| Code | Description | Claims | Beneficiaries | Total Paid |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
33,206 |
30,999 |
$3.53M |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
15,312 |
13,416 |
$3.08M |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
23,208 |
20,550 |
$2.81M |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
23,159 |
20,711 |
$2.66M |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
4,631 |
3,726 |
$1.25M |
| 96361 |
Intravenous infusion, hydration; each additional hour |
3,840 |
2,746 |
$1.25M |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
18,245 |
4,881 |
$1.24M |
| 70450 |
Computed tomography, head or brain; without contrast material |
3,874 |
3,396 |
$873K |
| 0241U |
Neonatal screening for hereditary disorders, genomic sequence analysis panel |
4,115 |
3,675 |
$602K |
| 96360 |
Intravenous infusion, hydration; initial, 31 minutes to 1 hour |
2,250 |
1,860 |
$550K |
| 80053 |
Comprehensive metabolic panel |
42,778 |
37,194 |
$492K |
| 92507 |
Treatment of speech, language, voice, communication, and/or auditory processing disorder |
5,870 |
1,779 |
$459K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
3,904 |
3,613 |
$405K |
| 43239 |
Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple |
1,087 |
999 |
$377K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
1,371 |
1,147 |
$357K |
| 96366 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour |
1,160 |
898 |
$312K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
2,436 |
2,201 |
$257K |
| 45380 |
Colonoscopy, flexible; with biopsy, single or multiple |
770 |
716 |
$243K |
| 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 |
1,725 |
1,553 |
$241K |
| 71275 |
Computed tomographic angiography, chest, with contrast material |
805 |
659 |
$204K |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
2,178 |
1,201 |
$193K |
| 45385 |
Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) |
322 |
290 |
$185K |
| 84443 |
Thyroid stimulating hormone (TSH) |
10,198 |
9,492 |
$174K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
52,313 |
44,457 |
$166K |
| 11042 |
Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm |
2,497 |
1,055 |
$162K |
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
6,678 |
5,507 |
$156K |
| G0378 |
Hospital observation service, per hour |
2,288 |
1,114 |
$143K |
| 97112 |
Therapeutic procedure, each 15 minutes; neuromuscular reeducation of movement, balance, coordination |
2,330 |
696 |
$133K |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
1,358 |
1,244 |
$133K |
| 80061 |
Lipid panel |
10,307 |
9,739 |
$120K |
| 93306 |
Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete |
557 |
471 |
$118K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
10,488 |
8,369 |
$93K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
7,864 |
7,199 |
$92K |
| 97162 |
|
1,419 |
1,173 |
$77K |
| 73721 |
Magnetic resonance imaging, any joint of lower extremity; without contrast material |
306 |
266 |
$68K |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
3,313 |
3,115 |
$67K |
| 36415 |
Collection of venous blood by venipuncture |
29,665 |
23,736 |
$64K |
| 71260 |
Computed tomography, thorax, diagnostic; with contrast material |
296 |
247 |
$60K |
| 96367 |
|
398 |
227 |
$59K |
| 84439 |
|
2,251 |
2,070 |
$48K |
| 82607 |
|
2,583 |
2,376 |
$47K |
| 97140 |
Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) |
1,185 |
387 |
$46K |
| 71046 |
Radiologic examination, chest; 2 views |
7,877 |
7,093 |
$46K |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
532 |
434 |
$44K |
| 74018 |
|
1,201 |
963 |
$43K |
| 84484 |
|
14,593 |
10,972 |
$38K |
| 76700 |
Ultrasound, abdominal, real time with image documentation; complete |
248 |
222 |
$35K |
| 12001 |
|
241 |
205 |
$34K |
| 99291 |
Critical care, evaluation and management of the critically ill patient, first 30-74 minutes |
423 |
311 |
$34K |
| 97161 |
|
542 |
443 |
$32K |
| 94060 |
|
372 |
317 |
$30K |
| 50590 |
|
21 |
14 |
$30K |
| 95810 |
Polysomnography; sleep staging with 4 or more additional parameters |
40 |
38 |
$26K |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
1,549 |
1,293 |
$26K |
| 76642 |
|
256 |
204 |
$26K |
| 97530 |
Therapeutic activities, direct patient contact, each 15 minutes |
933 |
512 |
$25K |
| 71045 |
Radiologic examination, chest; single view |
5,432 |
4,703 |
$25K |
| 72125 |
Computed tomography, cervical spine; without contrast material |
715 |
610 |
$24K |
| 93971 |
|
338 |
281 |
$22K |
| 99215 |
Prolong outpt/office vis |
202 |
193 |
$21K |
| 71250 |
|
242 |
219 |
$20K |
| 76830 |
Ultrasound, transvaginal |
295 |
221 |
$20K |
| 70553 |
Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences |
76 |
65 |
$20K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
17,836 |
15,375 |
$20K |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
471 |
425 |
$20K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
219 |
184 |
$19K |
| 97803 |
|
320 |
265 |
$19K |
| 80076 |
|
1,289 |
1,167 |
$19K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
760 |
688 |
$17K |
| 73221 |
|
80 |
76 |
$16K |
| 71271 |
|
103 |
94 |
$16K |
| 95811 |
|
30 |
28 |
$16K |
| 87081 |
|
1,775 |
1,591 |
$16K |
| 97016 |
|
463 |
145 |
$16K |
| 85610 |
|
3,556 |
2,576 |
$15K |
| 70486 |
|
190 |
156 |
$15K |
| 87088 |
|
3,719 |
3,096 |
$14K |
| 83540 |
|
1,484 |
1,300 |
$14K |
| 94729 |
|
372 |
314 |
$14K |
| 82728 |
|
885 |
767 |
$13K |
| 87637 |
Infectious agent detection by nucleic acid; SARS-CoV-2, influenza, and RSV |
319 |
304 |
$13K |
| 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 |
1,357 |
1,046 |
$13K |
| 94727 |
|
321 |
272 |
$12K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
2,840 |
2,300 |
$12K |
| 86140 |
|
667 |
570 |
$12K |
| 84153 |
|
787 |
732 |
$12K |
| 72131 |
|
158 |
137 |
$12K |
| 20610 |
|
93 |
78 |
$11K |
| 83550 |
|
1,215 |
1,054 |
$11K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
6,855 |
4,751 |
$10K |
| 83735 |
|
2,241 |
1,674 |
$10K |
| 96413 |
Chemotherapy administration, intravenous infusion; up to 1 hour, single or initial substance |
217 |
111 |
$10K |
| 0012A |
|
255 |
255 |
$10K |
| 81001 |
|
11,681 |
10,149 |
$9K |
| 0011A |
|
262 |
257 |
$9K |
| J3490 |
Unclassified drugs |
1,997 |
1,260 |
$9K |
| 80320 |
|
383 |
362 |
$8K |
| 93017 |
|
69 |
55 |
$7K |
| 62323 |
|
27 |
25 |
$7K |
| 74019 |
|
165 |
129 |
$7K |
| J1741 |
Injection, ibuprofen, 100 mg |
1,038 |
735 |
$7K |
| 86900 |
|
486 |
407 |
$7K |
| 73030 |
|
508 |
439 |
$7K |
| 96375 |
Therapeutic injection; each additional sequential IV push |
13,473 |
10,904 |
$7K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
541 |
428 |
$6K |
| 93970 |
|
44 |
38 |
$6K |
| 84703 |
|
10,169 |
8,632 |
$6K |
| 83690 |
|
9,487 |
7,958 |
$6K |
| 29581 |
|
59 |
13 |
$5K |
| 73630 |
|
643 |
556 |
$5K |
| 85007 |
|
3,050 |
2,142 |
$5K |
| 73610 |
|
661 |
564 |
$5K |
| 10060 |
|
37 |
26 |
$5K |
| 73130 |
|
513 |
438 |
$5K |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
5,640 |
4,196 |
$5K |
| 72148 |
Magnetic resonance imaging, lumbar spine; without contrast material |
27 |
27 |
$5K |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
1,392 |
1,139 |
$5K |
| 99281 |
Emergency department visit for the evaluation and management, self-limited or minor |
39 |
31 |
$4K |
| 83605 |
|
5,249 |
3,895 |
$4K |
| 82043 |
|
713 |
644 |
$4K |
| 72100 |
|
220 |
186 |
$4K |
| 82570 |
|
515 |
480 |
$4K |
| J7030 |
Infusion, normal saline solution , 1000 cc |
17,336 |
13,970 |
$4K |
| 11043 |
|
54 |
24 |
$4K |
| 87077 |
|
1,132 |
900 |
$4K |
| 29580 |
|
38 |
12 |
$4K |
| 86038 |
|
166 |
141 |
$4K |
| 90715 |
|
261 |
215 |
$4K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
57 |
39 |
$4K |
| 94664 |
|
141 |
107 |
$4K |
| 83880 |
|
1,035 |
831 |
$4K |
| 85027 |
|
2,923 |
2,013 |
$4K |
| 81003 |
|
4,667 |
3,895 |
$4K |
| 70496 |
|
17 |
13 |
$4K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
539 |
426 |
$3K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
16 |
12 |
$3K |
| 72141 |
|
20 |
14 |
$3K |
| 86703 |
|
158 |
153 |
$3K |
| 76536 |
|
30 |
25 |
$3K |
| 74246 |
|
27 |
25 |
$3K |
| 82947 |
|
703 |
274 |
$3K |
| 82746 |
|
411 |
334 |
$3K |
| 86850 |
|
297 |
266 |
$3K |
| 84481 |
|
235 |
207 |
$3K |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
6,799 |
5,719 |
$3K |
| 86803 |
|
144 |
139 |
$3K |
| 87070 |
|
384 |
316 |
$3K |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
2,888 |
2,573 |
$3K |
| 97116 |
|
208 |
116 |
$3K |
| 73562 |
|
142 |
124 |
$3K |
| 86592 |
|
443 |
427 |
$3K |
| 73110 |
|
348 |
297 |
$2K |
| C9803 |
Hospital outpatient clinic visit specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source |
55 |
55 |
$2K |
| 80074 |
|
293 |
270 |
$2K |
| 85651 |
|
578 |
486 |
$2K |
| 70551 |
Magnetic resonance imaging, brain; without contrast material |
14 |
12 |
$2K |
| J0702 |
Injection, betamethasone acetate 3 mg and betamethasone sodium phosphate 3 mg |
56 |
39 |
$2K |
| 96376 |
|
2,012 |
1,124 |
$2K |
| 70491 |
|
13 |
12 |
$2K |
| 94726 |
|
37 |
30 |
$2K |
| 82550 |
|
1,980 |
1,593 |
$2K |
| 87186 |
|
1,125 |
720 |
$2K |
| 87340 |
|
191 |
185 |
$2K |
| 96368 |
|
33 |
29 |
$2K |
| 73564 |
|
356 |
304 |
$2K |
| 87506 |
|
12 |
12 |
$2K |
| 86762 |
|
172 |
166 |
$2K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
1,797 |
1,466 |
$2K |
| 86787 |
|
163 |
158 |
$2K |
| 84702 |
|
304 |
204 |
$2K |
| 93976 |
|
12 |
12 |
$2K |
| 86141 |
|
39 |
39 |
$2K |
| 86901 |
|
486 |
407 |
$2K |
| 97165 |
|
14 |
13 |
$1K |
| 82784 |
|
104 |
95 |
$1K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
15 |
13 |
$1K |
| 87493 |
|
45 |
31 |
$1K |
| J1170 |
Injection, hydromorphone, up to 4 mg |
3,820 |
2,245 |
$1K |
| 73502 |
|
117 |
87 |
$1K |
| 87040 |
|
1,682 |
921 |
$1K |
| 77066 |
Tomosynthesis, mammo |
29 |
25 |
$1K |
| 82553 |
|
113 |
98 |
$1K |
| 76981 |
|
19 |
14 |
$1K |
| 36592 |
|
695 |
600 |
$1K |
| A9270 |
Non-covered item or service |
2,487 |
1,116 |
$1K |
| 80069 |
|
68 |
65 |
$1K |
| J2270 |
Injection, morphine sulfate, up to 10 mg |
3,367 |
2,510 |
$1K |
| U0002 |
2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc |
801 |
772 |
$1K |
| 72110 |
|
17 |
17 |
$1K |
| C1713 |
Anchor/screw for opposing bone-to-bone or soft tissue-to-bone (implantable) |
490 |
341 |
$966.87 |
| 85379 |
|
1,374 |
1,091 |
$948.31 |
| 87205 |
|
335 |
276 |
$923.67 |
| 93880 |
|
13 |
12 |
$911.67 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
1,208 |
990 |
$895.71 |
| A4217 |
Sterile water/saline, 500 ml |
1,020 |
740 |
$868.12 |
| J0690 |
Injection, cefazolin sodium, 500 mg |
3,062 |
1,996 |
$851.36 |
| 73080 |
|
94 |
77 |
$823.32 |
| 85730 |
|
866 |
614 |
$806.64 |
| 94761 |
|
3,936 |
3,475 |
$796.27 |
| 84100 |
|
280 |
194 |
$788.63 |
| 73590 |
|
53 |
41 |
$719.54 |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
53 |
45 |
$711.09 |
| 00731 |
|
835 |
785 |
$687.80 |
| 82140 |
|
133 |
81 |
$611.70 |
| 86364 |
|
30 |
27 |
$589.42 |
| C1776 |
Joint device (implantable) |
66 |
51 |
$584.06 |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
11,838 |
9,287 |
$571.16 |
| 84403 |
|
32 |
25 |
$556.56 |
| J7120 |
Ringers lactate infusion, up to 1000 cc |
3,486 |
2,596 |
$555.36 |
| J0500 |
Injection, dicyclomine hcl, up to 20 mg |
12 |
12 |
$549.13 |
| G0483 |
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; 22 or more drug class(es), including metabolite(s) if performed |
26 |
26 |
$516.35 |
| 85014 |
|
204 |
131 |
$514.47 |
| 88342 |
|
802 |
777 |
$507.18 |
| J1815 |
Injection, insulin, per 5 units |
239 |
123 |
$505.35 |
| 85018 |
|
322 |
210 |
$493.60 |
| 83630 |
|
25 |
24 |
$465.88 |
| J2704 |
Injection, propofol, 10 mg |
6,222 |
5,273 |
$434.07 |
| G0279 |
Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066) |
17 |
14 |
$428.14 |
| 29515 |
|
192 |
167 |
$420.55 |
| 87328 |
|
25 |
24 |
$420.52 |
| 0031A |
|
16 |
15 |
$419.68 |
| 76819 |
Fetal biophysical profile; without non-stress testing |
16 |
12 |
$394.40 |
| 87507 |
|
18 |
13 |
$377.84 |
| 82565 |
|
44 |
36 |
$353.44 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
5,653 |
4,688 |
$344.19 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
1,508 |
991 |
$340.41 |
| 87420 |
|
13 |
13 |
$329.59 |
| 76000 |
|
48 |
42 |
$310.34 |
| 73140 |
|
63 |
52 |
$303.02 |
| 00811 |
|
918 |
836 |
$294.49 |
| J1644 |
Injection, heparin sodium, per 1000 units |
972 |
416 |
$293.64 |
| 87075 |
|
144 |
121 |
$290.27 |
| 87651 |
Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe |
179 |
176 |
$286.48 |
| 29125 |
|
323 |
279 |
$258.82 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
3,213 |
2,005 |
$239.83 |
| J1650 |
Injection, enoxaparin sodium, 10 mg |
283 |
93 |
$227.87 |
| 85652 |
|
86 |
73 |
$225.17 |
| 97164 |
|
13 |
12 |
$225.09 |
| 80164 |
|
15 |
13 |
$195.01 |
| J2550 |
Injection, promethazine hcl, up to 50 mg |
512 |
356 |
$194.70 |
| Q3014 |
Telehealth originating site facility fee |
12 |
12 |
$176.36 |
| 94760 |
|
4,572 |
3,283 |
$175.97 |
| J2543 |
Injection, piperacillin sodium/tazobactam sodium, 1 gram/0.125 grams (1.125 grams) |
28 |
12 |
$169.41 |
| J3301 |
Injection, triamcinolone acetonide, not otherwise specified, 10 mg |
835 |
678 |
$167.13 |
| 80143 |
|
112 |
86 |
$158.97 |
| 87045 |
|
13 |
12 |
$154.66 |
| 82009 |
|
224 |
132 |
$154.52 |
| 82150 |
|
197 |
185 |
$141.31 |
| 76937 |
|
41 |
40 |
$123.00 |
| 83874 |
|
20 |
14 |
$112.94 |
| J2930 |
Injection, methylprednisolone sodium succinate, up to 125 mg |
550 |
359 |
$106.01 |
| 84436 |
|
14 |
12 |
$103.71 |
| 87329 |
|
13 |
12 |
$102.13 |
| 87427 |
|
13 |
12 |
$102.13 |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
3,391 |
2,687 |
$99.92 |
| J2060 |
Injection, lorazepam, 2 mg |
759 |
528 |
$98.88 |
| J3420 |
Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg |
34 |
24 |
$89.76 |
| 82962 |
|
558 |
438 |
$88.37 |
| J1940 |
Injection, furosemide, up to 20 mg |
68 |
40 |
$88.01 |
| J2765 |
Injection, metoclopramide hcl, up to 10 mg |
1,150 |
790 |
$85.73 |
| 80179 |
|
91 |
69 |
$79.49 |
| 87046 |
|
13 |
12 |
$77.33 |
| J1642 |
Injection, heparin sodium, (heparin lock flush), per 10 units |
208 |
139 |
$74.90 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
360 |
281 |
$72.68 |
| 81025 |
|
151 |
146 |
$67.09 |
| 80347 |
|
13 |
13 |
$65.56 |
| 84156 |
|
13 |
12 |
$60.27 |
| A9577 |
Injection, gadobenate dimeglumine (multihance), per ml |
269 |
242 |
$58.75 |
| J1200 |
Injection, diphenhydramine hcl, up to 50 mg |
1,363 |
887 |
$57.54 |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
4,054 |
3,072 |
$55.56 |
| 84520 |
|
12 |
12 |
$53.45 |
| 87210 |
|
20 |
13 |
$48.84 |
| J0171 |
Injection, adrenalin, epinephrine, 0.1 mg |
219 |
151 |
$45.23 |
| J2919 |
Injection, methylprednisolone sodium succinate, 5 mg |
217 |
175 |
$42.80 |
| 87808 |
|
20 |
13 |
$35.16 |
| J3480 |
Injection, potassium chloride, per 2 meq |
232 |
116 |
$35.05 |
| J0665 |
Injection, bupivicaine, not otherwise specified, 0.5 mg |
884 |
679 |
$31.11 |
| J2272 |
Injection, morphine sulfate (fresenius kabi), not therapeutically equivalent to j2270, up to 10 mg |
141 |
124 |
$30.31 |
| J3370 |
Injection, vancomycin hcl, 500 mg |
275 |
185 |
$30.31 |
| 82375 |
|
40 |
26 |
$22.47 |
| J7050 |
Infusion, normal saline solution, 250 cc |
1,108 |
548 |
$20.80 |
| J7070 |
Infusion, d5w, 1000 cc |
17 |
13 |
$14.02 |
| 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 |
1,019 |
863 |
$13.04 |
| J2360 |
Injection, orphenadrine citrate, up to 60 mg |
164 |
130 |
$9.76 |
| J0456 |
Injection, azithromycin, 500 mg |
24 |
12 |
$6.61 |
| J0360 |
Injection, hydralazine hcl, up to 20 mg |
17 |
12 |
$5.76 |
| 91301 |
|
518 |
486 |
$5.05 |
| J7040 |
Infusion, normal saline solution, sterile (500 ml = 1 unit) |
136 |
127 |
$2.56 |
| J3475 |
Injection, magnesium sulfate, per 500 mg |
30 |
13 |
$1.32 |
| 83050 |
|
25 |
15 |
$1.06 |
| J1956 |
Injection, levofloxacin, 250 mg |
16 |
12 |
$0.93 |
| J8597 |
Antiemetic drug, oral, not otherwise specified |
14 |
14 |
$0.36 |
| J7510 |
Prednisolone oral, per 5 mg |
24 |
24 |
$0.19 |
| 91303 |
|
16 |
15 |
$0.11 |
| J1171 |
Injection, hydromorphone, 0.1 mg |
45 |
36 |
$0.09 |
| J7512 |
Prednisone, immediate release or delayed release, oral, 1 mg |
15 |
12 |
$0.04 |
| 51702 |
|
14 |
14 |
$0.00 |
| 00873 |
|
21 |
14 |
$0.00 |
| Q9966 |
Low osmolar contrast material, 200-299 mg/ml iodine concentration, per ml |
104 |
85 |
$0.00 |
| 00170 |
Anesthesia for intraoral procedures, including biopsy |
14 |
12 |
$0.00 |
| 36600 |
|
16 |
12 |
$0.00 |
| 01810 |
|
24 |
16 |
$0.00 |
| 76942 |
|
16 |
13 |
$0.00 |
| 01630 |
|
18 |
13 |
$0.00 |
| 51701 |
|
12 |
12 |
$0.00 |
| 82803 |
|
82 |
52 |
$0.00 |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
18 |
12 |
$0.00 |
| 88304 |
|
83 |
65 |
$0.00 |
| 73560 |
|
13 |
13 |
$0.00 |
| J2175 |
Injection, meperidine hydrochloride, per 100 mg |
36 |
26 |
$0.00 |
| Q9969 |
Tc-99m from non-highly enriched uranium source, full cost recovery add-on, per study dose |
13 |
13 |
$0.00 |
| A9500 |
Technetium tc-99m sestamibi, diagnostic, per study dose |
12 |
12 |
$0.00 |
| 01400 |
|
12 |
12 |
$0.00 |