| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99284 |
Emergency department visit for the evaluation and management, high severity |
32,247 |
30,952 |
$6.15M |
| T1015 |
Clinic visit/encounter, all-inclusive |
99,188 |
88,781 |
$3.55M |
| J9271 |
Injection, pembrolizumab, 1 mg |
3,892 |
3,017 |
$2.72M |
| 96413 |
Chemotherapy administration, intravenous infusion; up to 1 hour, single or initial substance |
15,774 |
10,356 |
$1.37M |
| J9312 |
Injection, rituximab, 10 mg |
830 |
653 |
$1.23M |
| J2323 |
Injection, natalizumab, 1 mg |
1,963 |
1,885 |
$1.20M |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
9,928 |
9,650 |
$1.16M |
| J9299 |
Injection, nivolumab, 1 mg |
1,136 |
737 |
$1.05M |
| J9173 |
Injection, durvalumab, 10 mg |
576 |
413 |
$973K |
| J9306 |
Injection, pertuzumab, 1 mg |
1,161 |
838 |
$965K |
| Q5107 |
Injection, bevacizumab-awwb, biosimilar, (mvasi), 10 mg |
2,160 |
938 |
$888K |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
3,558 |
3,433 |
$753K |
| 99215 |
Prolong outpt/office vis |
7,794 |
5,260 |
$717K |
| G0378 |
Hospital observation service, per hour |
2,077 |
907 |
$659K |
| 59410 |
|
497 |
484 |
$657K |
| J9022 |
Injection, atezolizumab, 10 mg |
852 |
645 |
$654K |
| 87661 |
Infectious agent detection by nucleic acid; Trichomonas vaginalis, amplified probe |
20,089 |
19,688 |
$650K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
28,523 |
27,950 |
$638K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
28,280 |
27,715 |
$615K |
| G9012 |
Other specified case management service not elsewhere classified |
3,985 |
3,012 |
$613K |
| Q5116 |
Injection, trastuzumab-qyyp, biosimilar, (trazimera), 10 mg |
1,833 |
1,103 |
$531K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
5,013 |
4,975 |
$414K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
91,839 |
59,699 |
$404K |
| 88175 |
Cytopathology, cervical or vaginal, any reporting system; collected in preservative fluid, automated thin layer |
12,461 |
12,403 |
$383K |
| J7298 |
Levonorgestrel-releasing intrauterine contraceptive system (mirena), 52 mg |
957 |
939 |
$346K |
| 87624 |
Infectious agent detection by nucleic acid; human papillomavirus (HPV), high-risk types |
8,679 |
8,612 |
$342K |
| J2350 |
Injection, ocrelizumab, 1 mg |
198 |
190 |
$321K |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
5,342 |
4,067 |
$320K |
| J7307 |
Etonogestrel (contraceptive) implant system, including implant and supplies |
929 |
907 |
$313K |
| Q5108 |
Injection, pegfilgrastim-jmdb (fulphila), biosimilar, 0.5 mg |
872 |
646 |
$305K |
| Q5111 |
Injection, pegfilgrastim-cbqv (udenyca), biosimilar, 0.5 mg |
242 |
168 |
$299K |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
15,126 |
14,331 |
$292K |
| J1569 |
Injection, immune globulin, (gammagard liquid), non-lyophilized, (e.g., liquid), 500 mg |
2,242 |
1,233 |
$281K |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
1,997 |
1,940 |
$270K |
| 93976 |
|
4,773 |
4,636 |
$259K |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
8,083 |
4,891 |
$255K |
| J1745 |
Injection, infliximab, excludes biosimilar, 10 mg |
460 |
439 |
$255K |
| 80053 |
Comprehensive metabolic panel |
21,736 |
16,222 |
$252K |
| 81507 |
|
431 |
429 |
$249K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
3,877 |
3,404 |
$242K |
| J9264 |
Injection, paclitaxel protein-bound particles, 1 mg |
480 |
156 |
$239K |
| T1001 |
Nursing assessment / evaluation |
1,142 |
1,106 |
$234K |
| 81220 |
CFTR (cystic fibrosis transmembrane conductance regulator) gene analysis; common variants |
512 |
507 |
$232K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
5,175 |
4,936 |
$223K |
| 76811 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, detailed |
2,300 |
2,274 |
$209K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
4,596 |
3,954 |
$203K |
| 76830 |
Ultrasound, transvaginal |
5,095 |
5,010 |
$194K |
| 84703 |
|
29,749 |
28,796 |
$192K |
| J9305 |
Injection, pemetrexed, not otherwise specified, 10 mg |
356 |
134 |
$191K |
| 96375 |
Therapeutic injection; each additional sequential IV push |
13,749 |
11,825 |
$186K |
| 76801 |
|
5,849 |
5,210 |
$182K |
| 59515 |
|
131 |
129 |
$174K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
12,677 |
10,876 |
$151K |
| J9355 |
Injection, trastuzumab, excludes biosimilar, 10 mg |
66 |
49 |
$149K |
| 77066 |
Tomosynthesis, mammo |
1,802 |
1,766 |
$146K |
| 86702 |
|
9,506 |
9,365 |
$127K |
| 96367 |
|
6,526 |
3,389 |
$124K |
| 86780 |
|
6,874 |
6,683 |
$114K |
| 96417 |
|
2,432 |
1,552 |
$114K |
| 86701 |
|
9,507 |
9,365 |
$112K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
18,446 |
16,728 |
$111K |
| 82330 |
|
15,742 |
10,248 |
$111K |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
4,966 |
4,929 |
$108K |
| 81025 |
|
17,339 |
16,827 |
$107K |
| J0185 |
Injection, aprepitant, 1 mg |
3,496 |
2,268 |
$103K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
1,487 |
1,338 |
$101K |
| 77065 |
Tomosynthesis, mammo |
1,664 |
1,544 |
$98K |
| J0897 |
Injection, denosumab, 1 mg |
366 |
326 |
$97K |
| 87390 |
|
9,504 |
9,363 |
$97K |
| H0004 |
Behavioral health counseling and therapy, per 15 minutes |
2,797 |
2,662 |
$95K |
| 76642 |
|
2,563 |
2,494 |
$94K |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
12,353 |
11,804 |
$93K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,177 |
1,065 |
$92K |
| 76819 |
Fetal biophysical profile; without non-stress testing |
1,725 |
1,068 |
$91K |
| 96415 |
|
3,008 |
2,097 |
$89K |
| 84702 |
|
6,536 |
5,389 |
$85K |
| Q5119 |
Injection, rituximab-pvvr, biosimilar, (ruxience), 10 mg |
1,408 |
942 |
$84K |
| 83735 |
|
15,152 |
10,408 |
$79K |
| 81003 |
|
37,423 |
35,466 |
$76K |
| 81329 |
|
680 |
676 |
$75K |
| J9395 |
Injection, fulvestrant, 25 mg |
1,051 |
745 |
$74K |
| 59409 |
Vaginal delivery only (with or without episiotomy and/or forceps) |
48 |
41 |
$73K |
| 58571 |
|
120 |
119 |
$71K |
| 87653 |
|
1,611 |
1,595 |
$68K |
| 43239 |
Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple |
278 |
273 |
$65K |
| J3490 |
Unclassified drugs |
7,657 |
4,362 |
$64K |
| 99429 |
|
249 |
229 |
$63K |
| 88185 |
|
250 |
227 |
$61K |
| J1756 |
Injection, iron sucrose, 1 mg |
11,218 |
5,380 |
$61K |
| 80050 |
General health panel |
1,274 |
1,171 |
$58K |
| 83615 |
|
10,289 |
7,084 |
$56K |
| 78815 |
Positron emission tomography (PET) for limited area imaging |
69 |
65 |
$55K |
| 76813 |
|
996 |
985 |
$55K |
| 84100 |
|
11,413 |
7,903 |
$53K |
| 80076 |
|
8,655 |
8,307 |
$52K |
| 71275 |
Computed tomographic angiography, chest, with contrast material |
322 |
318 |
$50K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
1,345 |
1,202 |
$50K |
| 11981 |
|
261 |
258 |
$49K |
| 19083 |
|
325 |
308 |
$48K |
| J9217 |
Leuprolide acetate (for depot suspension), 7.5 mg |
1,162 |
1,104 |
$47K |
| G0472 |
Hepatitis c antibody screening, for individual at high risk and other covered indication(s) |
2,265 |
2,245 |
$47K |
| G0279 |
Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066) |
2,910 |
2,848 |
$46K |
| 36430 |
|
425 |
255 |
$45K |
| 96040 |
|
1,709 |
1,694 |
$44K |
| Q0111 |
Wet mounts, including preparations of vaginal, cervical or skin specimens |
8,216 |
8,016 |
$44K |
| J9202 |
Goserelin acetate implant, per 3.6 mg |
765 |
705 |
$44K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
850 |
843 |
$43K |
| 96402 |
|
1,394 |
1,244 |
$41K |
| 11982 |
|
198 |
196 |
$40K |
| 96361 |
Intravenous infusion, hydration; each additional hour |
3,878 |
2,904 |
$40K |
| 84443 |
Thyroid stimulating hormone (TSH) |
2,104 |
1,978 |
$40K |
| 88341 |
|
614 |
562 |
$38K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
630 |
589 |
$37K |
| 96411 |
|
887 |
570 |
$37K |
| 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 |
562 |
550 |
$35K |
| J9070 |
Cyclophosphamide, 100 mg |
573 |
312 |
$34K |
| 58558 |
|
40 |
40 |
$34K |
| J1561 |
Injection, immune globulin, (gamunex-c/gammaked), non-lyophilized (e.g., liquid), 500 mg |
68 |
50 |
$33K |
| 0241U |
Neonatal screening for hereditary disorders, genomic sequence analysis panel |
573 |
568 |
$33K |
| 58301 |
|
282 |
280 |
$33K |
| 86300 |
|
1,499 |
1,253 |
$31K |
| 77080 |
|
573 |
567 |
$31K |
| 96360 |
Intravenous infusion, hydration; initial, 31 minutes to 1 hour |
1,127 |
742 |
$29K |
| 96156 |
|
508 |
504 |
$29K |
| 82728 |
|
3,066 |
2,899 |
$29K |
| 71260 |
Computed tomography, thorax, diagnostic; with contrast material |
435 |
429 |
$29K |
| 58661 |
|
44 |
41 |
$29K |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
3,500 |
3,388 |
$28K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
4,058 |
3,871 |
$28K |
| J2505 |
Injection, pegfilgrastim, 6 mg |
30 |
26 |
$27K |
| Q3014 |
Telehealth originating site facility fee |
1,644 |
1,591 |
$27K |
| 70551 |
Magnetic resonance imaging, brain; without contrast material |
131 |
127 |
$27K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
407 |
399 |
$25K |
| 80055 |
|
1,831 |
1,818 |
$25K |
| 90715 |
|
2,233 |
2,181 |
$24K |
| 58300 |
|
457 |
453 |
$24K |
| 93306 |
Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete |
326 |
323 |
$24K |
| J2997 |
Injection, alteplase recombinant, 1 mg |
563 |
427 |
$23K |
| 82784 |
|
1,454 |
1,083 |
$23K |
| 88342 |
|
913 |
883 |
$23K |
| J1930 |
Injection, lanreotide, 1 mg |
40 |
36 |
$23K |
| Q0112 |
All potassium hydroxide (koh) preparations |
4,336 |
4,258 |
$22K |
| 83690 |
|
6,557 |
6,251 |
$21K |
| J2469 |
Injection, palonosetron hcl, 25 mcg |
5,739 |
3,417 |
$21K |
| G0399 |
Home sleep test (hst) with type iii portable monitor, unattended; minimum of 4 channels: 2 respiratory movement/airflow, 1 ecg/heart rate and 1 oxygen saturation |
169 |
166 |
$21K |
| 71046 |
Radiologic examination, chest; 2 views |
1,226 |
1,202 |
$21K |
| 96401 |
|
654 |
311 |
$20K |
| 82607 |
|
2,014 |
1,957 |
$20K |
| 57452 |
|
189 |
184 |
$20K |
| 77386 |
|
94 |
13 |
$19K |
| 82105 |
|
1,088 |
1,049 |
$19K |
| 84460 |
|
6,066 |
4,239 |
$18K |
| 76827 |
|
483 |
465 |
$18K |
| 81001 |
|
7,694 |
7,472 |
$18K |
| J0881 |
Injection, darbepoetin alfa, 1 microgram (non-esrd use) |
130 |
100 |
$18K |
| 76641 |
|
347 |
335 |
$18K |
| 84450 |
|
6,183 |
4,340 |
$18K |
| 84550 |
|
3,201 |
2,144 |
$18K |
| 96366 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour |
1,598 |
1,133 |
$17K |
| 86592 |
|
3,962 |
3,917 |
$17K |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
266 |
261 |
$17K |
| 86850 |
|
3,243 |
2,972 |
$17K |
| 83540 |
|
2,523 |
2,389 |
$17K |
| 70450 |
Computed tomography, head or brain; without contrast material |
325 |
321 |
$17K |
| 72148 |
Magnetic resonance imaging, lumbar spine; without contrast material |
113 |
110 |
$16K |
| 84163 |
|
946 |
943 |
$16K |
| P9021 |
Red blood cells, each unit |
175 |
161 |
$16K |
| 19081 |
|
111 |
108 |
$15K |
| 93971 |
|
270 |
258 |
$15K |
| 76820 |
|
614 |
351 |
$15K |
| 83021 |
|
776 |
649 |
$15K |
| 82565 |
|
6,058 |
4,478 |
$15K |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
448 |
443 |
$15K |
| 59820 |
|
25 |
25 |
$14K |
| 96409 |
|
192 |
134 |
$14K |
| M0222 |
Intravenous injection, bebtelovimab, includes injection and post administration monitoring |
65 |
63 |
$14K |
| 77049 |
|
62 |
62 |
$14K |
| J0640 |
Injection, leucovorin calcium, per 50 mg |
4,279 |
1,120 |
$14K |
| 88360 |
|
470 |
450 |
$14K |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
748 |
738 |
$13K |
| 59025 |
Fetal non-stress test |
2,708 |
1,340 |
$13K |
| J1439 |
Injection, ferric carboxymaltose, 1 mg |
980 |
686 |
$13K |
| 82950 |
|
1,712 |
1,700 |
$12K |
| 72197 |
|
27 |
27 |
$12K |
| 84484 |
|
1,909 |
1,740 |
$12K |
| 82746 |
|
1,352 |
1,307 |
$12K |
| 90651 |
|
939 |
938 |
$12K |
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
2,243 |
1,704 |
$12K |
| 58662 |
|
18 |
18 |
$12K |
| M0243 |
Intravenous infusion or subcutaneous injection, casirivimab and imdevimab includes infusion or injection, and post administration monitoring |
29 |
28 |
$12K |
| 86923 |
|
352 |
257 |
$12K |
| 87522 |
Neg quan hep c or qual rna |
321 |
313 |
$12K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
288 |
281 |
$11K |
| 84439 |
|
1,905 |
1,717 |
$11K |
| 82570 |
|
1,644 |
1,476 |
$11K |
| 85027 |
|
2,027 |
1,756 |
$11K |
| 83986 |
|
4,918 |
4,825 |
$11K |
| J9045 |
Injection, carboplatin, 50 mg |
2,726 |
1,727 |
$11K |
| 96523 |
|
779 |
622 |
$11K |
| 85730 |
|
1,888 |
1,776 |
$11K |
| 87077 |
|
1,532 |
1,469 |
$11K |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
8,846 |
8,296 |
$10K |
| 45385 |
Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) |
25 |
25 |
$10K |
| J9263 |
Injection, oxaliplatin, 0.5 mg |
3,186 |
960 |
$10K |
| 85610 |
|
3,545 |
3,302 |
$10K |
| 77334 |
|
113 |
81 |
$10K |
| 76770 |
|
254 |
250 |
$10K |
| 83550 |
|
2,476 |
2,348 |
$10K |
| J9267 |
Injection, paclitaxel, 1 mg |
2,570 |
1,148 |
$10K |
| 57455 |
|
44 |
43 |
$9K |
| 86900 |
|
3,373 |
3,084 |
$9K |
| 76536 |
|
201 |
198 |
$9K |
| 76700 |
Ultrasound, abdominal, real time with image documentation; complete |
171 |
170 |
$9K |
| 82247 |
|
4,807 |
3,216 |
$9K |
| 86901 |
|
3,373 |
3,081 |
$9K |
| 88142 |
|
529 |
524 |
$9K |
| 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 |
302 |
247 |
$9K |
| 86334 |
|
481 |
413 |
$8K |
| 71045 |
Radiologic examination, chest; single view |
1,699 |
1,639 |
$8K |
| C9399 |
Unclassified drugs or biologicals |
195 |
173 |
$8K |
| 88184 |
|
254 |
232 |
$8K |
| 71250 |
|
143 |
138 |
$8K |
| 87497 |
|
207 |
104 |
$8K |
| G0008 |
Administration of influenza virus vaccine |
771 |
765 |
$8K |
| 83880 |
|
308 |
293 |
$8K |
| 84075 |
|
4,827 |
3,200 |
$8K |
| 84146 |
|
281 |
273 |
$7K |
| 87340 |
|
557 |
528 |
$7K |
| 82378 |
|
600 |
510 |
$7K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
1,168 |
1,133 |
$7K |
| 84403 |
|
306 |
295 |
$7K |
| 80061 |
Lipid panel |
571 |
562 |
$7K |
| 86803 |
|
384 |
360 |
$7K |
| 88237 |
|
43 |
39 |
$7K |
| J1170 |
Injection, hydromorphone, up to 4 mg |
13,750 |
5,392 |
$7K |
| 84156 |
|
1,720 |
1,476 |
$7K |
| 96368 |
|
773 |
514 |
$7K |
| 73721 |
Magnetic resonance imaging, any joint of lower extremity; without contrast material |
29 |
28 |
$7K |
| 85018 |
|
3,091 |
2,941 |
$7K |
| 83605 |
|
1,228 |
1,131 |
$7K |
| 84520 |
|
4,756 |
3,349 |
$7K |
| 72141 |
|
29 |
29 |
$6K |
| 77336 |
|
170 |
89 |
$6K |
| 99281 |
Emergency department visit for the evaluation and management, self-limited or minor |
176 |
166 |
$6K |
| 82977 |
|
833 |
527 |
$6K |
| 81002 |
|
1,647 |
1,580 |
$6K |
| 87186 |
|
804 |
770 |
$6K |
| 82232 |
|
470 |
398 |
$5K |
| 73564 |
|
299 |
286 |
$5K |
| 45380 |
Colonoscopy, flexible; with biopsy, single or multiple |
13 |
13 |
$5K |
| 86704 |
|
384 |
361 |
$5K |
| 84165 |
|
530 |
460 |
$5K |
| J7120 |
Ringers lactate infusion, up to 1000 cc |
17,334 |
10,448 |
$5K |
| 70491 |
|
73 |
73 |
$5K |
| J3535 |
Drug administered through a metered dose inhaler |
319 |
283 |
$5K |
| 86304 |
|
334 |
298 |
$5K |
| M0245 |
Intravenous infusion, bamlanivimab and etesevimab, includes infusion and post administration monitoring |
13 |
13 |
$5K |
| 77412 |
|
124 |
17 |
$5K |
| J3489 |
Injection, zoledronic acid, 1 mg |
1,230 |
1,156 |
$5K |
| 84402 |
|
167 |
164 |
$5K |
| 87040 |
|
382 |
263 |
$5K |
| 86902 |
|
196 |
147 |
$4K |
| M0247 |
Intravenous infusion, sotrovimab, includes infusion and post administration monitoring |
13 |
13 |
$4K |
| 90682 |
|
282 |
279 |
$4K |
| 84155 |
|
4,425 |
2,913 |
$4K |
| 84153 |
|
332 |
306 |
$4K |
| P9058 |
Red blood cells, leukocytes reduced, cmv-negative, irradiated, each unit |
159 |
109 |
$4K |
| 86706 |
|
342 |
334 |
$4K |
| 36593 |
|
245 |
211 |
$4K |
| 93970 |
|
60 |
57 |
$4K |
| 87102 |
|
444 |
425 |
$4K |
| 58100 |
|
73 |
72 |
$4K |
| 82310 |
|
3,999 |
2,629 |
$4K |
| 93325 |
|
177 |
176 |
$4K |
| J2790 |
Injection, rho d immune globulin, human, full dose, 300 micrograms (1500 i.u.) |
482 |
416 |
$4K |
| 82677 |
|
193 |
193 |
$4K |
| J1815 |
Injection, insulin, per 5 units |
273 |
181 |
$4K |
| 83001 |
|
202 |
201 |
$4K |
| 77295 |
|
14 |
13 |
$3K |
| 88264 |
|
25 |
25 |
$3K |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
17,841 |
10,979 |
$3K |
| J7030 |
Infusion, normal saline solution , 1000 cc |
12,181 |
7,404 |
$3K |
| 84132 |
|
3,901 |
2,541 |
$3K |
| 82947 |
|
4,148 |
2,816 |
$3K |
| 74181 |
|
13 |
12 |
$3K |
| 70553 |
Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences |
13 |
13 |
$3K |
| 86038 |
|
229 |
220 |
$3K |
| 36415 |
Collection of venous blood by venipuncture |
4,953 |
3,922 |
$3K |
| 86147 |
|
138 |
132 |
$3K |
| A9577 |
Injection, gadobenate dimeglumine (multihance), per ml |
684 |
672 |
$3K |
| 86301 |
|
244 |
191 |
$3K |
| 84295 |
|
3,791 |
2,480 |
$3K |
| 82951 |
|
199 |
197 |
$3K |
| J1626 |
Injection, granisetron hydrochloride, 100 mcg |
7,134 |
3,674 |
$3K |
| 86235 |
|
45 |
42 |
$3K |
| J9206 |
Injection, irinotecan, 20 mg |
1,053 |
387 |
$3K |
| 82435 |
|
3,734 |
2,441 |
$3K |
| 86922 |
|
68 |
58 |
$3K |
| 82962 |
|
1,828 |
1,337 |
$3K |
| 74018 |
|
205 |
196 |
$3K |
| J2930 |
Injection, methylprednisolone sodium succinate, up to 125 mg |
1,240 |
1,043 |
$3K |
| 90674 |
|
879 |
865 |
$3K |
| 86708 |
|
178 |
175 |
$2K |
| 73562 |
|
210 |
202 |
$2K |
| 82374 |
|
3,408 |
2,244 |
$2K |
| 82040 |
|
3,311 |
2,251 |
$2K |
| 85379 |
|
296 |
284 |
$2K |
| 83970 |
|
55 |
55 |
$2K |
| J1720 |
Injection, hydrocortisone sodium succinate, up to 100 mg |
871 |
633 |
$2K |
| 73501 |
|
219 |
214 |
$2K |
| 82248 |
|
300 |
231 |
$2K |
| 38222 |
|
24 |
24 |
$2K |
| 82670 |
|
91 |
88 |
$2K |
| 81000 |
|
466 |
446 |
$2K |
| 76942 |
|
186 |
181 |
$2K |
| 73610 |
|
142 |
137 |
$2K |
| 82550 |
|
376 |
297 |
$2K |
| 85240 |
|
142 |
140 |
$2K |
| 86360 |
|
29 |
29 |
$2K |
| J9181 |
Injection, etoposide, 10 mg |
221 |
56 |
$2K |
| 72100 |
|
98 |
97 |
$2K |
| 85384 |
|
204 |
191 |
$2K |
| 84480 |
|
302 |
261 |
$2K |
| 73630 |
|
207 |
202 |
$2K |
| 86880 |
|
253 |
237 |
$2K |
| J9060 |
Injection, cisplatin, powder or solution, 10 mg |
754 |
370 |
$2K |
| 86359 |
|
31 |
31 |
$2K |
| 76857 |
|
95 |
93 |
$2K |
| 82103 |
|
102 |
99 |
$2K |
| 86870 |
|
142 |
138 |
$2K |
| 87205 |
|
456 |
435 |
$2K |
| 73560 |
|
143 |
135 |
$1K |
| 80051 |
|
252 |
229 |
$1K |
| 85041 |
|
503 |
499 |
$1K |
| 85044 |
|
447 |
406 |
$1K |
| 87070 |
|
318 |
303 |
$1K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
24 |
24 |
$1K |
| 70486 |
|
24 |
24 |
$1K |
| J1610 |
Injection, glucagon hydrochloride, per 1 mg |
13 |
13 |
$1K |
| S9443 |
Lactation classes, non-physician provider, per session |
25 |
25 |
$1K |
| J3475 |
Injection, magnesium sulfate, per 500 mg |
2,605 |
1,649 |
$1K |
| 86355 |
|
29 |
29 |
$1K |
| 86357 |
|
29 |
29 |
$1K |
| 86146 |
|
15 |
15 |
$1K |
| 85007 |
|
409 |
351 |
$1K |
| 82150 |
|
304 |
251 |
$1K |
| 73130 |
|
132 |
129 |
$1K |
| J0670 |
Injection, mepivacaine hydrochloride, per 10 ml |
642 |
574 |
$1K |
| 85732 |
|
139 |
138 |
$1K |
| 80081 |
|
12 |
12 |
$1K |
| 51701 |
|
48 |
47 |
$1K |
| 82533 |
|
124 |
113 |
$1K |
| 36512 |
|
39 |
38 |
$1K |
| 86256 |
|
112 |
108 |
$1K |
| J0780 |
Injection, prochlorperazine, up to 10 mg |
2,034 |
1,600 |
$1K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
18 |
17 |
$1K |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
9,804 |
8,091 |
$1K |
| 86140 |
|
503 |
471 |
$995.04 |
| 83010 |
|
95 |
85 |
$992.55 |
| J9171 |
Injection, docetaxel, 1 mg |
230 |
158 |
$981.84 |
| 88307 |
|
419 |
408 |
$978.99 |
| 99195 |
|
111 |
95 |
$946.02 |
| 84425 |
|
151 |
151 |
$940.86 |
| 73030 |
|
66 |
65 |
$939.48 |
| A9576 |
Injection, gadoteridol, (prohance multipack), per ml |
350 |
341 |
$902.56 |
| J9000 |
Injection, doxorubicin hydrochloride, 10 mg |
279 |
139 |
$894.56 |
| 85652 |
|
487 |
452 |
$891.15 |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
14,193 |
10,547 |
$886.17 |
| J3420 |
Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg |
3,597 |
2,913 |
$864.64 |
| J1200 |
Injection, diphenhydramine hcl, up to 50 mg |
9,294 |
6,333 |
$858.17 |
| 76882 |
|
150 |
147 |
$848.37 |
| 88368 |
|
17 |
13 |
$820.43 |
| 85597 |
|
30 |
30 |
$807.08 |
| 86644 |
|
28 |
26 |
$790.13 |
| 73110 |
|
87 |
85 |
$721.93 |
| 82043 |
|
96 |
93 |
$678.70 |
| Q9963 |
High osmolar contrast material, 350-399 mg/ml iodine concentration, per ml |
1,281 |
1,255 |
$670.55 |
| J7040 |
Infusion, normal saline solution, sterile (500 ml = 1 unit) |
2,721 |
1,527 |
$652.72 |
| 85660 |
|
178 |
141 |
$648.08 |
| 82952 |
|
183 |
181 |
$645.62 |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
3,610 |
2,920 |
$639.09 |
| 87081 |
|
197 |
193 |
$636.56 |
| 77280 |
|
18 |
15 |
$623.80 |
| 73502 |
|
31 |
29 |
$616.64 |
| J9201 |
Injection, gemcitabine hydrochloride, not otherwise specified, 200 mg |
458 |
109 |
$587.05 |
| 51798 |
|
60 |
54 |
$586.17 |
| J3480 |
Injection, potassium chloride, per 2 meq |
1,898 |
917 |
$563.97 |
| 83030 |
|
119 |
111 |
$552.30 |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
288 |
284 |
$549.68 |
| 78306 |
|
14 |
12 |
$501.85 |
| J0690 |
Injection, cefazolin sodium, 500 mg |
1,145 |
828 |
$500.64 |
| J2765 |
Injection, metoclopramide hcl, up to 10 mg |
4,263 |
3,630 |
$493.89 |
| 82627 |
|
24 |
24 |
$476.49 |
| S0028 |
Injection, famotidine, 20 mg |
2,081 |
1,430 |
$442.32 |
| J9190 |
Injection, fluorouracil, 500 mg |
692 |
338 |
$440.40 |
| J0694 |
Injection, cefoxitin sodium, 1 gm |
329 |
250 |
$428.66 |
| 82390 |
|
47 |
46 |
$423.12 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
2,103 |
1,895 |
$416.84 |
| J1644 |
Injection, heparin sodium, per 1000 units |
1,233 |
641 |
$404.00 |
| 74240 |
|
16 |
13 |
$389.17 |
| 85670 |
|
45 |
45 |
$385.37 |
| 87106 |
|
38 |
37 |
$385.15 |
| 85014 |
|
158 |
154 |
$384.70 |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
4,502 |
3,968 |
$379.90 |
| 86769 |
|
27 |
25 |
$372.28 |
| J7121 |
5% dextrose in lactated ringers infusion, up to 1000 cc |
712 |
413 |
$371.25 |
| 86376 |
|
48 |
48 |
$359.23 |
| J1650 |
Injection, enoxaparin sodium, 10 mg |
1,212 |
646 |
$356.77 |
| 82140 |
|
92 |
91 |
$346.16 |
| J2270 |
Injection, morphine sulfate, up to 10 mg |
987 |
651 |
$338.27 |
| 85705 |
|
43 |
43 |
$337.38 |
| 86645 |
|
12 |
12 |
$302.41 |
| 87075 |
|
42 |
39 |
$284.20 |
| 86787 |
|
14 |
14 |
$273.39 |
| 83883 |
|
85 |
58 |
$243.95 |
| 85097 |
|
12 |
12 |
$242.97 |
| 85046 |
|
53 |
49 |
$233.87 |
| 87430 |
|
72 |
69 |
$219.24 |
| 85613 |
|
18 |
18 |
$218.47 |
| 82803 |
|
16 |
12 |
$205.87 |
| 84134 |
|
14 |
13 |
$202.23 |
| J0131 |
Injection, acetaminophen, not otherwise specified,10 mg |
5,713 |
4,887 |
$193.01 |
| J8501 |
Aprepitant, oral, 5 mg |
14 |
14 |
$180.00 |
| 96377 |
|
14 |
13 |
$178.11 |
| J0702 |
Injection, betamethasone acetate 3 mg and betamethasone sodium phosphate 3 mg |
21 |
12 |
$158.00 |
| J7050 |
Infusion, normal saline solution, 250 cc |
2,019 |
1,260 |
$141.42 |
| J7060 |
5% dextrose/water (500 ml = 1 unit) |
612 |
421 |
$139.40 |
| S0119 |
Ondansetron, oral, 4 mg (for circumstances falling under the medicare statute, use hcpcs q code) |
603 |
464 |
$136.44 |
| 88112 |
|
16 |
16 |
$136.17 |
| J2704 |
Injection, propofol, 10 mg |
4,927 |
3,639 |
$132.09 |
| 86431 |
|
12 |
12 |
$78.28 |
| 85048 |
|
29 |
28 |
$77.13 |
| 97161 |
|
15 |
15 |
$69.97 |
| J2060 |
Injection, lorazepam, 2 mg |
413 |
271 |
$65.84 |
| 88304 |
|
82 |
82 |
$57.20 |
| S0020 |
Injection, bupivicaine hydrochloride, 30 ml |
760 |
666 |
$53.09 |
| 94760 |
|
152 |
96 |
$48.41 |
| J0360 |
Injection, hydralazine hcl, up to 20 mg |
37 |
26 |
$47.46 |
| 87220 |
|
12 |
12 |
$47.19 |
| A4648 |
Tissue marker, implantable, any type, each |
107 |
88 |
$46.43 |
| Q0163 |
Diphenhydramine hydrochloride, 50 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at time of chemotherapy treatment not to exceed a 48 hour dosage regimen |
327 |
257 |
$46.36 |
| J2920 |
Injection, methylprednisolone sodium succinate, up to 40 mg |
342 |
208 |
$46.34 |
| J1580 |
Injection, garamycin, gentamicin, up to 80 mg |
33 |
24 |
$44.52 |
| 85651 |
|
16 |
16 |
$39.57 |
| J8540 |
Dexamethasone, oral, 0.25 mg |
1,169 |
561 |
$36.91 |
| J1630 |
Injection, haloperidol, up to 5 mg |
101 |
79 |
$8.23 |
| J7620 |
Albuterol, up to 2.5 mg and ipratropium bromide, up to 0.5 mg, fda-approved final product, non-compounded, administered through dme |
712 |
454 |
$7.43 |
| J2710 |
Injection, neostigmine methylsulfate, up to 0.5 mg |
356 |
321 |
$6.86 |
| J7613 |
Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg |
311 |
200 |
$4.10 |
| J0134 |
Injection, acetaminophen (fresenius kabi), not therapeutically equivalent to j0131, 10 mg |
461 |
426 |
$4.00 |
| J7512 |
Prednisone, immediate release or delayed release, oral, 1 mg |
741 |
533 |
$3.37 |
| J2001 |
Injection, lidocaine hcl for intravenous infusion, 10 mg |
54 |
53 |
$0.20 |
| Q0247 |
Injection, sotrovimab, 500 mg |
89 |
89 |
$0.03 |
| J9358 |
Injection, fam-trastuzumab deruxtecan-nxki, 1 mg |
51 |
27 |
$0.00 |
| J1750 |
Injection, iron dextran, 50 mg |
293 |
264 |
$0.00 |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
2,942 |
2,923 |
$0.00 |
| 90678 |
|
32 |
32 |
$0.00 |
| J9144 |
Injection, daratumumab, 10 mg and hyaluronidase-fihj |
649 |
366 |
$0.00 |
| J2916 |
Injection, sodium ferric gluconate complex in sucrose injection, 12.5 mg |
1,938 |
995 |
$0.00 |
| C9803 |
Hospital outpatient clinic visit specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source |
59 |
59 |
$0.00 |
| J0137 |
Injection, acetaminophen (hikma), not therapeutically equivalent to j0131, 10 mg |
213 |
202 |
$0.00 |
| J1453 |
Injection, fosaprepitant, 1 mg |
239 |
168 |
$0.00 |
| J9035 |
Injection, bevacizumab, 10 mg |
281 |
98 |
$0.00 |
| J2919 |
Injection, methylprednisolone sodium succinate, 5 mg |
270 |
169 |
$0.00 |
| J1596 |
Injection, glycopyrrolate, 0.1 mg |
27 |
26 |
$0.00 |
| J9073 |
Injection, cyclophosphamide (dr. reddy's), 5 mg |
25 |
15 |
$0.00 |
| J1171 |
Injection, hydromorphone, 0.1 mg |
277 |
175 |
$0.00 |
| J2506 |
Injection, pegfilgrastim, excludes biosimilar, 0.5 mg |
15 |
12 |
$0.00 |
| 88302 |
|
47 |
46 |
$0.00 |
| S0030 |
Injection, metronidazole, 500 mg |
50 |
12 |
$0.00 |
| J0461 |
Injection, atropine sulfate, 0.01 mg |
328 |
188 |
$0.00 |
| 36591 |
|
861 |
597 |
$0.00 |
| J9304 |
Injection, pemetrexed (pemfexy), 10 mg |
16 |
12 |
$0.00 |
| Q5121 |
Injection, infliximab-axxq, biosimilar, (avsola), 10 mg |
796 |
736 |
$0.00 |
| J0330 |
Injection, succinylcholine chloride, up to 20 mg |
816 |
727 |
$0.00 |
| J7999 |
Compounded drug, not otherwise classified |
1,853 |
1,424 |
$0.00 |
| Q5120 |
Injection, pegfilgrastim-bmez (ziextenzo), biosimilar, 0.5 mg |
566 |
425 |
$0.00 |
| A9579 |
Injection, gadolinium-based magnetic resonance contrast agent, not otherwise specified (nos), per ml |
310 |
309 |
$0.00 |
| S0074 |
Injection, cefotetan disodium, 500 mg |
230 |
203 |
$0.00 |
| Q5104 |
Injection, infliximab-abda, biosimilar, (renflexis), 10 mg |
338 |
325 |
$0.00 |
| J7611 |
Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, concentrated form, 1 mg |
12 |
12 |
$0.00 |
| Q0222 |
Injection, bebtelovimab, 175 mg |
82 |
81 |
$0.00 |
| 90673 |
|
15 |
15 |
$0.00 |
| J2150 |
Injection, mannitol, 25% in 50 ml |
19 |
13 |
$0.00 |
| J0490 |
Injection, belimumab, 10 mg |
27 |
12 |
$0.00 |