| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
96,460 |
85,127 |
$10.47M |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
53,576 |
48,204 |
$6.02M |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
45,259 |
42,274 |
$5.34M |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
36,840 |
33,526 |
$4.84M |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
36,379 |
33,266 |
$4.75M |
| 96361 |
Intravenous infusion, hydration; each additional hour |
15,349 |
13,495 |
$4.15M |
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
25,285 |
20,473 |
$1.77M |
| 70450 |
Computed tomography, head or brain; without contrast material |
6,071 |
5,273 |
$1.51M |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
12,518 |
11,460 |
$1.25M |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
10,497 |
9,834 |
$1.09M |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
3,913 |
3,288 |
$1.02M |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
11,958 |
4,366 |
$861K |
| 80053 |
Comprehensive metabolic panel |
58,049 |
50,742 |
$661K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
5,592 |
5,249 |
$595K |
| 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 |
2,831 |
2,736 |
$516K |
| 96360 |
Intravenous infusion, hydration; initial, 31 minutes to 1 hour |
1,871 |
1,557 |
$438K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
1,465 |
1,206 |
$423K |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
2,228 |
1,523 |
$404K |
| 87631 |
|
2,577 |
2,495 |
$389K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
3,080 |
2,824 |
$363K |
| 81514 |
|
2,432 |
2,203 |
$310K |
| 99281 |
Emergency department visit for the evaluation and management, self-limited or minor |
2,107 |
1,985 |
$302K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
2,626 |
2,338 |
$292K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
5,135 |
4,752 |
$276K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
2,242 |
2,014 |
$265K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
1,341 |
1,154 |
$258K |
| 71275 |
Computed tomographic angiography, chest, with contrast material |
846 |
686 |
$255K |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
14,798 |
13,131 |
$209K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
1,799 |
1,551 |
$208K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
76,511 |
66,647 |
$202K |
| 87636 |
Infectious agent detection by nucleic acid; SARS-CoV-2 and influenza virus types A and B |
13,203 |
11,726 |
$191K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
761 |
548 |
$184K |
| 0241U |
Neonatal screening for hereditary disorders, genomic sequence analysis panel |
911 |
845 |
$183K |
| 84443 |
Thyroid stimulating hormone (TSH) |
7,960 |
7,192 |
$179K |
| 11042 |
Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm |
1,682 |
852 |
$162K |
| 96366 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour |
606 |
435 |
$147K |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
1,371 |
1,294 |
$144K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
16,501 |
14,046 |
$141K |
| 36415 |
Collection of venous blood by venipuncture |
81,462 |
71,041 |
$137K |
| G0378 |
Hospital observation service, per hour |
2,776 |
1,535 |
$137K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
1,310 |
1,287 |
$125K |
| 97140 |
Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) |
4,101 |
1,689 |
$124K |
| 96413 |
Chemotherapy administration, intravenous infusion; up to 1 hour, single or initial substance |
454 |
290 |
$119K |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
2,262 |
2,037 |
$111K |
| 71046 |
Radiologic examination, chest; 2 views |
12,873 |
11,602 |
$104K |
| 59025 |
Fetal non-stress test |
575 |
381 |
$101K |
| 76642 |
|
759 |
693 |
$99K |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
981 |
851 |
$94K |
| 99215 |
Prolong outpt/office vis |
1,007 |
877 |
$93K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
5,172 |
4,783 |
$92K |
| 90686 |
|
9,101 |
8,325 |
$91K |
| 71260 |
Computed tomography, thorax, diagnostic; with contrast material |
595 |
506 |
$91K |
| 20610 |
|
567 |
445 |
$91K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
31,355 |
27,454 |
$90K |
| 73721 |
Magnetic resonance imaging, any joint of lower extremity; without contrast material |
365 |
319 |
$88K |
| 93306 |
Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete |
338 |
298 |
$84K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
7,933 |
6,691 |
$82K |
| 80320 |
|
5,554 |
5,073 |
$80K |
| 80061 |
Lipid panel |
5,279 |
4,761 |
$79K |
| 97161 |
|
1,180 |
1,012 |
$77K |
| 70551 |
Magnetic resonance imaging, brain; without contrast material |
438 |
389 |
$76K |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
1,393 |
912 |
$74K |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
14,468 |
12,902 |
$70K |
| 97113 |
|
795 |
272 |
$65K |
| 97162 |
|
1,097 |
969 |
$65K |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
2,479 |
2,159 |
$65K |
| 84484 |
|
16,233 |
11,274 |
$64K |
| 72148 |
Magnetic resonance imaging, lumbar spine; without contrast material |
395 |
360 |
$61K |
| 93307 |
|
257 |
221 |
$60K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
607 |
456 |
$59K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
3,522 |
3,093 |
$58K |
| 90839 |
|
553 |
504 |
$58K |
| 87637 |
Infectious agent detection by nucleic acid; SARS-CoV-2, influenza, and RSV |
1,318 |
1,078 |
$56K |
| 70553 |
Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences |
197 |
175 |
$54K |
| 93975 |
|
394 |
327 |
$52K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
5,867 |
4,779 |
$51K |
| 76830 |
Ultrasound, transvaginal |
1,268 |
1,093 |
$50K |
| 71250 |
|
547 |
499 |
$49K |
| 93971 |
|
700 |
602 |
$49K |
| 81002 |
|
12,402 |
9,070 |
$48K |
| 97530 |
Therapeutic activities, direct patient contact, each 15 minutes |
1,827 |
1,034 |
$46K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
21,883 |
17,960 |
$44K |
| 87661 |
Infectious agent detection by nucleic acid; Trichomonas vaginalis, amplified probe |
2,165 |
2,054 |
$44K |
| 90677 |
|
1,197 |
988 |
$43K |
| 97112 |
Therapeutic procedure, each 15 minutes; neuromuscular reeducation of movement, balance, coordination |
1,250 |
530 |
$43K |
| 87081 |
|
5,256 |
4,857 |
$41K |
| 90670 |
|
6,087 |
5,783 |
$40K |
| 87481 |
|
1,649 |
1,565 |
$39K |
| 85027 |
|
5,114 |
3,840 |
$39K |
| 86850 |
|
1,575 |
1,272 |
$39K |
| 74018 |
|
719 |
633 |
$35K |
| 81001 |
|
42,616 |
38,899 |
$32K |
| 90715 |
|
2,268 |
1,852 |
$32K |
| 90723 |
|
4,538 |
4,153 |
$31K |
| 97014 |
|
875 |
340 |
$31K |
| 76770 |
|
203 |
195 |
$31K |
| 81003 |
|
11,612 |
8,140 |
$31K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
2,270 |
2,042 |
$31K |
| 76536 |
|
248 |
225 |
$31K |
| 12001 |
|
173 |
158 |
$30K |
| 87801 |
Infectious agent detection by nucleic acid; amplified probe, multiple organisms |
1,624 |
1,565 |
$30K |
| 71045 |
Radiologic examination, chest; single view |
8,698 |
7,636 |
$30K |
| 71271 |
|
161 |
144 |
$28K |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
28,007 |
25,058 |
$27K |
| 82607 |
|
1,008 |
864 |
$25K |
| 86900 |
|
1,812 |
1,458 |
$25K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
9,193 |
7,490 |
$25K |
| 97035 |
|
321 |
131 |
$25K |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
817 |
716 |
$24K |
| 90651 |
|
1,176 |
982 |
$24K |
| 99291 |
Critical care, evaluation and management of the critically ill patient, first 30-74 minutes |
184 |
159 |
$24K |
| 70491 |
|
90 |
76 |
$24K |
| 73030 |
|
1,063 |
887 |
$24K |
| 11045 |
|
81 |
31 |
$23K |
| 87150 |
|
360 |
322 |
$23K |
| 90688 |
|
1,748 |
1,505 |
$22K |
| 73630 |
|
1,159 |
992 |
$21K |
| 73130 |
|
1,083 |
929 |
$21K |
| 72110 |
|
393 |
354 |
$21K |
| 72125 |
Computed tomography, cervical spine; without contrast material |
1,507 |
1,244 |
$21K |
| 86592 |
|
486 |
420 |
$21K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
150 |
150 |
$21K |
| 90647 |
|
3,655 |
3,391 |
$18K |
| 84702 |
|
2,187 |
1,740 |
$18K |
| 78452 |
Myocardial perfusion imaging, tomographic (SPECT); multiple studies at rest and/or stress |
47 |
41 |
$18K |
| 97165 |
|
288 |
223 |
$17K |
| 73610 |
|
1,001 |
868 |
$17K |
| 86140 |
|
1,376 |
1,160 |
$17K |
| 90633 |
|
2,242 |
1,921 |
$17K |
| 76801 |
|
562 |
462 |
$17K |
| 84439 |
|
726 |
609 |
$17K |
| 70486 |
|
351 |
297 |
$17K |
| 96127 |
|
433 |
277 |
$16K |
| 86803 |
|
628 |
540 |
$16K |
| 82728 |
|
744 |
642 |
$15K |
| 73564 |
|
907 |
787 |
$15K |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
893 |
598 |
$14K |
| 73221 |
|
59 |
50 |
$13K |
| 73110 |
|
644 |
547 |
$13K |
| 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 |
645 |
613 |
$13K |
| 72050 |
|
231 |
198 |
$13K |
| 73502 |
|
577 |
491 |
$12K |
| 73562 |
|
224 |
193 |
$12K |
| 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 |
4,146 |
3,460 |
$12K |
| 86038 |
|
284 |
246 |
$12K |
| 81025 |
|
15,112 |
13,270 |
$11K |
| 83550 |
|
892 |
759 |
$11K |
| 83540 |
|
970 |
814 |
$11K |
| 97116 |
|
688 |
333 |
$11K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
600 |
500 |
$11K |
| 86762 |
|
406 |
356 |
$11K |
| 93017 |
|
124 |
112 |
$11K |
| 99385 |
|
143 |
132 |
$10K |
| 96375 |
Therapeutic injection; each additional sequential IV push |
17,555 |
15,099 |
$10K |
| 95810 |
Polysomnography; sleep staging with 4 or more additional parameters |
12 |
12 |
$10K |
| 72100 |
|
961 |
857 |
$10K |
| 95811 |
|
15 |
13 |
$10K |
| C1713 |
Anchor/screw for opposing bone-to-bone or soft tissue-to-bone (implantable) |
109 |
69 |
$10K |
| 72141 |
|
53 |
48 |
$10K |
| 86901 |
|
1,812 |
1,458 |
$10K |
| 77062 |
|
241 |
218 |
$10K |
| 87800 |
|
735 |
580 |
$9K |
| 73560 |
|
408 |
345 |
$9K |
| 83970 |
|
269 |
217 |
$9K |
| 87510 |
|
512 |
494 |
$9K |
| 87077 |
|
844 |
689 |
$9K |
| 76982 |
|
204 |
188 |
$9K |
| 87340 |
|
526 |
455 |
$9K |
| 83001 |
|
262 |
220 |
$8K |
| 93970 |
|
72 |
66 |
$8K |
| 99386 |
|
96 |
90 |
$8K |
| 90734 |
|
1,045 |
837 |
$8K |
| 83690 |
|
13,528 |
12,022 |
$8K |
| 80069 |
|
458 |
357 |
$8K |
| 92552 |
|
106 |
92 |
$8K |
| 87480 |
|
512 |
494 |
$8K |
| 94760 |
|
7,389 |
6,420 |
$8K |
| 88341 |
|
60 |
44 |
$8K |
| 90461 |
|
10,094 |
9,414 |
$7K |
| 87205 |
|
1,437 |
1,178 |
$7K |
| 82570 |
|
873 |
744 |
$7K |
| 90716 |
|
587 |
444 |
$7K |
| 88304 |
|
296 |
214 |
$6K |
| 87660 |
|
514 |
495 |
$6K |
| 85652 |
|
1,122 |
928 |
$6K |
| A9575 |
Injection, gadoterate meglumine, 0.1 ml |
624 |
564 |
$6K |
| 87186 |
|
1,577 |
1,249 |
$6K |
| 76000 |
|
42 |
32 |
$6K |
| 84153 |
|
304 |
271 |
$6K |
| 85610 |
|
4,345 |
3,517 |
$6K |
| 90648 |
|
802 |
690 |
$6K |
| 82550 |
|
917 |
673 |
$6K |
| 82950 |
|
339 |
298 |
$6K |
| 84403 |
|
269 |
229 |
$6K |
| 80076 |
|
1,088 |
872 |
$6K |
| 82947 |
|
3,694 |
1,613 |
$6K |
| 96376 |
|
1,630 |
1,009 |
$6K |
| 76775 |
|
43 |
37 |
$6K |
| 84146 |
|
243 |
201 |
$6K |
| 20611 |
|
19 |
15 |
$5K |
| 12011 |
|
24 |
24 |
$5K |
| J1756 |
Injection, iron sucrose, 1 mg |
160 |
47 |
$5K |
| 90681 |
|
721 |
645 |
$5K |
| 77080 |
|
80 |
80 |
$5K |
| 90707 |
|
595 |
451 |
$5K |
| 83605 |
|
2,637 |
1,883 |
$5K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
1,306 |
1,090 |
$4K |
| 82043 |
|
454 |
390 |
$4K |
| 86481 |
|
98 |
85 |
$4K |
| 83735 |
|
3,071 |
2,535 |
$4K |
| 83002 |
|
183 |
152 |
$4K |
| 73140 |
|
173 |
152 |
$4K |
| 83520 |
|
761 |
604 |
$4K |
| 90680 |
|
840 |
703 |
$4K |
| 83615 |
|
537 |
408 |
$4K |
| 99152 |
|
553 |
444 |
$4K |
| 72170 |
|
165 |
138 |
$4K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
39 |
38 |
$4K |
| 90656 |
|
460 |
454 |
$4K |
| 84550 |
|
395 |
304 |
$4K |
| 90696 |
|
375 |
317 |
$4K |
| 97166 |
|
142 |
108 |
$4K |
| 87070 |
|
648 |
494 |
$4K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
1,414 |
1,260 |
$4K |
| 96367 |
|
69 |
56 |
$3K |
| 77061 |
|
102 |
94 |
$3K |
| 90700 |
|
514 |
374 |
$3K |
| 73590 |
|
233 |
189 |
$3K |
| 82077 |
|
1,419 |
1,064 |
$3K |
| 85014 |
|
329 |
199 |
$3K |
| 77066 |
Tomosynthesis, mammo |
297 |
265 |
$3K |
| 73080 |
|
138 |
124 |
$3K |
| 73090 |
|
169 |
147 |
$3K |
| 97535 |
Self-care/home management training, each 15 minutes |
112 |
65 |
$3K |
| 84402 |
|
109 |
94 |
$3K |
| 10060 |
|
16 |
14 |
$3K |
| 86706 |
|
97 |
84 |
$3K |
| 86431 |
|
126 |
112 |
$3K |
| 87505 |
|
19 |
12 |
$3K |
| 92060 |
|
57 |
55 |
$3K |
| J3490 |
Unclassified drugs |
2,842 |
1,726 |
$2K |
| 87147 |
|
443 |
387 |
$2K |
| 77065 |
Tomosynthesis, mammo |
232 |
214 |
$2K |
| 90620 |
|
245 |
198 |
$2K |
| 87641 |
|
53 |
51 |
$2K |
| 85018 |
|
557 |
396 |
$2K |
| 82746 |
|
259 |
218 |
$2K |
| 85651 |
|
319 |
308 |
$2K |
| 86787 |
|
84 |
76 |
$2K |
| 82565 |
|
211 |
155 |
$2K |
| 72131 |
|
31 |
26 |
$2K |
| 82553 |
|
208 |
132 |
$2K |
| 86160 |
|
105 |
75 |
$2K |
| 86780 |
|
71 |
67 |
$2K |
| 82627 |
|
46 |
36 |
$2K |
| 85730 |
|
912 |
662 |
$2K |
| 82805 |
|
285 |
235 |
$2K |
| 88175 |
Cytopathology, cervical or vaginal, any reporting system; collected in preservative fluid, automated thin layer |
171 |
155 |
$2K |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
14,577 |
12,476 |
$2K |
| 90682 |
|
82 |
59 |
$2K |
| 88342 |
|
61 |
46 |
$2K |
| 97597 |
|
17 |
12 |
$2K |
| 90710 |
|
300 |
268 |
$2K |
| 83525 |
|
44 |
39 |
$2K |
| 90662 |
|
254 |
213 |
$2K |
| 87651 |
Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe |
861 |
749 |
$1K |
| 80332 |
|
71 |
70 |
$1K |
| 87502 |
Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets |
273 |
266 |
$1K |
| 88307 |
|
36 |
26 |
$1K |
| 84450 |
|
246 |
187 |
$1K |
| 90832 |
Psychotherapy, 30 minutes with patient |
46 |
44 |
$1K |
| 83655 |
|
40 |
39 |
$1K |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
132 |
127 |
$1K |
| J2543 |
Injection, piperacillin sodium/tazobactam sodium, 1 gram/0.125 grams (1.125 grams) |
415 |
207 |
$1K |
| 87624 |
Infectious agent detection by nucleic acid; human papillomavirus (HPV), high-risk types |
60 |
53 |
$1K |
| 84460 |
|
260 |
202 |
$1K |
| 86225 |
|
53 |
40 |
$1K |
| J7030 |
Infusion, normal saline solution , 1000 cc |
13,091 |
11,125 |
$1K |
| J0500 |
Injection, dicyclomine hcl, up to 20 mg |
81 |
66 |
$1K |
| 82248 |
|
291 |
243 |
$1K |
| U0002 |
2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc |
232 |
204 |
$1K |
| 84703 |
|
1,131 |
933 |
$1K |
| 85379 |
|
403 |
317 |
$1K |
| 84132 |
|
361 |
294 |
$1K |
| 87040 |
|
1,351 |
727 |
$1K |
| 98925 |
|
26 |
24 |
$1K |
| 86003 |
|
32 |
28 |
$1K |
| 72072 |
|
64 |
58 |
$978.20 |
| 99153 |
Mod sedat endo service >5yrs |
135 |
104 |
$971.29 |
| 99384 |
|
15 |
15 |
$960.19 |
| 86308 |
|
48 |
44 |
$955.99 |
| 84520 |
|
189 |
141 |
$952.22 |
| 80337 |
|
84 |
83 |
$858.78 |
| 80338 |
|
84 |
83 |
$858.78 |
| J2270 |
Injection, morphine sulfate, up to 10 mg |
2,899 |
2,024 |
$835.18 |
| 93880 |
|
15 |
13 |
$805.00 |
| 99406 |
|
28 |
25 |
$801.30 |
| 80074 |
|
26 |
24 |
$737.16 |
| 85007 |
|
266 |
199 |
$724.12 |
| 84156 |
|
130 |
97 |
$709.27 |
| 86364 |
|
22 |
16 |
$692.22 |
| 72114 |
|
13 |
12 |
$683.28 |
| J1815 |
Injection, insulin, per 5 units |
268 |
121 |
$649.71 |
| 87075 |
|
1,239 |
697 |
$618.85 |
| 82150 |
|
101 |
82 |
$612.85 |
| J8499 |
Prescription drug, oral, non chemotherapeutic, nos |
1,150 |
465 |
$602.54 |
| 87634 |
|
89 |
80 |
$586.00 |
| C1889 |
Implantable/insertable device, not otherwise classified |
58 |
40 |
$571.27 |
| 76870 |
|
30 |
25 |
$552.36 |
| A9270 |
Non-covered item or service |
2,240 |
410 |
$541.58 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
433 |
402 |
$522.17 |
| 84100 |
|
126 |
100 |
$485.06 |
| 84165 |
|
32 |
28 |
$483.62 |
| 87563 |
|
12 |
12 |
$476.09 |
| 87430 |
|
440 |
383 |
$474.93 |
| 83880 |
|
1,101 |
875 |
$458.73 |
| 93296 |
|
31 |
30 |
$415.94 |
| 75774 |
|
14 |
13 |
$414.55 |
| 75716 |
|
13 |
13 |
$409.05 |
| J1170 |
Injection, hydromorphone, up to 4 mg |
1,301 |
745 |
$395.71 |
| C9113 |
Injection, pantoprazole sodium, per vial |
214 |
118 |
$392.57 |
| 80143 |
|
1,000 |
864 |
$382.22 |
| 87798 |
Infectious agent detection by nucleic acid; not otherwise specified, amplified probe, each organism |
12 |
12 |
$366.20 |
| 83721 |
|
28 |
25 |
$354.00 |
| 83529 |
|
15 |
14 |
$351.85 |
| J7120 |
Ringers lactate infusion, up to 1000 cc |
2,773 |
1,668 |
$349.47 |
| 84480 |
|
16 |
12 |
$329.34 |
| 85300 |
|
549 |
468 |
$321.79 |
| J1650 |
Injection, enoxaparin sodium, 10 mg |
450 |
167 |
$306.06 |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
15,497 |
13,047 |
$270.48 |
| J2930 |
Injection, methylprednisolone sodium succinate, up to 125 mg |
754 |
515 |
$267.84 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
1,615 |
1,183 |
$266.81 |
| 87210 |
|
49 |
38 |
$260.39 |
| 69209 |
|
76 |
68 |
$260.24 |
| G0404 |
Electrocardiogram, routine ecg with 12 leads; tracing only, without interpretation and report, performed as a screening for the initial preventive physical examination |
101 |
74 |
$217.91 |
| 90685 |
|
50 |
49 |
$217.50 |
| J1644 |
Injection, heparin sodium, per 1000 units |
1,093 |
509 |
$212.90 |
| 80361 |
|
139 |
126 |
$204.00 |
| 80354 |
|
121 |
111 |
$204.00 |
| 80347 |
|
13 |
13 |
$204.00 |
| 80326 |
|
13 |
13 |
$204.00 |
| 80360 |
|
13 |
13 |
$204.00 |
| 83992 |
|
13 |
13 |
$204.00 |
| 80356 |
|
13 |
13 |
$204.00 |
| 80377 |
|
13 |
13 |
$204.00 |
| J3301 |
Injection, triamcinolone acetonide, not otherwise specified, 10 mg |
1,298 |
1,059 |
$200.73 |
| 80373 |
|
120 |
110 |
$187.00 |
| 76937 |
|
16 |
12 |
$182.84 |
| Q3014 |
Telehealth originating site facility fee |
90 |
67 |
$181.91 |
| C1769 |
Guide wire |
174 |
133 |
$159.53 |
| 80179 |
|
986 |
857 |
$155.38 |
| 87109 |
|
15 |
12 |
$139.80 |
| J2060 |
Injection, lorazepam, 2 mg |
860 |
609 |
$135.06 |
| G1004 |
Clinical decision support mechanism national decision support company, as defined by the medicare appropriate use criteria program |
588 |
410 |
$130.96 |
| J2704 |
Injection, propofol, 10 mg |
2,465 |
1,728 |
$130.81 |
| J7999 |
Compounded drug, not otherwise classified |
170 |
111 |
$130.64 |
| J1200 |
Injection, diphenhydramine hcl, up to 50 mg |
1,731 |
1,336 |
$127.49 |
| 80365 |
|
141 |
128 |
$126.40 |
| 80331 |
|
13 |
13 |
$126.40 |
| 80334 |
|
13 |
13 |
$126.40 |
| 80355 |
|
13 |
13 |
$126.40 |
| 80348 |
|
13 |
13 |
$126.40 |
| 80364 |
|
13 |
13 |
$126.40 |
| 80370 |
|
13 |
13 |
$126.40 |
| 80372 |
|
13 |
13 |
$126.40 |
| 80344 |
|
13 |
13 |
$126.40 |
| 80366 |
|
13 |
13 |
$126.40 |
| 80358 |
|
121 |
111 |
$126.40 |
| 80368 |
|
121 |
111 |
$126.40 |
| 80357 |
|
13 |
13 |
$126.40 |
| 80353 |
|
13 |
13 |
$126.40 |
| 80359 |
|
13 |
13 |
$126.40 |
| 80367 |
|
13 |
13 |
$126.40 |
| 80371 |
|
13 |
13 |
$126.40 |
| 80341 |
|
13 |
13 |
$126.40 |
| J0780 |
Injection, prochlorperazine, up to 10 mg |
528 |
435 |
$118.31 |
| J3370 |
Injection, vancomycin hcl, 500 mg |
164 |
102 |
$103.33 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
2,626 |
2,030 |
$99.29 |
| J2360 |
Injection, orphenadrine citrate, up to 60 mg |
486 |
411 |
$94.52 |
| J1010 |
Injection, methylprednisolone acetate, 1 mg |
88 |
78 |
$85.07 |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
3,620 |
2,224 |
$83.30 |
| J2919 |
Injection, methylprednisolone sodium succinate, 5 mg |
357 |
296 |
$76.54 |
| J1630 |
Injection, haloperidol, up to 5 mg |
489 |
369 |
$63.92 |
| 90474 |
|
168 |
165 |
$60.48 |
| 94664 |
|
20 |
12 |
$58.80 |
| J8597 |
Antiemetic drug, oral, not otherwise specified |
527 |
475 |
$53.02 |
| J0689 |
Injection, cefazolin sodium (baxter), not therapeutically equivalent to j0690, 500 mg |
529 |
347 |
$50.90 |
| J2765 |
Injection, metoclopramide hcl, up to 10 mg |
672 |
504 |
$47.34 |
| 72020 |
|
72 |
60 |
$44.49 |
| J3360 |
Injection, diazepam, up to 5 mg |
17 |
12 |
$43.76 |
| J8540 |
Dexamethasone, oral, 0.25 mg |
346 |
192 |
$38.12 |
| J7040 |
Infusion, normal saline solution, sterile (500 ml = 1 unit) |
990 |
775 |
$37.63 |
| J7512 |
Prednisone, immediate release or delayed release, oral, 1 mg |
920 |
699 |
$36.69 |
| J0690 |
Injection, cefazolin sodium, 500 mg |
716 |
455 |
$34.70 |
| J1030 |
Injection, methylprednisolone acetate, 40 mg |
313 |
250 |
$31.38 |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
3,688 |
3,069 |
$29.19 |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
3,178 |
2,368 |
$26.30 |
| A4649 |
Surgical supply; miscellaneous |
211 |
177 |
$23.56 |
| J2370 |
Injection, phenylephrine hcl, up to 1 ml |
54 |
31 |
$22.05 |
| J3486 |
Injection, ziprasidone mesylate, 10 mg |
17 |
12 |
$20.44 |
| J2710 |
Injection, neostigmine methylsulfate, up to 0.5 mg |
225 |
141 |
$20.20 |
| J3420 |
Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg |
19 |
12 |
$17.79 |
| 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 |
506 |
423 |
$17.34 |
| J7050 |
Infusion, normal saline solution, 250 cc |
434 |
276 |
$11.19 |
| G0008 |
Administration of influenza virus vaccine |
241 |
202 |
$10.30 |
| J3475 |
Injection, magnesium sulfate, per 500 mg |
83 |
73 |
$9.79 |
| J2003 |
Injection, lidocaine hydrochloride, 1 mg |
324 |
289 |
$7.64 |
| C1894 |
Introducer/sheath, other than guiding, other than intracardiac electrophysiological, non-laser |
110 |
85 |
$7.20 |
| J3480 |
Injection, potassium chloride, per 2 meq |
57 |
41 |
$6.80 |
| J3411 |
Injection, thiamine hcl, 100 mg |
23 |
13 |
$6.78 |
| J7620 |
Albuterol, up to 2.5 mg and ipratropium bromide, up to 0.5 mg, fda-approved final product, non-compounded, administered through dme |
535 |
363 |
$6.40 |
| J2272 |
Injection, morphine sulfate (fresenius kabi), not therapeutically equivalent to j2270, up to 10 mg |
35 |
33 |
$5.07 |
| 82962 |
|
148 |
109 |
$5.00 |
| J1940 |
Injection, furosemide, up to 20 mg |
39 |
24 |
$4.49 |
| 82330 |
|
111 |
101 |
$3.48 |
| J2550 |
Injection, promethazine hcl, up to 50 mg |
42 |
24 |
$3.26 |
| J1171 |
Injection, hydromorphone, 0.1 mg |
91 |
68 |
$2.43 |
| J7613 |
Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg |
211 |
161 |
$1.84 |
| 84295 |
|
92 |
81 |
$1.12 |
| 82435 |
|
93 |
81 |
$1.12 |
| J0665 |
Injection, bupivicaine, not otherwise specified, 0.5 mg |
262 |
202 |
$1.00 |
| J2371 |
Injection, phenylephrine hydrochloride, 20 micrograms |
54 |
32 |
$0.90 |
| Q0244 |
Injection, casirivimab and imdevimab, 1200 mg |
73 |
73 |
$0.52 |
| 90671 |
|
97 |
94 |
$0.00 |
| 00840 |
|
87 |
51 |
$0.00 |
| J2004 |
Injection, lidocaine hcl with epinephrine, 1 mg |
46 |
43 |
$0.00 |
| J3372 |
Injection, vancomycin hcl (xellia), not therapeutically equivalent to j3370, 500 mg |
49 |
31 |
$0.00 |
| A9502 |
Technetium tc-99m tetrofosmin, diagnostic, per study dose |
34 |
28 |
$0.00 |
| Q9966 |
Low osmolar contrast material, 200-299 mg/ml iodine concentration, per ml |
138 |
131 |
$0.00 |
| J1596 |
Injection, glycopyrrolate, 0.1 mg |
15 |
12 |
$0.00 |
| 80346 |
|
111 |
100 |
$0.00 |
| J7070 |
Infusion, d5w, 1000 cc |
29 |
13 |
$0.00 |
| 76942 |
|
21 |
12 |
$0.00 |
| 82010 |
|
14 |
12 |
$0.00 |
| M0247 |
Intravenous infusion, sotrovimab, includes infusion and post administration monitoring |
12 |
12 |
$0.00 |
| 29125 |
|
13 |
13 |
$0.00 |
| 01999 |
|
12 |
12 |
$0.00 |
| 36416 |
|
1,234 |
948 |
$0.00 |
| J2785 |
Injection, regadenoson, 0.1 mg |
31 |
27 |
$0.00 |
| J1040 |
Injection, methylprednisolone acetate, 80 mg |
42 |
40 |
$0.00 |
| 76377 |
|
289 |
246 |
$0.00 |
| 94761 |
|
37 |
36 |
$0.00 |
| 80329 |
|
50 |
21 |
$0.00 |
| M0243 |
Intravenous infusion or subcutaneous injection, casirivimab and imdevimab includes infusion or injection, and post administration monitoring |
73 |
73 |
$0.00 |
| 0011A |
|
60 |
60 |
$0.00 |
| 73060 |
|
14 |
12 |
$0.00 |
| 72040 |
|
15 |
12 |
$0.00 |
| 91301 |
|
112 |
112 |
$0.00 |
| 0012A |
|
36 |
36 |
$0.00 |
| 82803 |
|
18 |
13 |
$0.00 |
| 91303 |
|
23 |
23 |
$0.00 |
| A9698 |
Non-radioactive contrast imaging material, not otherwise classified, per study |
13 |
12 |
$0.00 |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
39 |
24 |
$0.00 |
| 0031A |
|
23 |
23 |
$0.00 |
| 95886 |
|
13 |
12 |
$0.00 |
| J2470 |
Injection, pantoprazole sodium, 40 mg |
32 |
25 |
$0.00 |