109K |
| 76700 |
Ultrasound, abdominal, real time with image documentation; complete |
1,906 |
1,839 |
$106K |
| 74018 |
|
17,507 |
11,301 |
$102K |
| 77427 |
|
902 |
391 |
$100K |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
4,759 |
4,206 |
$99K |
| 99219 |
|
1,331 |
1,255 |
$96K |
| 92060 |
|
2,523 |
2,391 |
$95K |
| 00790 |
|
324 |
186 |
$93K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
3,207 |
3,033 |
$89K |
| 93970 |
|
2,326 |
2,045 |
$89K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
3,180 |
3,008 |
$89K |
| 99479 |
Subsequent intensive care, per day, very low birth weight infant |
1,191 |
209 |
$87K |
| 0002A |
|
4,172 |
4,130 |
$87K |
| 99217 |
|
2,211 |
2,091 |
$86K |
| 82728 |
|
8,846 |
8,469 |
$83K |
| 88332 |
|
624 |
467 |
$82K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
1,559 |
1,134 |
$82K |
| 99480 |
Subsequent intensive care, per day, low birth weight infant |
1,193 |
257 |
$82K |
| 82565 |
|
29,640 |
25,493 |
$81K |
| 86769 |
|
2,279 |
2,163 |
$80K |
| 97162 |
|
1,330 |
1,300 |
$80K |
| 80061 |
Lipid panel |
10,288 |
9,861 |
$79K |
| 72125 |
Computed tomography, cervical spine; without contrast material |
2,624 |
2,456 |
$78K |
| 93224 |
|
1,597 |
1,552 |
$78K |
| S0302 |
Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service) |
1,740 |
1,708 |
$77K |
| 0001A |
|
4,083 |
4,043 |
$77K |
| 93971 |
|
2,573 |
2,299 |
$75K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
12,146 |
11,690 |
$75K |
| 94060 |
|
2,802 |
2,704 |
$75K |
| 96156 |
|
1,181 |
1,158 |
$75K |
| 95886 |
|
1,186 |
1,136 |
$74K |
| 92134 |
|
3,203 |
3,043 |
$73K |
| 99220 |
|
774 |
749 |
$73K |
| 80053 |
Comprehensive metabolic panel |
9,567 |
8,424 |
$72K |
| G6002 |
Stereoscopic x-ray guidance for localization of target volume for the delivery of radiation therapy |
4,517 |
505 |
$71K |
| 73630 |
|
6,013 |
4,583 |
$71K |
| 90834 |
Psychotherapy, 45 minutes with patient |
1,131 |
811 |
$71K |
| 59400 |
Routine obstetric care including antepartum care, vaginal delivery, and postpartum care |
69 |
67 |
$70K |
| 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 |
972 |
748 |
$69K |
| 87651 |
Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe |
2,349 |
2,282 |
$68K |
| 74174 |
|
468 |
436 |
$67K |
| 76536 |
|
1,077 |
1,059 |
$64K |
| 00400 |
|
556 |
264 |
$64K |
| 99469 |
Subsequent inpatient neonatal critical care, per day, 28 days or younger |
232 |
85 |
$62K |
| 36620 |
|
2,694 |
2,337 |
$62K |
| 76811 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, detailed |
476 |
468 |
$59K |
| 90686 |
|
5,973 |
5,873 |
$57K |
| D7140 |
Extraction, erupted tooth or exposed root |
954 |
234 |
$56K |
| 90935 |
Hemodialysis procedure with single evaluation by a physician |
2,164 |
858 |
$56K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
2,600 |
2,460 |
$56K |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
1,410 |
1,173 |
$55K |
| 92083 |
|
1,508 |
1,435 |
$55K |
| 97803 |
|
1,635 |
1,574 |
$54K |
| 96375 |
Therapeutic injection; each additional sequential IV push |
2,853 |
1,572 |
$53K |
| 76942 |
|
2,825 |
2,557 |
$53K |
| 45380 |
Colonoscopy, flexible; with biopsy, single or multiple |
579 |
562 |
$53K |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
2,309 |
2,266 |
$53K |
| 84450 |
|
18,221 |
16,230 |
$52K |
| 99441 |
|
1,799 |
1,712 |
$51K |
| 90691 |
|
643 |
633 |
$51K |
| 72131 |
|
1,502 |
1,426 |
$50K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
588 |
584 |
$49K |
| 70496 |
|
824 |
788 |
$49K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
2,105 |
2,035 |
$49K |
| 31575 |
|
768 |
748 |
$49K |
| 93976 |
|
1,060 |
1,013 |
$48K |
| 73610 |
|
4,403 |
3,373 |
$47K |
| 94726 |
|
1,466 |
1,416 |
$47K |
| 0004A |
|
1,626 |
1,546 |
$47K |
| 92567 |
|
5,128 |
5,014 |
$46K |
| 20611 |
|
805 |
734 |
$46K |
| 86481 |
|
485 |
477 |
$45K |
| 99152 |
|
8,117 |
7,106 |
$45K |
| 0764T |
|
2,532 |
2,179 |
$44K |
| 76642 |
|
865 |
704 |
$43K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
7,480 |
6,622 |
$43K |
| 90750 |
|
339 |
328 |
$43K |
| 97165 |
|
790 |
769 |
$43K |
| 00840 |
|
207 |
117 |
$43K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
567 |
546 |
$43K |
| 94762 |
|
2,981 |
2,870 |
$43K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
1,016 |
909 |
$42K |
| 97597 |
|
1,229 |
976 |
$41K |
| X5622 |
|
306 |
262 |
$41K |
| 72148 |
Magnetic resonance imaging, lumbar spine; without contrast material |
369 |
367 |
$41K |
| 93975 |
|
459 |
399 |
$41K |
| 70498 |
|
682 |
658 |
$40K |
| 99241 |
|
1,632 |
1,568 |
$40K |
| 93296 |
|
2,736 |
2,659 |
$40K |
| 85610 |
|
15,858 |
9,906 |
$40K |
| 77334 |
|
395 |
312 |
$39K |
| 00811 |
|
325 |
298 |
$38K |
| 87631 |
|
440 |
419 |
$38K |
| 73030 |
|
3,244 |
2,643 |
$38K |
| 80050 |
General health panel |
858 |
822 |
$38K |
| 73130 |
|
3,141 |
2,276 |
$38K |
| 82784 |
|
3,892 |
3,261 |
$37K |
| D8080 |
Comprehensive orthodontic treatment of the adolescent dentition |
633 |
570 |
$37K |
| 85027 |
|
8,705 |
7,853 |
$37K |
| 97140 |
Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) |
1,939 |
1,173 |
$36K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
686 |
662 |
$35K |
| 92523 |
|
233 |
225 |
$34K |
| 74230 |
|
737 |
679 |
$34K |
| 84460 |
|
11,845 |
10,580 |
$33K |
| 83516 |
|
3,876 |
2,781 |
$33K |
| 0072A |
|
870 |
869 |
$33K |
| 70486 |
|
539 |
519 |
$32K |
| 45385 |
Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) |
223 |
212 |
$32K |
| 99354 |
|
527 |
485 |
$32K |
| 84439 |
|
4,829 |
4,499 |
$31K |
| 77263 |
|
323 |
303 |
$31K |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
5,839 |
5,469 |
$31K |
| 97810 |
|
1,537 |
1,224 |
$31K |
| 95004 |
Percutaneous tests with allergenic extracts, immediate type reaction |
441 |
435 |
$31K |
| 95720 |
|
277 |
140 |
$31K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
2,383 |
2,188 |
$30K |
| 83880 |
|
1,299 |
1,191 |
$30K |
| 0071A |
|
810 |
809 |
$30K |
| 84132 |
|
13,393 |
11,219 |
$29K |
| 88173 |
|
395 |
336 |
$29K |
| 95951 |
|
212 |
112 |
$29K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
361 |
359 |
$29K |
| 90715 |
|
1,225 |
1,207 |
$29K |
| 82607 |
|
2,926 |
2,797 |
$29K |
| 80197 |
|
4,646 |
2,799 |
$29K |
| 73564 |
|
2,070 |
1,592 |
$28K |
| 86780 |
|
2,697 |
2,602 |
$28K |
| 96167 |
|
669 |
607 |
$28K |
| 86140 |
|
8,147 |
7,677 |
$28K |
| 73502 |
|
1,982 |
1,727 |
$28K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
399 |
389 |
$28K |
| 82947 |
|
11,938 |
10,704 |
$27K |
| 92133 |
|
1,236 |
1,198 |
$27K |
| 93303 |
Transthoracic echocardiography for congenital cardiac anomalies, follow-up or limited study |
805 |
760 |
$27K |
| 93271 |
|
298 |
290 |
$27K |
| 93923 |
|
512 |
481 |
$26K |
| 82247 |
|
9,619 |
8,092 |
$26K |
| 72100 |
|
1,542 |
1,437 |
$26K |
| 96158 |
|
696 |
592 |
$26K |
| 72128 |
|
874 |
838 |
$26K |
| 83735 |
|
6,170 |
4,766 |
$26K |
| 97811 |
|
1,544 |
1,233 |
$25K |
| 83970 |
|
951 |
900 |
$25K |
| 73721 |
Magnetic resonance imaging, any joint of lower extremity; without contrast material |
192 |
177 |
$25K |
| 86833 |
|
156 |
139 |
$25K |
| 76376 |
|
2,101 |
1,964 |
$24K |
| 90853 |
Group psychotherapy (other than of a multiple-family group) |
2,678 |
358 |
$24K |
| 84075 |
|
8,817 |
7,741 |
$24K |
| 43235 |
|
403 |
390 |
$24K |
| 90791 |
Psychiatric diagnostic evaluation |
396 |
377 |
$24K |
| 81001 |
|
11,475 |
10,751 |
$23K |
| 87624 |
Infectious agent detection by nucleic acid; human papillomavirus (HPV), high-risk types |
680 |
664 |
$23K |
| 96164 |
|
1,519 |
542 |
$23K |
| 00104 |
|
424 |
368 |
$23K |
| G0123 |
Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, screening by cytotechnologist under physician supervision |
1,415 |
1,381 |
$23K |
| 99468 |
|
47 |
40 |
$23K |
| 84295 |
|
10,445 |
9,062 |
$23K |
| 86832 |
|
143 |
127 |
$22K |
| 96417 |
|
551 |
325 |
$22K |
| 92557 |
|
1,029 |
998 |
$22K |
| 73110 |
|
1,623 |
1,294 |
$22K |
| 86850 |
|
3,222 |
2,804 |
$22K |
| 90651 |
|
291 |
287 |
$21K |
| 95810 |
Polysomnography; sleep staging with 4 or more additional parameters |
261 |
261 |
$21K |
| 96165 |
|
1,114 |
441 |
$21K |
| G0279 |
Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066) |
662 |
643 |
$20K |
| 99201 |
|
892 |
856 |
$20K |
| 99251 |
|
590 |
536 |
$20K |
| 77300 |
|
277 |
247 |
$20K |
| 0064A |
|
692 |
689 |
$20K |
| 0054A |
|
519 |
516 |
$20K |
| G0472 |
Hepatitis c antibody screening, for individual at high risk and other covered indication(s) |
1,004 |
966 |
$20K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
2,785 |
2,470 |
$20K |
| 77301 |
|
49 |
40 |
$19K |
| 73562 |
|
861 |
654 |
$19K |
| 92002 |
|
316 |
315 |
$19K |
| 96112 |
|
250 |
247 |
$19K |
| 82248 |
|
6,277 |
5,265 |
$19K |
| 76801 |
|
243 |
232 |
$18K |
| 76377 |
|
482 |
459 |
$18K |
| 92579 |
|
622 |
615 |
$18K |
| 76937 |
|
3,203 |
2,478 |
$18K |
| 59025 |
Fetal non-stress test |
903 |
603 |
$18K |
| 51798 |
|
2,902 |
2,739 |
$18K |
| 97535 |
Self-care/home management training, each 15 minutes |
481 |
297 |
$18K |
| 74178 |
|
95 |
93 |
$17K |
| 95885 |
|
354 |
325 |
$17K |
| 87340 |
|
2,228 |
2,157 |
$17K |
| 82310 |
|
6,993 |
6,230 |
$17K |
| 88313 |
|
826 |
682 |
$16K |
| 99358 |
Prolong nursin fac eval 15m |
284 |
241 |
$16K |
| 93320 |
|
1,555 |
1,404 |
$16K |
| 93325 |
|
7,706 |
6,528 |
$16K |
| 87636 |
Infectious agent detection by nucleic acid; SARS-CoV-2 and influenza virus types A and B |
114 |
114 |
$16K |
| 73560 |
|
1,469 |
1,087 |
$16K |
| 82570 |
|
4,153 |
3,673 |
$16K |
| D0140 |
Limited oral evaluation - problem focused |
399 |
387 |
$15K |
| 77387 |
|
374 |
36 |
$15K |
| 82533 |
|
1,130 |
1,005 |
$15K |
| 96139 |
|
67 |
66 |
$15K |
| 75574 |
|
152 |
148 |
$15K |
| 62326 |
|
307 |
298 |
$15K |
| 43762 |
|
132 |
132 |
$15K |
| 87077 |
|
2,592 |
2,138 |
$14K |
| 90837 |
Psychotherapy, 53 minutes with patient |
136 |
106 |
$14K |
| J1610 |
Injection, glucagon hydrochloride, per 1 mg |
87 |
85 |
$14K |
| 72082 |
|
371 |
352 |
$14K |
| 90717 |
|
135 |
133 |
$13K |
| 94010 |
|
730 |
707 |
$13K |
| 99457 |
|
519 |
498 |
$13K |
| 88112 |
|
513 |
457 |
$13K |
| 90732 |
|
143 |
142 |
$13K |
| D1120 |
Prophylaxis - child |
407 |
396 |
$13K |
| 92341 |
|
546 |
503 |
$13K |
| 99417 |
Prolong home eval add 15m |
193 |
166 |
$13K |
| 84403 |
|
654 |
623 |
$13K |
| 92610 |
|
225 |
220 |
$13K |
| 99255 |
|
136 |
123 |
$12K |
| D1206 |
Topical application of fluoride varnish |
614 |
597 |
$12K |
| 93308 |
|
681 |
592 |
$12K |
| 99606 |
|
432 |
371 |
$12K |
| 99460 |
|
247 |
236 |
$12K |
| 84702 |
|
928 |
790 |
$11K |
| 95923 |
|
189 |
177 |
$11K |
| 87536 |
|
195 |
184 |
$11K |
| 0124A |
|
343 |
342 |
$11K |
| 99225 |
|
278 |
167 |
$11K |
| 90670 |
|
477 |
475 |
$11K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
118 |
118 |
$11K |
| 93294 |
|
552 |
546 |
$11K |
| 72156 |
|
72 |
65 |
$11K |
| 96132 |
|
107 |
103 |
$11K |
| 73140 |
|
820 |
685 |
$11K |
| V2020 |
Frames, purchases |
336 |
307 |
$10K |
| 70355 |
|
1,139 |
1,098 |
$10K |
| 83883 |
|
566 |
448 |
$10K |
| 84100 |
|
4,290 |
3,533 |
$10K |
| D0120 |
Periodic oral evaluation - established patient |
319 |
316 |
$10K |
| 90739 |
|
97 |
95 |
$10K |
| 49083 |
|
129 |
69 |
$10K |
| 86038 |
|
1,103 |
1,063 |
$10K |
| 82040 |
|
4,303 |
3,895 |
$9K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
138 |
126 |
$9K |
| 31231 |
|
67 |
66 |
$9K |
| 86480 |
|
363 |
343 |
$9K |
| 90662 |
|
247 |
243 |
$9K |
| 96150 |
|
292 |
275 |
$9K |
| 99472 |
Subsequent inpatient pediatric critical care, per day, 2-5 years |
29 |
15 |
$9K |
| 70491 |
|
131 |
117 |
$9K |
| 77080 |
|
1,670 |
1,628 |
$9K |
| 87186 |
|
1,639 |
1,374 |
$9K |
| 99607 |
|
257 |
230 |
$9K |
| 86200 |
|
857 |
819 |
$9K |
| 36556 |
|
201 |
162 |
$8K |
| 77066 |
Tomosynthesis, mammo |
79 |
78 |
$8K |
| 82043 |
|
2,537 |
2,429 |
$8K |
| 87661 |
Infectious agent detection by nucleic acid; Trichomonas vaginalis, amplified probe |
265 |
263 |
$8K |
| 99463 |
|
124 |
118 |
$8K |
| 95908 |
|
112 |
108 |
$8K |
| 90734 |
|
300 |
284 |
$8K |
| 72141 |
|
102 |
99 |
$8K |
| 83550 |
|
1,304 |
1,246 |
$8K |
| 95782 |
|
57 |
57 |
$8K |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
400 |
375 |
$8K |
| 84520 |
|
4,512 |
3,857 |
$7K |
| 85651 |
|
3,739 |
3,490 |
$7K |
| 95924 |
|
83 |
83 |
$7K |
| 81025 |
|
1,096 |
1,070 |
$7K |
| 92582 |
|
166 |
164 |
$7K |
| 86706 |
|
1,004 |
965 |
$7K |
| 88304 |
|
699 |
651 |
$7K |
| 83615 |
|
1,777 |
1,521 |
$7K |
| 0011A |
|
538 |
537 |
$7K |
| 86376 |
|
736 |
689 |
$7K |
| 84153 |
|
466 |
446 |
$7K |
| 81050 |
|
1,831 |
1,623 |
$7K |
| 77338 |
|
44 |
38 |
$7K |
| 0012A |
|
547 |
545 |
$7K |
| 86360 |
|
225 |
218 |
$7K |
| 45378 |
Colonoscopy, flexible; diagnostic, including collection of specimen(s) |
64 |
64 |
$7K |
| 83655 |
|
708 |
696 |
$7K |
| V5266 |
Battery for use in hearing device |
379 |
323 |
$7K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
187 |
181 |
$7K |
| 86235 |
|
70 |
67 |
$7K |
| 83540 |
|
1,529 |
1,450 |
$7K |
| 99462 |
|
303 |
229 |
$7K |
| 96367 |
|
198 |
129 |
$7K |
| 99199 |
Unlisted special service, procedure or report |
220 |
194 |
$7K |
| 0003A |
|
231 |
229 |
$7K |
| 92611 |
|
127 |
124 |
$7K |
| 90632 |
|
120 |
119 |
$6K |
| 84165 |
|
972 |
904 |
$6K |
| 73590 |
|
831 |
689 |
$6K |
| 93321 |
|
1,541 |
1,345 |
$6K |
| 86900 |
|
2,779 |
2,336 |
$6K |
| 36416 |
|
2,181 |
1,378 |
$6K |
| 72040 |
|
343 |
328 |
$6K |
| 86901 |
|
2,800 |
2,353 |
$6K |
| 0031A |
|
293 |
239 |
$6K |
| 93016 |
|
481 |
465 |
$6K |
| 51741 |
|
749 |
715 |
$6K |
| 11104 |
|
98 |
95 |
$6K |
| 88312 |
|
121 |
115 |
$6K |
| 93351 |
|
122 |
119 |
$6K |
| 86359 |
|
229 |
219 |
$5K |
| 00320 |
|
23 |
15 |
$5K |
| 84550 |
|
2,079 |
1,866 |
$5K |
| 86704 |
|
659 |
640 |
$5K |
| 93295 |
|
246 |
245 |
$5K |
| 84155 |
|
2,472 |
2,244 |
$5K |
| 87798 |
Infectious agent detection by nucleic acid; not otherwise specified, amplified probe, each organism |
137 |
110 |
$5K |
| 96153 |
|
639 |
177 |
$5K |
| 77290 |
|
48 |
43 |
$5K |
| 76775 |
|
153 |
150 |
$5K |
| 82610 |
|
368 |
353 |
$5K |
| 81003 |
|
2,569 |
2,497 |
$5K |
| 76882 |
|
128 |
117 |
$4K |
| 96138 |
|
98 |
96 |
$4K |
| 95909 |
|
51 |
49 |
$4K |
| 93018 |
|
481 |
465 |
$4K |
| 98940 |
|
535 |
442 |
$4K |
| 93228 |
|
293 |
287 |
$4K |
| 82542 |
|
227 |
177 |
$4K |
| 92136 |
|
271 |
225 |
$4K |
| 82805 |
|
68 |
65 |
$4K |
| 72157 |
|
28 |
26 |
$4K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
347 |
183 |
$4K |
| 99458 |
|
275 |
250 |
$4K |
| 85652 |
|
1,673 |
1,591 |
$4K |
| 99407 |
|
219 |
193 |
$4K |
| 99188 |
|
282 |
278 |
$4K |
| 80076 |
|
538 |
501 |
$4K |
| 82550 |
|
860 |
785 |
$4K |
| 99499 |
|
12 |
12 |
$4K |
| 96415 |
|
185 |
124 |
$4K |
| 99444 |
|
145 |
138 |
$3K |
| G2212 |
Prolonged office or other outpatient evaluation and management service(s) beyond the maximum required time of the primary procedure which has been selected using total time on the date of the primary service; each additional 15 minutes by the physician or qualified healthcare professional, with or without direct patient contact (list separately in addition to cpt codes 99205, 99215, 99483 for office or other outpatient evaluation and management services) (do not report g2212 on the same date of service as 99358, 99359, 99415, 99416). (do not report g2212 for any time unit less than 15 minutes) |
81 |
74 |
$3K |
| G0008 |
Administration of influenza virus vaccine |
716 |
706 |
$3K |
| 73090 |
|
381 |
306 |
$3K |
| 77065 |
Tomosynthesis, mammo |
46 |
41 |
$3K |
| 0134A |
|
130 |
129 |
$3K |
| 90832 |
Psychotherapy, 30 minutes with patient |
64 |
52 |
$3K |
| 80069 |
|
473 |
417 |
$3K |
| 0052A |
|
84 |
84 |
$3K |
| 83014 |
|
422 |
414 |
$3K |
| 72158 |
|
26 |
25 |
$3K |
| 31624 |
|
39 |
39 |
$3K |
| 91322 |
|
33 |
33 |
$3K |
| 87205 |
|
1,255 |
1,157 |
$3K |
| 87081 |
|
577 |
561 |
$3K |
| 0074A |
|
84 |
84 |
$3K |
| 00902 |
|
17 |
12 |
$3K |
| 92229 |
|
101 |
99 |
$3K |
| 73700 |
|
57 |
47 |
$3K |
| J1030 |
Injection, methylprednisolone acetate, 40 mg |
565 |
445 |
$3K |
| 99422 |
|
209 |
161 |
$3K |
| D9420 |
|
171 |
158 |
$3K |
| 88321 |
|
87 |
61 |
$3K |
| 81376 |
|
20 |
15 |
$3K |
| 96154 |
|
105 |
87 |
$3K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
27 |
27 |
$3K |
| 92551 |
|
385 |
375 |
$3K |
| 83520 |
|
202 |
184 |
$3K |
| 83001 |
|
169 |
158 |
$3K |
| 86787 |
|
268 |
227 |
$3K |
| 73552 |
|
248 |
212 |
$3K |
| 36591 |
|
187 |
148 |
$3K |
| 52000 |
|
18 |
18 |
$3K |
| 84156 |
|
861 |
787 |
$3K |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
3,625 |
1,824 |
$3K |
| 99218 |
|
58 |
57 |
$2K |
| 82670 |
|
87 |
82 |
$2K |
| D0210 |
Intraoral - complete series of radiographic images |
69 |
65 |
$2K |
| 86160 |
|
143 |
123 |
$2K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
28 |
28 |
$2K |
| G0475 |
Hiv antigen/antibody, combination assay, screening |
524 |
496 |
$2K |
| 90962 |
|
35 |
30 |
$2K |
| 31500 |
|
29 |
25 |
$2K |
| 86803 |
|
336 |
323 |
$2K |
| 72170 |
|
185 |
177 |
$2K |
| 86431 |
|
450 |
436 |
$2K |
| 77072 |
|
154 |
154 |
$2K |
| 82746 |
|
274 |
261 |
$2K |
| 87799 |
|
357 |
255 |
$2K |
| 95251 |
|
99 |
99 |
$2K |
| 93270 |
|
291 |
284 |
$2K |
| 90713 |
|
138 |
136 |
$2K |
| 80051 |
|
1,053 |
939 |
$2K |
| 96040 |
|
65 |
65 |
$2K |
| 85730 |
|
511 |
459 |
$2K |
| 00813 |
|
13 |
12 |
$2K |
| 95910 |
|
14 |
14 |
$2K |
| 83690 |
|
415 |
381 |
$2K |
| 96116 |
|
41 |
41 |
$2K |
| 0082A |
|
48 |
48 |
$2K |
| 93312 |
|
25 |
24 |
$2K |
| 84146 |
|
115 |
107 |
$2K |
| 98941 |
Chiropractic manipulative treatment; spinal, 3-4 regions |
144 |
123 |
$2K |
| 82105 |
|
147 |
141 |
$2K |
| 00170 |
Anesthesia for intraoral procedures, including biopsy |
17 |
12 |
$2K |
| 97116 |
|
95 |
76 |
$2K |
| 87640 |
|
40 |
37 |
$2K |
| 76881 |
|
43 |
38 |
$2K |
| 82948 |
|
671 |
510 |
$1K |
| 87070 |
|
315 |
290 |
$1K |
| 88350 |
|
14 |
13 |
$1K |
| 99226 |
|
21 |
13 |
$1K |
| 77092 |
|
122 |
115 |
$1K |
| 73100 |
|
252 |
155 |
$1K |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
2,136 |
1,148 |
$1K |
| 96152 |
|
58 |
48 |
$1K |
| 76870 |
|
32 |
28 |
$1K |
| 90707 |
|
106 |
105 |
$1K |
| 77001 |
|
261 |
221 |
$1K |
| 0051A |
|
33 |
33 |
$1K |
| 86255 |
|
86 |
50 |
$1K |
| 90480 |
|
46 |
46 |
$1K |
| 73200 |
|
14 |
12 |
$1K |
| 87517 |
|
25 |
25 |
$1K |
| 96159 |
|
81 |
68 |
$1K |
| 17110 |
|
27 |
26 |
$1K |
| 0013A |
|
53 |
52 |
$1K |
| 95012 |
|
98 |
96 |
$1K |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
30 |
27 |
$1K |
| 83921 |
|
64 |
64 |
$1K |
| 86762 |
|
66 |
64 |
$1K |
| 99464 |
|
26 |
26 |
$981.25 |
| 92558 |
|
259 |
257 |
$940.88 |
| 0112A |
|
23 |
23 |
$924.09 |
| 0154A |
|
25 |
25 |
$916.45 |
| 90698 |
|
410 |
408 |
$891.81 |
| 92526 |
|
14 |
12 |
$861.62 |
| 73070 |
|
86 |
65 |
$844.60 |
| 77073 |
|
44 |
37 |
$839.93 |
| 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 |
351 |
$837.14 |
| 90746 |
|
14 |
14 |
$830.62 |
| 85097 |
|
12 |
12 |
$807.90 |
| 99401 |
|
31 |
31 |
$807.04 |
| 90656 |
|
59 |
56 |
$806.34 |
| Q9958 |
High osmolar contrast material, up to 149 mg/ml iodine concentration, per ml |
663 |
636 |
$786.85 |
| 76820 |
|
38 |
24 |
$772.55 |
| D1351 |
Sealant - per tooth |
141 |
26 |
$763.32 |
| 92650 |
|
43 |
41 |
$735.56 |
| 0111A |
|
19 |
18 |
$722.92 |
| 88291 |
|
31 |
27 |
$722.42 |
| 84305 |
|
42 |
41 |
$706.56 |
| 84410 |
|
14 |
14 |
$696.47 |
| 97542 |
|
15 |
12 |
$674.10 |
| 58300 |
|
13 |
13 |
$663.21 |
| 87522 |
Neg quan hep c or qual rna |
26 |
25 |
$636.02 |
| 99605 |
|
12 |
12 |
$634.92 |
| 90461 |
|
27 |
27 |
$616.19 |
| 96127 |
|
158 |
153 |
$589.39 |
| 0034A |
|
23 |
23 |
$576.00 |
| 92586 |
|
129 |
123 |
$567.81 |
| 72070 |
|
37 |
37 |
$561.62 |
| 91122 |
|
13 |
12 |
$560.76 |
| 90716 |
|
42 |
40 |
$560.46 |
| 88346 |
|
14 |
13 |
$553.55 |
| 95874 |
|
29 |
25 |
$551.86 |
| 87102 |
|
121 |
114 |
$541.31 |
| 99446 |
|
491 |
460 |
$513.67 |
| 92587 |
|
89 |
89 |
$505.93 |
| 11100 |
|
68 |
66 |
$504.91 |
| 93227 |
|
51 |
51 |
$503.10 |
| 99402 |
|
12 |
12 |
$481.01 |
| 86225 |
|
68 |
67 |
$480.28 |
| 0077U |
|
281 |
245 |
$479.34 |
| J3301 |
Injection, triamcinolone acetonide, not otherwise specified, 10 mg |
118 |
103 |
$471.47 |
| 85045 |
|
179 |
166 |
$458.44 |
| 92555 |
|
24 |
24 |
$453.65 |
| 92556 |
|
14 |
14 |
$450.62 |
| 87338 |
|
52 |
51 |
$433.66 |
| 84484 |
|
65 |
60 |
$418.96 |
| P9603 |
Travel allowance one way in connection with medically necessary laboratory specimen collection drawn from home bound or nursing home bound patient; prorated miles actually travelled |
825 |
527 |
$414.56 |
| 86580 |
|
43 |
42 |
$399.02 |
| 94681 |
|
67 |
66 |
$389.63 |
| 82627 |
|
13 |
13 |
$385.66 |
| 99173 |
|
230 |
227 |
$368.80 |
| 87206 |
|
117 |
102 |
$366.69 |
| Q9965 |
Low osmolar contrast material, 100-199 mg/ml iodine concentration, per ml |
190 |
185 |
$350.98 |
| 74019 |
|
77 |
68 |
$347.91 |
| 88311 |
|
26 |
24 |
$338.72 |
| 95938 |
|
12 |
12 |
$329.90 |
| 73060 |
|
58 |
44 |
$293.53 |
| 91200 |
|
26 |
26 |
$293.01 |
| 96168 |
|
15 |
14 |
$287.13 |
| 88142 |
|
14 |
14 |
$285.03 |
| Q3014 |
Telehealth originating site facility fee |
41 |
27 |
$278.82 |
| J0702 |
Injection, betamethasone acetate 3 mg and betamethasone sodium phosphate 3 mg |
37 |
36 |
$277.00 |
| D0230 |
Intraoral - periapical each additional radiographic image |
20 |
13 |
$267.28 |
| 80195 |
|
16 |
12 |
$245.72 |
| 92504 |
|
13 |
12 |
$244.87 |
| 99309 |
Subsequent nursing facility care, per day, low to moderate complexity |
291 |
246 |
$237.50 |
| 73080 |
|
33 |
32 |
$224.08 |
| D0220 |
Intraoral - periapical first radiographic image |
13 |
13 |
$215.67 |
| 84446 |
|
15 |
15 |
$215.60 |
| 11102 |
|
14 |
14 |
$215.16 |
| 82977 |
|
78 |
68 |
$189.50 |
| 85613 |
|
12 |
12 |
$177.43 |
| 86708 |
|
14 |
12 |
$164.12 |
| 84590 |
|
14 |
14 |
$163.93 |
| 84080 |
|
12 |
12 |
$161.10 |
| 80164 |
|
13 |
13 |
$150.30 |
| 83002 |
|
28 |
27 |
$149.37 |
| 84630 |
|
12 |
12 |
$135.02 |
| G1004 |
Clinical decision support mechanism national decision support company, as defined by the medicare appropriate use criteria program |
8,510 |
5,403 |
$120.78 |
| 80180 |
|
13 |
13 |
$116.40 |
| 82150 |
|
31 |
28 |
$105.60 |
| 95800 |
|
41 |
29 |
$99.44 |
| G0476 |
Infectious agent detection by nucleic acid (dna or rna); human papillomavirus (hpv), high-risk types (e.g., 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 68) for cervical cancer screening, must be performed in addition to pap test |
201 |
194 |
$92.24 |
| 94618 |
|
12 |
12 |
$79.27 |
| 98968 |
|
37 |
31 |
$78.81 |
| Q9961 |
High osmolar contrast material, 250-299 mg/ml iodine concentration, per ml |
57 |
57 |
$78.12 |
| 99308 |
Subsequent nursing facility care, per day, straightforward |
260 |
185 |
$77.63 |
| J7120 |
Ringers lactate infusion, up to 1000 cc |
27 |
25 |
$55.70 |
| J3490 |
Unclassified drugs |
48 |
28 |
$55.69 |
| J2704 |
Injection, propofol, 10 mg |
46 |
25 |
$47.50 |
| 90672 |
|
14 |
14 |
$45.75 |
| 73120 |
|
68 |
27 |
$39.18 |
| Q0091 |
Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory |
25 |
25 |
$32.50 |
| G0500 |
Moderate sedation services provided by the same physician or other qualified health care professional performing a gastrointestinal endoscopic service that sedation supports, requiring the presence of an independent trained observer to assist in the monitoring of the patient's level of consciousness and physiological status; initial 15 minutes of intra-service time; patient age 5 years or older (additional time may be reported with 99153, as appropriate) |
40 |
40 |
$31.13 |
| 99070 |
|
124 |
77 |
$13.73 |
| 3078F |
|
10,377 |
9,364 |
$0.00 |
| 91300 |
|
8,700 |
7,932 |
$0.00 |
| 3077F |
|
1,813 |
1,696 |
$0.00 |
| 3051F |
|
420 |
284 |
$0.00 |
| 0502F |
|
566 |
461 |
$0.00 |
| 90633 |
|
280 |
273 |
$0.00 |
| 91311 |
|
66 |
65 |
$0.00 |
| 3046F |
|
287 |
195 |
$0.00 |
| 91313 |
|
62 |
62 |
$0.00 |
| G8978 |
Mobility: walking & moving around functional limitation, current status, at therapy episode outset and at reporting intervals |
123 |
114 |
$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 |
168 |
151 |
$0.00 |
| 90710 |
|
12 |
12 |
$0.00 |
| 91308 |
|
93 |
92 |
$0.00 |
| 91312 |
|
235 |
234 |
$0.00 |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
79 |
65 |
$0.00 |
| 82374 |
|
31 |
30 |
$0.00 |
| 86334 |
|
28 |
26 |
$0.00 |
| 54150 |
|
26 |
26 |
$0.00 |
| 90680 |
|
93 |
92 |
$0.00 |
| 3074F |
|
11,632 |
10,456 |
$0.00 |
| G9717 |
Documentation stating the patient has had a diagnosis of bipolar disorder |
18,616 |
12,757 |
$0.00 |
| 91307 |
|
1,855 |
1,724 |
$0.00 |
| 1123F |
|
1,430 |
1,041 |
$0.00 |
| 3044F |
|
1,773 |
1,351 |
$0.00 |
| 99024 |
|
18,017 |
12,753 |
$0.00 |
| 91301 |
|
1,046 |
1,041 |
$0.00 |
| 3079F |
|
3,044 |
2,874 |
$0.00 |
| 91303 |
|
260 |
206 |
$0.00 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
706 |
686 |
$0.00 |
| 3075F |
|
1,687 |
1,623 |
$0.00 |
| 90744 |
|
60 |
59 |
$0.00 |
| 1111F |
|
1,359 |
828 |
$0.00 |
| G8432 |
Depression screening not documented, reason not given |
1,960 |
1,464 |
$0.00 |
| 92250 |
|
29 |
25 |
$0.00 |
| 3080F |
|
834 |
792 |
$0.00 |
| 3052F |
|
351 |
208 |
$0.00 |
| 91305 |
|
717 |
707 |
$0.00 |
| 84402 |
|
15 |
14 |
$0.00 |
| 91306 |
|
456 |
455 |
$0.00 |
| 94761 |
|
31 |
28 |
$0.00 |
| 73503 |
|
17 |
13 |
$0.00 |
| 91315 |
|
25 |
25 |
$0.00 |
| 82378 |
|
13 |
12 |
$0.00 |
| Q9969 |
Tc-99m from non-highly enriched uranium source, full cost recovery add-on, per study dose |
14 |
12 |
$0.00 |
| 99493 |
|
12 |
12 |
$0.00 |