| Code | Description | Claims | Beneficiaries | Total Paid |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
247,926 |
237,699 |
$17.08M |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
233,505 |
231,211 |
$13.81M |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
105,523 |
104,036 |
$11.02M |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
204,467 |
195,061 |
$10.44M |
| 99232 |
Subsequent hospital care, per day, moderate complexity |
133,627 |
63,467 |
$8.39M |
| 99215 |
Prolong outpt/office vis |
90,192 |
84,106 |
$8.05M |
| 99233 |
Prolong inpt eval add15 m |
85,443 |
37,303 |
$7.82M |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
54,617 |
53,555 |
$6.57M |
| 99244 |
Office or other outpatient consultation, moderate to high complexity |
39,823 |
39,322 |
$5.70M |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
37,665 |
37,105 |
$5.63M |
| 99243 |
|
36,360 |
35,902 |
$3.60M |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
38,496 |
37,138 |
$3.34M |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
73,352 |
70,877 |
$3.10M |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
19,237 |
19,005 |
$2.99M |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
70,608 |
69,833 |
$2.64M |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
14,390 |
13,941 |
$2.58M |
| 93303 |
Transthoracic echocardiography for congenital cardiac anomalies, follow-up or limited study |
35,448 |
33,361 |
$2.51M |
| 99472 |
Subsequent inpatient pediatric critical care, per day, 2-5 years |
5,444 |
1,616 |
$1.94M |
| 92015 |
Determination of refractive state |
90,615 |
89,156 |
$1.79M |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
29,335 |
28,789 |
$1.78M |
| 93306 |
Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete |
23,050 |
21,919 |
$1.71M |
| 99291 |
Critical care, evaluation and management of the critically ill patient, first 30-74 minutes |
8,504 |
3,865 |
$1.60M |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
26,744 |
9,580 |
$1.54M |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
17,691 |
17,393 |
$1.49M |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
17,966 |
17,082 |
$1.46M |
| 99239 |
Hospital discharge day management, more than 30 minutes |
15,248 |
15,129 |
$1.46M |
| 95720 |
|
6,411 |
3,936 |
$1.24M |
| 99222 |
Initial hospital care, per day, moderate complexity |
10,033 |
9,956 |
$1.20M |
| 70551 |
Magnetic resonance imaging, brain; without contrast material |
19,203 |
18,488 |
$1.19M |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
12,074 |
11,924 |
$1.13M |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
13,062 |
12,946 |
$1.08M |
| 99245 |
|
6,269 |
6,213 |
$1.05M |
| 71045 |
Radiologic examination, chest; single view |
93,708 |
56,529 |
$831K |
| 93010 |
Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only |
88,849 |
81,939 |
$772K |
| 99479 |
Subsequent intensive care, per day, very low birth weight infant |
6,881 |
2,481 |
$752K |
| 70553 |
Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences |
7,486 |
7,249 |
$745K |
| 95951 |
|
2,059 |
1,030 |
$730K |
| 93320 |
|
36,945 |
34,222 |
$723K |
| 97803 |
|
16,622 |
15,872 |
$721K |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
25,600 |
24,959 |
$718K |
| 95810 |
Polysomnography; sleep staging with 4 or more additional parameters |
5,319 |
5,190 |
$699K |
| 01922 |
|
1,817 |
1,805 |
$640K |
| 76770 |
|
18,862 |
18,594 |
$627K |
| 71046 |
Radiologic examination, chest; 2 views |
59,840 |
58,707 |
$624K |
| 42820 |
Tonsillectomy and adenoidectomy; younger than age 12 |
2,059 |
2,024 |
$580K |
| 90791 |
Psychiatric diagnostic evaluation |
5,563 |
5,361 |
$579K |
| 99469 |
Subsequent inpatient neonatal critical care, per day, 28 days or younger |
1,526 |
622 |
$524K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
5,538 |
5,473 |
$518K |
| 92060 |
|
7,630 |
7,515 |
$473K |
| 74018 |
|
54,174 |
44,280 |
$470K |
| S9470 |
Nutritional counseling, dietitian visit |
3,195 |
3,085 |
$446K |
| 99242 |
|
6,331 |
6,263 |
$434K |
| 99480 |
Subsequent intensive care, per day, low birth weight infant |
4,074 |
1,697 |
$429K |
| 70450 |
Computed tomography, head or brain; without contrast material |
10,352 |
10,147 |
$419K |
| 99238 |
Hospital discharge day management, 30 minutes or less |
5,668 |
5,582 |
$375K |
| 69436 |
Tympanostomy (requiring insertion of ventilating tube), general anesthesia |
1,875 |
1,822 |
$364K |
| 43239 |
Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple |
3,136 |
2,997 |
$352K |
| 95782 |
|
2,102 |
2,017 |
$336K |
| 95819 |
|
5,375 |
5,278 |
$320K |
| 99205 |
Prolong outpt/office vis |
2,253 |
2,218 |
$264K |
| 99417 |
Prolong home eval add 15m |
4,316 |
4,033 |
$240K |
| 99255 |
|
1,389 |
1,382 |
$238K |
| 74019 |
|
20,552 |
19,921 |
$227K |
| 88342 |
|
6,190 |
5,253 |
$225K |
| 93325 |
|
47,663 |
43,546 |
$222K |
| 95004 |
Percutaneous tests with allergenic extracts, immediate type reaction |
3,067 |
2,946 |
$218K |
| 99254 |
|
1,517 |
1,498 |
$214K |
| 90837 |
Psychotherapy, 53 minutes with patient |
2,670 |
1,355 |
$214K |
| 97802 |
|
3,075 |
3,038 |
$205K |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
2,267 |
2,206 |
$193K |
| 92587 |
|
9,795 |
9,421 |
$189K |
| 99231 |
Subsequent hospital care, per day, straightforward or low complexity |
5,437 |
2,902 |
$188K |
| 96156 |
|
2,096 |
2,046 |
$186K |
| 97112 |
Therapeutic procedure, each 15 minutes; neuromuscular reeducation of movement, balance, coordination |
5,148 |
2,177 |
$185K |
| 92567 |
|
12,100 |
11,750 |
$180K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
11,001 |
10,427 |
$172K |
| 97530 |
Therapeutic activities, direct patient contact, each 15 minutes |
3,576 |
1,421 |
$164K |
| 00170 |
Anesthesia for intraoral procedures, including biopsy |
627 |
623 |
$164K |
| 25600 |
|
488 |
480 |
$163K |
| 95816 |
|
2,713 |
2,669 |
$159K |
| 99223 |
Prolong inpt eval add15 m |
981 |
959 |
$159K |
| 88108 |
|
6,789 |
5,835 |
$151K |
| 92579 |
|
3,179 |
3,125 |
$147K |
| 97140 |
Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) |
5,342 |
2,101 |
$134K |
| 88307 |
|
1,111 |
1,053 |
$116K |
| 90834 |
Psychotherapy, 45 minutes with patient |
1,956 |
1,261 |
$115K |
| 54161 |
|
770 |
756 |
$114K |
| 88341 |
|
1,038 |
950 |
$110K |
| 73090 |
|
12,854 |
11,768 |
$104K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
4,301 |
3,909 |
$101K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
6,064 |
5,659 |
$99K |
| 99219 |
|
888 |
872 |
$99K |
| 74230 |
|
3,852 |
3,807 |
$99K |
| 44970 |
|
158 |
156 |
$97K |
| 22899 |
|
42 |
38 |
$94K |
| 94060 |
|
7,266 |
6,997 |
$89K |
| 94621 |
|
1,272 |
1,259 |
$85K |
| D8670 |
Periodic orthodontic treatment visit |
1,384 |
1,200 |
$85K |
| 76376 |
|
8,939 |
8,596 |
$85K |
| 88304 |
|
6,864 |
6,771 |
$82K |
| 64642 |
|
940 |
887 |
$78K |
| 93975 |
|
1,340 |
1,317 |
$75K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
2,465 |
2,416 |
$75K |
| 85060 |
|
3,447 |
3,247 |
$75K |
| 96112 |
|
637 |
610 |
$74K |
| 93000 |
|
4,292 |
4,131 |
$67K |
| 99253 |
|
658 |
650 |
$65K |
| 67311 |
|
108 |
105 |
$65K |
| 54300 |
|
109 |
109 |
$64K |
| 64643 |
|
828 |
773 |
$64K |
| T1016 |
Case management, each 15 minutes |
1,174 |
937 |
$62K |
| 92201 |
|
2,687 |
1,734 |
$61K |
| 90461 |
|
1,692 |
1,573 |
$60K |
| 95251 |
|
1,718 |
1,701 |
$56K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
2,140 |
1,938 |
$55K |
| 72148 |
Magnetic resonance imaging, lumbar spine; without contrast material |
832 |
811 |
$54K |
| 73610 |
|
6,395 |
6,021 |
$53K |
| 93793 |
|
5,352 |
1,598 |
$53K |
| 94010 |
|
6,251 |
6,157 |
$52K |
| 96131 |
|
261 |
248 |
$51K |
| 96167 |
|
786 |
451 |
$51K |
| 99292 |
|
379 |
215 |
$51K |
| 96450 |
|
633 |
585 |
$49K |
| 76825 |
|
651 |
637 |
$48K |
| 73080 |
|
5,412 |
5,221 |
$48K |
| 73630 |
|
5,626 |
5,035 |
$45K |
| 31622 |
|
554 |
505 |
$45K |
| 93227 |
|
1,706 |
1,668 |
$44K |
| 96113 |
|
619 |
586 |
$44K |
| 93976 |
|
1,068 |
1,051 |
$42K |
| 85097 |
|
910 |
845 |
$42K |
| 99335 |
|
531 |
480 |
$41K |
| 85390 |
|
1,093 |
620 |
$40K |
| 96130 |
|
573 |
556 |
$40K |
| 92002 |
|
495 |
484 |
$39K |
| 99464 |
|
633 |
625 |
$38K |
| 73590 |
|
4,739 |
4,341 |
$38K |
| 73521 |
|
3,577 |
3,519 |
$37K |
| 90792 |
Psychiatric diagnostic evaluation with medical services |
434 |
429 |
$37K |
| 72082 |
|
2,576 |
2,549 |
$37K |
| 73140 |
|
5,365 |
5,218 |
$37K |
| 49452 |
|
269 |
257 |
$34K |
| 93304 |
|
646 |
582 |
$34K |
| 97161 |
|
340 |
337 |
$33K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
850 |
738 |
$31K |
| 99418 |
Prolong nursin fac eval 15m |
295 |
273 |
$31K |
| 31624 |
|
252 |
248 |
$30K |
| 69210 |
|
641 |
602 |
$29K |
| 88300 |
|
6,591 |
6,437 |
$29K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
661 |
655 |
$28K |
| 93244 |
|
1,180 |
1,168 |
$28K |
| 29075 |
|
432 |
403 |
$27K |
| 93272 |
|
1,020 |
998 |
$26K |
| D0367 |
|
192 |
187 |
$26K |
| 76498 |
|
22 |
17 |
$25K |
| 72141 |
|
395 |
388 |
$25K |
| 76536 |
|
953 |
939 |
$24K |
| 73130 |
|
2,832 |
2,617 |
$23K |
| 92552 |
|
1,110 |
963 |
$23K |
| 73110 |
|
2,652 |
2,499 |
$22K |
| 31526 |
|
221 |
188 |
$22K |
| 90832 |
Psychotherapy, 30 minutes with patient |
492 |
329 |
$22K |
| 93321 |
|
2,504 |
2,302 |
$21K |
| 31575 |
|
181 |
177 |
$20K |
| 26720 |
|
106 |
104 |
$19K |
| 92555 |
|
767 |
752 |
$19K |
| 74240 |
|
504 |
499 |
$19K |
| 87811 |
Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) |
472 |
466 |
$19K |
| 94664 |
|
1,519 |
1,397 |
$18K |
| 76700 |
Ultrasound, abdominal, real time with image documentation; complete |
479 |
474 |
$18K |
| 99177 |
|
846 |
827 |
$18K |
| 29450 |
|
126 |
54 |
$18K |
| 93356 |
|
1,804 |
1,461 |
$17K |
| 76827 |
|
683 |
665 |
$17K |
| 99217 |
|
246 |
241 |
$17K |
| 77072 |
|
1,820 |
1,804 |
$17K |
| 93228 |
|
617 |
616 |
$16K |
| 70486 |
|
417 |
408 |
$16K |
| 73100 |
|
1,920 |
1,797 |
$16K |
| 70544 |
|
301 |
293 |
$16K |
| 73562 |
|
1,759 |
1,612 |
$15K |
| 95873 |
|
882 |
817 |
$15K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
499 |
491 |
$15K |
| 77073 |
|
1,203 |
1,181 |
$15K |
| 90853 |
Group psychotherapy (other than of a multiple-family group) |
1,023 |
607 |
$15K |
| 99460 |
|
215 |
209 |
$15K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
1,973 |
1,945 |
$14K |
| 99252 |
|
221 |
219 |
$14K |
| 96150 |
|
223 |
200 |
$14K |
| 81002 |
|
4,467 |
4,122 |
$14K |
| 98928 |
|
252 |
214 |
$14K |
| 76942 |
|
493 |
473 |
$13K |
| 71260 |
Computed tomography, thorax, diagnostic; with contrast material |
246 |
240 |
$13K |
| 76506 |
|
405 |
353 |
$12K |
| 36512 |
|
130 |
119 |
$12K |
| 98927 |
|
273 |
218 |
$12K |
| 92285 |
|
508 |
496 |
$12K |
| 88312 |
|
412 |
392 |
$12K |
| 92551 |
|
5,615 |
5,189 |
$11K |
| 76604 |
|
485 |
478 |
$11K |
| 99478 |
|
93 |
15 |
$11K |
| 95886 |
|
212 |
200 |
$11K |
| 87400 |
|
405 |
401 |
$11K |
| 99381 |
|
125 |
120 |
$11K |
| 93971 |
|
512 |
469 |
$11K |
| 29888 |
|
12 |
12 |
$11K |
| 92550 |
|
486 |
469 |
$10K |
| 00300 |
|
34 |
34 |
$10K |
| 95076 |
|
151 |
145 |
$10K |
| 29085 |
|
146 |
137 |
$10K |
| 0071A |
|
128 |
121 |
$10K |
| 96161 |
|
14,274 |
14,039 |
$9K |
| 99442 |
|
125 |
122 |
$9K |
| 95012 |
|
662 |
625 |
$9K |
| 92226 |
|
245 |
145 |
$9K |
| 93280 |
|
225 |
214 |
$9K |
| 93294 |
|
290 |
282 |
$8K |
| 73721 |
Magnetic resonance imaging, any joint of lower extremity; without contrast material |
146 |
135 |
$8K |
| 72146 |
|
133 |
128 |
$8K |
| 87807 |
|
613 |
588 |
$8K |
| 90833 |
Psychotherapy, 30 minutes with patient when performed with an E&M service (add-on) |
300 |
281 |
$8K |
| 96158 |
|
118 |
118 |
$8K |
| 85018 |
|
3,115 |
2,897 |
$8K |
| 96155 |
|
217 |
95 |
$8K |
| 0072A |
|
102 |
92 |
$7K |
| 77001 |
|
409 |
376 |
$7K |
| 72158 |
|
86 |
74 |
$7K |
| 99471 |
|
12 |
12 |
$7K |
| 99475 |
|
13 |
13 |
$7K |
| 76882 |
|
276 |
257 |
$7K |
| 96154 |
|
105 |
84 |
$7K |
| 72157 |
|
79 |
69 |
$7K |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
372 |
352 |
$7K |
| 96160 |
|
4,540 |
4,331 |
$7K |
| 73552 |
|
730 |
676 |
$6K |
| 96168 |
|
168 |
129 |
$6K |
| 74712 |
|
53 |
50 |
$6K |
| 70543 |
|
69 |
67 |
$6K |
| 83020 |
|
383 |
360 |
$6K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
185 |
176 |
$6K |
| 97750 |
|
141 |
130 |
$6K |
| 72081 |
|
509 |
500 |
$6K |
| 88313 |
|
274 |
267 |
$6K |
| 00731 |
|
26 |
26 |
$6K |
| 90847 |
Family psychotherapy with the patient present, 50 minutes |
86 |
37 |
$6K |
| 99173 |
|
7,628 |
6,972 |
$5K |
| 76870 |
|
173 |
168 |
$5K |
| 76937 |
|
388 |
350 |
$5K |
| 72156 |
|
66 |
56 |
$5K |
| 36415 |
Collection of venous blood by venipuncture |
1,507 |
1,463 |
$5K |
| 93784 |
|
110 |
109 |
$5K |
| 99356 |
|
57 |
32 |
$5K |
| D0350 |
|
224 |
214 |
$5K |
| 64640 |
|
45 |
39 |
$5K |
| 99443 |
|
42 |
40 |
$4K |
| 95991 |
|
123 |
123 |
$4K |
| 99383 |
|
39 |
39 |
$4K |
| 96137 |
|
98 |
93 |
$4K |
| 95117 |
|
321 |
240 |
$4K |
| 75557 |
|
40 |
37 |
$4K |
| 73000 |
|
425 |
412 |
$3K |
| 76010 |
|
390 |
383 |
$3K |
| 43762 |
|
93 |
91 |
$3K |
| 85576 |
|
180 |
174 |
$3K |
| 36011 |
|
33 |
25 |
$3K |
| 91122 |
|
38 |
37 |
$3K |
| 00140 |
|
12 |
12 |
$3K |
| 96127 |
|
605 |
598 |
$3K |
| 77075 |
|
108 |
107 |
$3K |
| 93597 |
|
21 |
13 |
$3K |
| 92250 |
|
102 |
92 |
$3K |
| 99462 |
|
92 |
74 |
$3K |
| 76981 |
|
93 |
92 |
$3K |
| 92225 |
|
73 |
60 |
$3K |
| 94770 |
|
360 |
325 |
$2K |
| 92558 |
|
312 |
304 |
$2K |
| D0160 |
|
93 |
92 |
$2K |
| 99220 |
|
13 |
12 |
$2K |
| 92582 |
|
26 |
26 |
$2K |
| 99221 |
|
26 |
26 |
$2K |
| 94726 |
|
173 |
170 |
$2K |
| 93505 |
|
12 |
12 |
$2K |
| 76800 |
|
41 |
41 |
$2K |
| 92556 |
|
56 |
55 |
$2K |
| 99235 |
|
13 |
13 |
$2K |
| 90686 |
|
16,578 |
14,403 |
$2K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
169 |
152 |
$2K |
| 73560 |
|
225 |
191 |
$2K |
| 73030 |
|
174 |
169 |
$2K |
| 72100 |
|
155 |
155 |
$2K |
| 75561 |
|
14 |
14 |
$2K |
| 97016 |
|
135 |
43 |
$2K |
| 99281 |
Emergency department visit for the evaluation and management, self-limited or minor |
80 |
80 |
$1K |
| 96116 |
|
17 |
12 |
$1K |
| 90677 |
|
364 |
352 |
$1K |
| 99347 |
|
30 |
29 |
$1K |
| 78816 |
|
12 |
12 |
$1K |
| 73070 |
|
144 |
137 |
$1K |
| 70491 |
|
12 |
12 |
$1K |
| 93567 |
|
35 |
25 |
$1K |
| 96136 |
|
85 |
81 |
$1K |
| 93568 |
|
28 |
25 |
$1K |
| 99241 |
|
28 |
28 |
$1K |
| 75565 |
|
102 |
96 |
$1K |
| 93308 |
|
45 |
40 |
$1K |
| 94729 |
|
106 |
104 |
$1K |
| 0081A |
|
12 |
12 |
$991.85 |
| 30802 |
|
12 |
12 |
$968.72 |
| 29130 |
|
32 |
30 |
$967.06 |
| 72170 |
|
126 |
125 |
$939.17 |
| 96170 |
|
13 |
12 |
$936.56 |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
24 |
24 |
$909.79 |
| 99174 |
|
309 |
286 |
$902.16 |
| 41899 |
Unlisted procedure, dentoalveolar structures |
28 |
13 |
$895.83 |
| 29125 |
|
21 |
18 |
$881.94 |
| 71555 |
|
12 |
12 |
$862.81 |
| 76514 |
|
125 |
116 |
$855.74 |
| 70250 |
|
94 |
88 |
$832.65 |
| 73060 |
|
100 |
96 |
$820.77 |
| 29065 |
|
12 |
12 |
$791.35 |
| 99348 |
|
12 |
12 |
$782.37 |
| 95165 |
Professional services for the supervision of preparation and provision of antigens for allergen immunotherapy, multiple dose vials |
12 |
12 |
$772.58 |
| 90670 |
|
7,016 |
6,188 |
$742.72 |
| D0470 |
|
12 |
12 |
$677.18 |
| 70487 |
|
13 |
13 |
$666.19 |
| 77080 |
|
70 |
70 |
$654.30 |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
80 |
79 |
$641.03 |
| 92083 |
|
15 |
13 |
$600.93 |
| 95812 |
|
12 |
12 |
$595.92 |
| 74270 |
|
12 |
12 |
$583.30 |
| 86077 |
|
14 |
13 |
$581.95 |
| 92553 |
|
12 |
12 |
$537.18 |
| 90698 |
|
3,912 |
3,538 |
$526.28 |
| 0001A |
|
13 |
13 |
$520.80 |
| 64447 |
|
12 |
12 |
$485.94 |
| 62370 |
|
16 |
16 |
$481.40 |
| 92133 |
|
13 |
13 |
$464.01 |
| 88344 |
|
12 |
12 |
$434.88 |
| D9430 |
|
42 |
39 |
$390.24 |
| 95972 |
|
13 |
12 |
$389.45 |
| 90480 |
|
12 |
12 |
$351.71 |
| 86580 |
|
44 |
42 |
$335.67 |
| 87420 |
|
25 |
25 |
$330.48 |
| 73660 |
|
52 |
52 |
$291.81 |
| 95885 |
|
15 |
12 |
$225.97 |
| 90734 |
|
486 |
412 |
$215.95 |
| 72070 |
|
24 |
24 |
$213.27 |
| 94760 |
|
582 |
462 |
$212.26 |
| 74455 |
|
12 |
12 |
$194.49 |
| 73564 |
|
18 |
14 |
$175.55 |
| 74021 |
|
14 |
14 |
$134.91 |
| 73620 |
|
18 |
13 |
$122.87 |
| 70360 |
|
14 |
12 |
$119.86 |
| 81025 |
|
15 |
13 |
$82.47 |
| 88720 |
|
12 |
12 |
$59.34 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
59 |
54 |
$57.65 |
| 99000 |
|
474 |
370 |
$55.48 |
| 90680 |
|
2,463 |
2,174 |
$47.68 |
| 90744 |
|
1,070 |
940 |
$27.59 |
| 90685 |
|
740 |
598 |
$19.32 |
| J7613 |
Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg |
63 |
61 |
$8.14 |
| 90700 |
|
854 |
603 |
$3.67 |
| 90651 |
|
913 |
781 |
$0.07 |
| 90656 |
|
197 |
162 |
$0.00 |
| 99024 |
|
154 |
131 |
$0.00 |
| 90619 |
|
52 |
50 |
$0.00 |
| 90716 |
|
464 |
392 |
$0.00 |
| 90647 |
|
188 |
97 |
$0.00 |
| 90620 |
|
41 |
36 |
$0.00 |
| 90696 |
|
24 |
24 |
$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 |
26 |
18 |
$0.00 |
| 91307 |
|
19 |
12 |
$0.00 |
| 94762 |
|
15 |
12 |
$0.00 |
| 90633 |
|
1,108 |
968 |
$0.00 |
| G9920 |
Screening performed and negative |
468 |
468 |
$0.00 |
| 90713 |
|
398 |
228 |
$0.00 |
| 90648 |
|
177 |
131 |
$0.00 |
| 90707 |
|
432 |
367 |
$0.00 |
| 90710 |
|
25 |
25 |
$0.00 |
| 90715 |
|
109 |
97 |
$0.00 |