| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 0121 |
|
3,381 |
3,268 |
$28.88M |
| 0214 |
|
2,428 |
2,369 |
$16.55M |
| 99281 |
Emergency department visit for the evaluation and management, self-limited or minor |
95,879 |
83,226 |
$6.98M |
| 97530 |
Therapeutic activities, direct patient contact, each 15 minutes |
69,987 |
22,625 |
$2.36M |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
8,038 |
7,705 |
$2.14M |
| 99460 |
|
459 |
437 |
$1.62M |
| 70450 |
Computed tomography, head or brain; without contrast material |
5,883 |
5,440 |
$1.23M |
| 87637 |
Infectious agent detection by nucleic acid; SARS-CoV-2, influenza, and RSV |
8,431 |
8,275 |
$1.13M |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
9,852 |
9,211 |
$1.08M |
| 93975 |
|
3,544 |
3,334 |
$1.06M |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
6,211 |
6,179 |
$1.04M |
| 72148 |
Magnetic resonance imaging, lumbar spine; without contrast material |
1,626 |
1,299 |
$1.00M |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
11,965 |
11,116 |
$991K |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
5,969 |
5,540 |
$974K |
| 70553 |
Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences |
996 |
870 |
$908K |
| 70551 |
Magnetic resonance imaging, brain; without contrast material |
1,554 |
1,300 |
$814K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
21,367 |
19,777 |
$805K |
| 96361 |
Intravenous infusion, hydration; each additional hour |
13,240 |
11,611 |
$721K |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
9,451 |
8,926 |
$686K |
| 93306 |
Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete |
4,031 |
3,568 |
$637K |
| 71260 |
Computed tomography, thorax, diagnostic; with contrast material |
1,832 |
1,811 |
$614K |
| 99243 |
|
8,753 |
8,722 |
$597K |
| 78815 |
Positron emission tomography (PET) for limited area imaging |
340 |
340 |
$587K |
| 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 |
7,710 |
6,348 |
$543K |
| 76700 |
Ultrasound, abdominal, real time with image documentation; complete |
4,062 |
3,940 |
$487K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
9,710 |
9,333 |
$477K |
| 80053 |
Comprehensive metabolic panel |
56,913 |
51,204 |
$458K |
| 71046 |
Radiologic examination, chest; 2 views |
14,835 |
14,093 |
$446K |
| 71275 |
Computed tomographic angiography, chest, with contrast material |
1,730 |
1,694 |
$426K |
| 87502 |
Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets |
6,114 |
5,995 |
$411K |
| 96360 |
Intravenous infusion, hydration; initial, 31 minutes to 1 hour |
5,157 |
5,012 |
$410K |
| 96375 |
Therapeutic injection; each additional sequential IV push |
7,236 |
6,573 |
$408K |
| 72125 |
Computed tomography, cervical spine; without contrast material |
1,353 |
1,301 |
$386K |
| 76830 |
Ultrasound, transvaginal |
3,732 |
3,586 |
$374K |
| 71250 |
|
1,606 |
1,596 |
$372K |
| 97799 |
|
8,237 |
2,542 |
$368K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
62,309 |
54,928 |
$368K |
| 76641 |
|
3,321 |
2,855 |
$319K |
| C9803 |
Hospital outpatient clinic visit specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source |
13,413 |
12,914 |
$296K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
2,741 |
2,600 |
$253K |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
2,789 |
2,605 |
$251K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
6,060 |
5,170 |
$241K |
| 78452 |
Myocardial perfusion imaging, tomographic (SPECT); multiple studies at rest and/or stress |
1,039 |
1,014 |
$237K |
| 77066 |
Tomosynthesis, mammo |
1,353 |
1,315 |
$228K |
| G0108 |
Diabetes outpatient self-management training services, individual, per 30 minutes |
2,632 |
2,063 |
$221K |
| 93971 |
|
1,626 |
1,537 |
$218K |
| 72141 |
|
332 |
280 |
$205K |
| 84443 |
Thyroid stimulating hormone (TSH) |
15,411 |
14,864 |
$200K |
| 93000 |
|
2,668 |
2,517 |
$198K |
| 74150 |
|
564 |
546 |
$193K |
| T1999 |
Miscellaneous therapeutic items and supplies, retail purchases, not otherwise classified; identify product in "remarks" |
98,830 |
40,868 |
$187K |
| 87651 |
Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe |
5,460 |
5,366 |
$167K |
| 73721 |
Magnetic resonance imaging, any joint of lower extremity; without contrast material |
352 |
230 |
$152K |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
1,559 |
1,463 |
$152K |
| 76770 |
|
1,477 |
1,423 |
$150K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
1,262 |
1,210 |
$148K |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
3,607 |
3,600 |
$142K |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
6,083 |
6,018 |
$139K |
| 95810 |
Polysomnography; sleep staging with 4 or more additional parameters |
358 |
234 |
$137K |
| 97802 |
|
785 |
784 |
$131K |
| 84484 |
|
15,309 |
11,899 |
$121K |
| 71045 |
Radiologic examination, chest; single view |
8,236 |
7,701 |
$111K |
| 80061 |
Lipid panel |
10,362 |
10,301 |
$111K |
| 76536 |
|
1,305 |
1,264 |
$100K |
| 92507 |
Treatment of speech, language, voice, communication, and/or auditory processing disorder |
2,588 |
762 |
$92K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
3,256 |
3,141 |
$92K |
| 70496 |
|
409 |
396 |
$88K |
| 73564 |
|
2,172 |
1,900 |
$88K |
| 93970 |
|
482 |
468 |
$88K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
2,959 |
2,849 |
$87K |
| 76801 |
|
1,073 |
917 |
$86K |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
2,485 |
2,226 |
$85K |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
12,868 |
12,039 |
$82K |
| 73030 |
|
2,140 |
1,971 |
$82K |
| 93017 |
|
1,588 |
1,575 |
$82K |
| 97803 |
|
575 |
538 |
$81K |
| 73610 |
|
1,923 |
1,740 |
$79K |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
2,408 |
2,178 |
$78K |
| 73630 |
|
2,049 |
1,863 |
$78K |
| 81001 |
|
31,238 |
28,911 |
$77K |
| 83690 |
|
14,521 |
13,385 |
$77K |
| 72110 |
|
953 |
935 |
$73K |
| 0450 |
Emergency room services |
6,909 |
6,466 |
$71K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
9,148 |
9,115 |
$69K |
| 90832 |
Psychotherapy, 30 minutes with patient |
675 |
612 |
$65K |
| 97165 |
|
1,001 |
988 |
$63K |
| 93015 |
|
278 |
277 |
$62K |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
14,385 |
8,754 |
$58K |
| A9552 |
Fluorodeoxyglucose f-18 fdg, diagnostic, per study dose, up to 45 millicuries |
298 |
298 |
$57K |
| 72100 |
|
1,384 |
1,340 |
$53K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
8,017 |
7,646 |
$51K |
| J7030 |
Infusion, normal saline solution , 1000 cc |
9,198 |
7,450 |
$50K |
| 83880 |
|
2,789 |
2,696 |
$48K |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
7,400 |
6,835 |
$45K |
| 81025 |
|
6,348 |
6,181 |
$45K |
| 87040 |
|
6,389 |
3,572 |
$45K |
| 74018 |
|
1,525 |
1,455 |
$44K |
| 0171 |
Inj, epinephrine (belcher) |
17 |
12 |
$42K |
| 73502 |
|
1,140 |
1,068 |
$41K |
| 84466 |
|
3,894 |
3,758 |
$41K |
| 84439 |
|
5,534 |
5,409 |
$40K |
| 73130 |
|
1,004 |
886 |
$39K |
| 77080 |
|
750 |
742 |
$38K |
| 70498 |
|
322 |
312 |
$36K |
| 83605 |
|
4,320 |
3,523 |
$34K |
| G0475 |
Hiv antigen/antibody, combination assay, screening |
1,632 |
1,624 |
$32K |
| 76870 |
|
325 |
313 |
$31K |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
891 |
706 |
$31K |
| 85379 |
|
4,059 |
3,991 |
$31K |
| 87801 |
Infectious agent detection by nucleic acid; amplified probe, multiple organisms |
824 |
800 |
$30K |
| J7050 |
Infusion, normal saline solution, 250 cc |
5,401 |
4,468 |
$29K |
| 87088 |
|
4,986 |
4,437 |
$29K |
| 82728 |
|
2,708 |
2,634 |
$29K |
| 84145 |
|
1,711 |
1,649 |
$29K |
| 86140 |
|
7,289 |
6,980 |
$28K |
| 87186 |
|
4,237 |
3,832 |
$27K |
| J2785 |
Injection, regadenoson, 0.1 mg |
351 |
347 |
$27K |
| J2270 |
Injection, morphine sulfate, up to 10 mg |
3,473 |
2,898 |
$26K |
| 82962 |
|
8,361 |
5,232 |
$25K |
| U0002 |
2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc |
528 |
509 |
$25K |
| 73110 |
|
711 |
556 |
$24K |
| 90839 |
|
416 |
402 |
$22K |
| 83540 |
|
4,075 |
3,937 |
$22K |
| 83735 |
|
4,696 |
4,267 |
$22K |
| 95957 |
|
120 |
80 |
$21K |
| 95811 |
|
57 |
39 |
$20K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
591 |
486 |
$20K |
| A9502 |
Technetium tc-99m tetrofosmin, diagnostic, per study dose |
381 |
344 |
$20K |
| 84481 |
|
1,493 |
1,447 |
$20K |
| 85610 |
|
6,754 |
6,264 |
$19K |
| 0002A |
|
480 |
480 |
$19K |
| 72070 |
|
387 |
375 |
$19K |
| Q3014 |
Telehealth originating site facility fee |
545 |
468 |
$19K |
| 93010 |
Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only |
1,525 |
1,374 |
$19K |
| 85730 |
|
4,824 |
4,677 |
$18K |
| 86780 |
|
1,577 |
1,560 |
$16K |
| 73221 |
|
37 |
25 |
$16K |
| 87081 |
|
2,589 |
2,546 |
$15K |
| 99291 |
Critical care, evaluation and management of the critically ill patient, first 30-74 minutes |
134 |
131 |
$15K |
| 11042 |
Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm |
1,156 |
723 |
$14K |
| 96379 |
|
18,211 |
6,765 |
$14K |
| 86480 |
|
340 |
339 |
$14K |
| 86803 |
|
1,205 |
1,199 |
$13K |
| 80074 |
|
332 |
331 |
$13K |
| 73560 |
|
400 |
323 |
$12K |
| A9500 |
Technetium tc-99m sestamibi, diagnostic, per study dose |
272 |
233 |
$12K |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
294 |
292 |
$12K |
| 84153 |
|
915 |
909 |
$12K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
1,137 |
992 |
$12K |
| 86481 |
|
229 |
229 |
$11K |
| 76881 |
|
168 |
147 |
$11K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
136 |
111 |
$11K |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
2,768 |
2,557 |
$11K |
| J0780 |
Injection, prochlorperazine, up to 10 mg |
1,093 |
1,034 |
$11K |
| 75574 |
|
39 |
39 |
$11K |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
1,958 |
1,783 |
$11K |
| 82746 |
|
1,018 |
1,008 |
$11K |
| J1170 |
Injection, hydromorphone, up to 4 mg |
1,584 |
1,154 |
$11K |
| 85652 |
|
5,329 |
5,084 |
$11K |
| Z7502 |
|
312 |
306 |
$11K |
| 0001A |
|
264 |
264 |
$11K |
| 94729 |
|
275 |
237 |
$10K |
| 82565 |
|
2,744 |
2,636 |
$10K |
| 93042 |
|
591 |
571 |
$10K |
| 86850 |
|
1,516 |
1,466 |
$9K |
| 84403 |
|
490 |
481 |
$9K |
| 70486 |
|
44 |
42 |
$9K |
| 94060 |
|
262 |
223 |
$9K |
| 95816 |
|
121 |
80 |
$9K |
| 94726 |
|
261 |
222 |
$9K |
| 74183 |
|
31 |
31 |
$9K |
| 94664 |
|
394 |
386 |
$9K |
| J2060 |
Injection, lorazepam, 2 mg |
1,875 |
1,625 |
$9K |
| J1200 |
Injection, diphenhydramine hcl, up to 50 mg |
1,971 |
1,804 |
$9K |
| 72040 |
|
217 |
214 |
$8K |
| 70491 |
|
27 |
26 |
$8K |
| 87653 |
|
337 |
335 |
$8K |
| 82550 |
|
1,568 |
1,405 |
$8K |
| 76813 |
|
84 |
79 |
$8K |
| 82043 |
|
1,627 |
1,618 |
$8K |
| 98960 |
|
160 |
150 |
$8K |
| 72050 |
|
102 |
101 |
$7K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
177 |
174 |
$7K |
| 73080 |
|
167 |
156 |
$7K |
| 83970 |
|
227 |
226 |
$7K |
| J2765 |
Injection, metoclopramide hcl, up to 10 mg |
1,445 |
1,287 |
$7K |
| 86038 |
|
1,262 |
1,243 |
$6K |
| 82607 |
|
952 |
945 |
$6K |
| 87340 |
|
776 |
773 |
$6K |
| 86901 |
|
2,579 |
2,446 |
$6K |
| 86900 |
|
2,578 |
2,445 |
$6K |
| 96366 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour |
99 |
93 |
$6K |
| 87210 |
|
1,183 |
1,168 |
$6K |
| 87806 |
|
174 |
170 |
$5K |
| 77049 |
|
12 |
12 |
$5K |
| 73590 |
|
158 |
146 |
$5K |
| 87536 |
|
74 |
74 |
$5K |
| 72131 |
|
14 |
13 |
$5K |
| 87070 |
|
634 |
606 |
$4K |
| 0054A |
|
108 |
108 |
$4K |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
912 |
876 |
$4K |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
936 |
815 |
$4K |
| G0279 |
Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066) |
101 |
101 |
$4K |
| 0012A |
|
97 |
97 |
$4K |
| 71101 |
|
79 |
77 |
$4K |
| 77336 |
|
57 |
25 |
$3K |
| 99199 |
Unlisted special service, procedure or report |
67 |
60 |
$3K |
| 73700 |
|
13 |
13 |
$3K |
| J7120 |
Ringers lactate infusion, up to 1000 cc |
619 |
508 |
$3K |
| 0250 |
|
6,528 |
6,161 |
$3K |
| 74178 |
|
13 |
13 |
$3K |
| 73140 |
|
100 |
93 |
$3K |
| 0270 |
|
2,776 |
2,457 |
$3K |
| 93246 |
|
153 |
153 |
$3K |
| 74019 |
|
91 |
89 |
$3K |
| 82248 |
|
749 |
666 |
$3K |
| 93350 |
|
27 |
27 |
$3K |
| 93880 |
|
24 |
24 |
$3K |
| 84550 |
|
728 |
707 |
$3K |
| 0949 |
|
4,577 |
4,442 |
$2K |
| 0300 |
|
6,102 |
5,874 |
$2K |
| 80069 |
|
323 |
297 |
$2K |
| 86308 |
|
421 |
409 |
$2K |
| 82670 |
|
104 |
104 |
$2K |
| 0301 |
|
6,028 |
5,752 |
$2K |
| 84270 |
|
114 |
114 |
$2K |
| 82803 |
|
114 |
103 |
$2K |
| 0064A |
|
44 |
44 |
$2K |
| 87427 |
|
264 |
132 |
$2K |
| 83001 |
|
127 |
126 |
$2K |
| J2272 |
Injection, morphine sulfate (fresenius kabi), not therapeutically equivalent to j2270, up to 10 mg |
248 |
218 |
$2K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
13 |
13 |
$2K |
| 87493 |
|
90 |
89 |
$2K |
| 0071A |
|
39 |
39 |
$2K |
| 73120 |
|
69 |
64 |
$2K |
| J1630 |
Injection, haloperidol, up to 5 mg |
262 |
215 |
$2K |
| 84156 |
|
637 |
621 |
$1K |
| 71020 |
|
25 |
25 |
$1K |
| 80076 |
|
227 |
223 |
$1K |
| 0350 |
|
1,304 |
1,289 |
$1K |
| 99221 |
|
842 |
418 |
$1K |
| 86592 |
|
308 |
303 |
$1K |
| 86431 |
|
332 |
331 |
$1K |
| J7070 |
Infusion, d5w, 1000 cc |
237 |
168 |
$1K |
| 0072A |
|
32 |
32 |
$1K |
| 0352 |
|
1,285 |
1,274 |
$1K |
| 72082 |
|
12 |
12 |
$1K |
| 84100 |
|
352 |
311 |
$1K |
| 87077 |
|
156 |
111 |
$1K |
| J3490 |
Unclassified drugs |
303 |
140 |
$1K |
| 90715 |
|
29 |
29 |
$1K |
| 76642 |
|
13 |
13 |
$1K |
| 0351 |
|
1,003 |
991 |
$1K |
| 72170 |
|
38 |
38 |
$995.92 |
| 0402 |
|
825 |
814 |
$975.29 |
| 87045 |
|
134 |
131 |
$959.43 |
| Z7610 |
|
101 |
50 |
$940.84 |
| 0004A |
|
23 |
23 |
$920.00 |
| 0011A |
|
23 |
23 |
$920.00 |
| 99000 |
|
2,067 |
1,986 |
$888.82 |
| 84450 |
|
193 |
189 |
$807.22 |
| 0730 |
|
3,599 |
3,500 |
$786.17 |
| 84075 |
|
186 |
182 |
$776.71 |
| 86359 |
|
25 |
25 |
$754.50 |
| 82247 |
|
188 |
183 |
$752.12 |
| 80055 |
|
12 |
12 |
$751.80 |
| 82040 |
|
184 |
179 |
$732.65 |
| 82784 |
|
140 |
114 |
$723.10 |
| 80164 |
|
80 |
75 |
$718.80 |
| 88304 |
|
21 |
15 |
$695.60 |
| 84702 |
|
41 |
27 |
$684.96 |
| 85044 |
|
164 |
160 |
$609.03 |
| 84155 |
|
185 |
181 |
$542.86 |
| 83615 |
|
92 |
86 |
$508.28 |
| 84703 |
|
710 |
673 |
$500.46 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
15 |
13 |
$495.81 |
| 86762 |
|
45 |
45 |
$489.18 |
| J2930 |
Injection, methylprednisolone sodium succinate, up to 125 mg |
49 |
49 |
$451.02 |
| 83516 |
|
47 |
38 |
$409.02 |
| Q9966 |
Low osmolar contrast material, 200-299 mg/ml iodine concentration, per ml |
33 |
19 |
$367.01 |
| 0320 |
|
716 |
700 |
$362.73 |
| 73090 |
|
13 |
12 |
$295.74 |
| J2919 |
Injection, methylprednisolone sodium succinate, 5 mg |
70 |
65 |
$286.99 |
| 0306 |
|
3,385 |
3,283 |
$284.51 |
| 0272 |
|
1,625 |
1,584 |
$280.42 |
| 86800 |
|
14 |
13 |
$241.50 |
| 86706 |
|
28 |
28 |
$233.67 |
| 82274 |
|
14 |
14 |
$230.43 |
| 0305 |
|
5,303 |
5,122 |
$228.83 |
| 82951 |
|
25 |
25 |
$226.60 |
| 86704 |
|
25 |
25 |
$221.72 |
| 93016 |
|
13 |
13 |
$212.82 |
| 0324 |
|
2,837 |
2,773 |
$199.25 |
| 0258 |
|
3,518 |
3,436 |
$191.95 |
| 80305 |
|
13 |
13 |
$186.68 |
| J3475 |
Injection, magnesium sulfate, per 500 mg |
54 |
52 |
$170.34 |
| 82533 |
|
14 |
13 |
$169.52 |
| J7040 |
Infusion, normal saline solution, sterile (500 ml = 1 unit) |
35 |
25 |
$157.73 |
| 85027 |
|
29 |
27 |
$155.25 |
| 36415 |
Collection of venous blood by venipuncture |
1,762 |
1,676 |
$139.76 |
| 11043 |
|
21 |
15 |
$139.41 |
| J1644 |
Injection, heparin sodium, per 1000 units |
41 |
27 |
$131.26 |
| 82172 |
|
12 |
12 |
$125.98 |
| 86200 |
|
27 |
27 |
$123.86 |
| 93018 |
|
13 |
13 |
$123.33 |
| 82009 |
|
42 |
38 |
$120.97 |
| 0255 |
|
2,125 |
2,087 |
$116.60 |
| 82330 |
|
12 |
12 |
$113.90 |
| 86160 |
|
19 |
12 |
$98.80 |
| J2001 |
Injection, lidocaine hcl for intravenous infusion, 10 mg |
25 |
24 |
$93.10 |
| 86635 |
|
14 |
14 |
$88.08 |
| 83002 |
|
12 |
12 |
$78.00 |
| 84436 |
|
13 |
12 |
$67.10 |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
15 |
13 |
$67.09 |
| 84132 |
|
27 |
26 |
$64.77 |
| 85014 |
|
13 |
13 |
$16.89 |
| J1171 |
Injection, hydromorphone, 0.1 mg |
14 |
13 |
$12.88 |
| J7613 |
Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg |
14 |
14 |
$2.07 |
| A9575 |
Injection, gadoterate meglumine, 0.1 ml |
312 |
220 |
$1.00 |
| Q0162 |
Ondansetron 1 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at the time of chemotherapy treatment, not to exceed a 48 hour dosage regimen |
30 |
28 |
$0.19 |
| 0430 |
|
844 |
831 |
$0.00 |
| 0489 |
|
1,392 |
1,382 |
$0.00 |
| 0360 |
|
134 |
132 |
$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 |
125 |
117 |
$0.00 |
| G8978 |
Mobility: walking & moving around functional limitation, current status, at therapy episode outset and at reporting intervals |
99 |
92 |
$0.00 |
| G8990 |
Other physical or occupational therapy primary functional limitation, current status, at therapy episode outset and at reporting intervals |
13 |
13 |
$0.00 |
| 0420 |
|
1,883 |
1,844 |
$0.00 |
| 0471 |
|
446 |
443 |
$0.00 |
| 0710 |
|
120 |
118 |
$0.00 |
| 0440 |
|
597 |
591 |
$0.00 |
| 0410 |
|
1,154 |
1,135 |
$0.00 |
| 0370 |
|
134 |
132 |
$0.00 |
| 0611 |
|
183 |
181 |
$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 |
27 |
24 |
$0.00 |
| 0310 |
|
36 |
36 |
$0.00 |
| 96376 |
|
180 |
149 |
$0.00 |
| G8991 |
Other physical or occupational therapy primary functional limitation, projected goal status, at therapy episode outset, at reporting intervals, and at discharge or to end reporting |
13 |
13 |
$0.00 |