| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
26,938 |
23,885 |
$14.22M |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
27,493 |
24,959 |
$10.83M |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
18,404 |
16,381 |
$4.63M |
| G0378 |
Hospital observation service, per hour |
5,162 |
3,905 |
$2.87M |
| 43239 |
Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple |
2,153 |
1,964 |
$1.22M |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
5,981 |
5,536 |
$1.18M |
| 70450 |
Computed tomography, head or brain; without contrast material |
7,361 |
6,596 |
$776K |
| 96375 |
Therapeutic injection; each additional sequential IV push |
11,811 |
9,283 |
$573K |
| 96361 |
Intravenous infusion, hydration; each additional hour |
8,193 |
6,101 |
$560K |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
14,633 |
12,880 |
$553K |
| OP710 |
|
6,282 |
5,555 |
$496K |
| 90832 |
Psychotherapy, 30 minutes with patient |
5,829 |
3,114 |
$473K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
21,040 |
17,808 |
$430K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
2,614 |
2,409 |
$392K |
| OP370 |
|
6,326 |
5,583 |
$375K |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
11,974 |
3,176 |
$360K |
| 90834 |
Psychotherapy, 45 minutes with patient |
7,516 |
3,542 |
$356K |
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
7,854 |
6,063 |
$326K |
| OP272 |
|
11,214 |
9,747 |
$326K |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
2,029 |
1,885 |
$316K |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
4,211 |
3,544 |
$308K |
| H0035 |
Mental health partial hospitalization, treatment, less than 24 hours |
1,131 |
159 |
$263K |
| 99281 |
Emergency department visit for the evaluation and management, self-limited or minor |
2,110 |
1,937 |
$248K |
| 80053 |
Comprehensive metabolic panel |
37,001 |
30,172 |
$246K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
45,616 |
35,869 |
$230K |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
5,738 |
3,612 |
$227K |
| 96366 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour |
3,010 |
1,747 |
$211K |
| 71045 |
Radiologic examination, chest; single view |
15,118 |
13,439 |
$205K |
| 0241U |
Neonatal screening for hereditary disorders, genomic sequence analysis panel |
4,205 |
3,877 |
$175K |
| 92507 |
Treatment of speech, language, voice, communication, and/or auditory processing disorder |
4,685 |
1,349 |
$169K |
| 71275 |
Computed tomographic angiography, chest, with contrast material |
1,383 |
1,280 |
$165K |
| 76830 |
Ultrasound, transvaginal |
2,215 |
2,082 |
$156K |
| 71046 |
Radiologic examination, chest; 2 views |
6,041 |
5,790 |
$150K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
2,288 |
2,188 |
$127K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
8,604 |
6,234 |
$126K |
| 45380 |
Colonoscopy, flexible; with biopsy, single or multiple |
332 |
294 |
$121K |
| 96376 |
|
3,706 |
2,176 |
$113K |
| 72125 |
Computed tomography, cervical spine; without contrast material |
1,283 |
1,111 |
$107K |
| 76700 |
Ultrasound, abdominal, real time with image documentation; complete |
1,287 |
1,225 |
$102K |
| OP250 |
|
122,023 |
42,906 |
$102K |
| 87631 |
|
3,837 |
3,334 |
$98K |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
4,772 |
4,214 |
$96K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
3,833 |
3,358 |
$94K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
2,013 |
1,683 |
$90K |
| 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 |
4,286 |
3,392 |
$87K |
| 88342 |
|
2,305 |
2,017 |
$86K |
| 96360 |
Intravenous infusion, hydration; initial, 31 minutes to 1 hour |
2,046 |
1,809 |
$82K |
| 97140 |
Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) |
4,065 |
1,437 |
$80K |
| 36415 |
Collection of venous blood by venipuncture |
46,156 |
33,848 |
$75K |
| 90853 |
Group psychotherapy (other than of a multiple-family group) |
3,214 |
1,084 |
$74K |
| 93306 |
Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete |
495 |
439 |
$73K |
| 93970 |
|
861 |
755 |
$69K |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
1,328 |
1,232 |
$67K |
| 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 |
1,322 |
1,295 |
$67K |
| 84484 |
|
12,853 |
10,101 |
$63K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
11,507 |
9,220 |
$63K |
| 71250 |
|
670 |
585 |
$61K |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
8,671 |
7,797 |
$60K |
| 93971 |
|
1,015 |
932 |
$59K |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
2,050 |
1,572 |
$58K |
| 73630 |
|
1,849 |
1,711 |
$57K |
| 97802 |
|
785 |
785 |
$55K |
| 73130 |
|
1,425 |
1,315 |
$51K |
| D0120 |
Periodic oral evaluation - established patient |
3,447 |
3,430 |
$49K |
| U0002 |
2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc |
2,669 |
2,366 |
$45K |
| OP279 |
|
4,389 |
4,159 |
$44K |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
9,184 |
8,532 |
$44K |
| 73030 |
|
1,576 |
1,434 |
$43K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
6,155 |
3,966 |
$42K |
| 73610 |
|
1,573 |
1,491 |
$41K |
| D1110 |
Prophylaxis - adult |
2,999 |
2,984 |
$41K |
| 85610 |
|
12,928 |
11,189 |
$41K |
| 96367 |
|
1,267 |
792 |
$40K |
| 81001 |
|
16,542 |
15,112 |
$40K |
| 83880 |
|
4,194 |
3,186 |
$40K |
| 86900 |
|
5,192 |
4,498 |
$39K |
| 73564 |
|
1,480 |
1,343 |
$39K |
| 86850 |
|
5,081 |
4,414 |
$38K |
| 83690 |
|
12,654 |
11,382 |
$38K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
488 |
436 |
$37K |
| 93458 |
|
24 |
17 |
$36K |
| 83735 |
|
13,304 |
9,781 |
$35K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
6,222 |
5,989 |
$34K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
1,142 |
899 |
$33K |
| 81025 |
|
17,856 |
16,488 |
$32K |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
1,176 |
868 |
$30K |
| 92557 |
|
418 |
384 |
$30K |
| 74220 |
|
601 |
561 |
$29K |
| 72131 |
|
399 |
354 |
$28K |
| 92587 |
|
464 |
436 |
$28K |
| D7140 |
Extraction, erupted tooth or exposed root |
1,155 |
699 |
$28K |
| OP270 |
|
4,211 |
3,596 |
$27K |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
1,417 |
1,323 |
$26K |
| 87070 |
|
6,394 |
6,105 |
$25K |
| 85730 |
|
9,922 |
8,822 |
$24K |
| 73110 |
|
739 |
663 |
$23K |
| 76641 |
|
354 |
317 |
$23K |
| 87040 |
|
3,684 |
2,693 |
$23K |
| C9399 |
Unclassified drugs or biologicals |
213 |
212 |
$23K |
| 70486 |
|
257 |
227 |
$22K |
| 88313 |
|
2,175 |
1,849 |
$22K |
| 82962 |
|
8,258 |
5,046 |
$21K |
| 90792 |
Psychiatric diagnostic evaluation with medical services |
349 |
286 |
$21K |
| 97162 |
|
738 |
646 |
$20K |
| 84443 |
Thyroid stimulating hormone (TSH) |
2,392 |
2,193 |
$20K |
| 83605 |
|
3,590 |
3,117 |
$20K |
| 90791 |
Psychiatric diagnostic evaluation |
190 |
143 |
$19K |
| 80061 |
Lipid panel |
2,026 |
1,889 |
$19K |
| 86901 |
|
5,211 |
4,498 |
$19K |
| D0140 |
Limited oral evaluation - problem focused |
1,412 |
1,393 |
$19K |
| 84702 |
|
2,858 |
2,384 |
$18K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
1,497 |
1,410 |
$17K |
| D1120 |
Prophylaxis - child |
1,061 |
1,055 |
$17K |
| 81003 |
|
10,519 |
9,603 |
$16K |
| 72110 |
|
432 |
407 |
$16K |
| 80076 |
|
2,744 |
2,559 |
$15K |
| 90715 |
|
1,076 |
1,017 |
$15K |
| J7030 |
Infusion, normal saline solution , 1000 cc |
13,903 |
11,435 |
$15K |
| 97530 |
Therapeutic activities, direct patient contact, each 15 minutes |
958 |
504 |
$14K |
| 93976 |
|
341 |
334 |
$13K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
1,483 |
1,398 |
$13K |
| 97112 |
Therapeutic procedure, each 15 minutes; neuromuscular reeducation of movement, balance, coordination |
643 |
266 |
$13K |
| 82248 |
|
2,705 |
2,494 |
$12K |
| J2704 |
Injection, propofol, 10 mg |
4,173 |
3,527 |
$12K |
| 87661 |
Infectious agent detection by nucleic acid; Trichomonas vaginalis, amplified probe |
785 |
773 |
$11K |
| 97803 |
|
197 |
184 |
$11K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
2,285 |
2,097 |
$10K |
| OP259 |
|
10,085 |
5,774 |
$10K |
| 84100 |
|
5,050 |
3,054 |
$9K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
118 |
112 |
$9K |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
8,067 |
6,446 |
$9K |
| D0210 |
Intraoral - complete series of radiographic images |
489 |
488 |
$9K |
| 80320 |
|
510 |
456 |
$9K |
| 82550 |
|
2,880 |
2,563 |
$9K |
| 76811 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, detailed |
66 |
58 |
$9K |
| J0131 |
Injection, acetaminophen, not otherwise specified,10 mg |
2,068 |
1,639 |
$9K |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
9,884 |
8,331 |
$8K |
| D0274 |
Bitewings - four radiographic images |
1,436 |
1,430 |
$8K |
| 85027 |
|
3,113 |
2,498 |
$8K |
| 85379 |
|
3,141 |
2,889 |
$8K |
| J1756 |
Injection, iron sucrose, 1 mg |
237 |
69 |
$7K |
| J2001 |
Injection, lidocaine hcl for intravenous infusion, 10 mg |
681 |
654 |
$7K |
| 82728 |
|
935 |
814 |
$7K |
| 96413 |
Chemotherapy administration, intravenous infusion; up to 1 hour, single or initial substance |
62 |
37 |
$7K |
| 0012A |
|
246 |
244 |
$7K |
| J3490 |
Unclassified drugs |
239 |
181 |
$7K |
| 74018 |
|
373 |
339 |
$7K |
| 82150 |
|
1,248 |
1,200 |
$7K |
| 71260 |
Computed tomography, thorax, diagnostic; with contrast material |
57 |
51 |
$6K |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
2,195 |
1,506 |
$6K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
145 |
132 |
$6K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
1,222 |
1,064 |
$6K |
| 87186 |
|
1,172 |
1,059 |
$6K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
439 |
439 |
$6K |
| 0011A |
|
219 |
219 |
$6K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
58 |
55 |
$6K |
| D0220 |
Intraoral - periapical first radiographic image |
2,084 |
2,034 |
$6K |
| D1208 |
Topical application of fluoride, excluding varnish |
856 |
850 |
$5K |
| 87077 |
|
1,106 |
1,027 |
$5K |
| G0279 |
Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066) |
346 |
290 |
$5K |
| 97161 |
|
147 |
139 |
$5K |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
3,434 |
2,803 |
$5K |
| 87807 |
|
837 |
823 |
$5K |
| 73502 |
|
258 |
224 |
$5K |
| J7120 |
Ringers lactate infusion, up to 1000 cc |
6,357 |
4,621 |
$5K |
| 92550 |
|
146 |
135 |
$5K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
208 |
172 |
$4K |
| 45385 |
Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) |
17 |
13 |
$4K |
| 77066 |
Tomosynthesis, mammo |
50 |
45 |
$4K |
| 80143 |
|
1,136 |
940 |
$3K |
| 80324 |
|
185 |
174 |
$3K |
| 80179 |
|
1,074 |
886 |
$3K |
| 73080 |
|
130 |
117 |
$3K |
| OP255 |
|
1,541 |
1,363 |
$3K |
| 76536 |
|
46 |
41 |
$3K |
| OP251 |
|
1,353 |
1,176 |
$3K |
| 82607 |
|
352 |
310 |
$3K |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
1,811 |
1,553 |
$3K |
| 84439 |
|
458 |
425 |
$3K |
| 97116 |
|
206 |
133 |
$3K |
| J7050 |
Infusion, normal saline solution, 250 cc |
3,703 |
1,138 |
$3K |
| D0330 |
Panoramic radiographic image |
214 |
214 |
$2K |
| C9290 |
Injection, bupivacaine liposome, 1 mg |
18 |
15 |
$2K |
| 76642 |
|
50 |
45 |
$2K |
| M0222 |
Intravenous injection, bebtelovimab, includes injection and post administration monitoring |
57 |
44 |
$2K |
| J2765 |
Injection, metoclopramide hcl, up to 10 mg |
1,853 |
1,554 |
$2K |
| 0001A |
|
68 |
68 |
$2K |
| J2270 |
Injection, morphine sulfate, up to 10 mg |
1,472 |
1,122 |
$2K |
| 85007 |
|
1,900 |
1,517 |
$2K |
| 85378 |
|
504 |
495 |
$2K |
| 82746 |
|
226 |
200 |
$2K |
| 86140 |
|
839 |
730 |
$2K |
| 87076 |
|
216 |
211 |
$2K |
| J3475 |
Injection, magnesium sulfate, per 500 mg |
794 |
533 |
$2K |
| OP637 |
|
1,296 |
964 |
$2K |
| J0690 |
Injection, cefazolin sodium, 500 mg |
1,203 |
859 |
$2K |
| 0002A |
|
54 |
54 |
$2K |
| J1650 |
Injection, enoxaparin sodium, 10 mg |
1,556 |
787 |
$2K |
| J0137 |
Injection, acetaminophen (hikma), not therapeutically equivalent to j0131, 10 mg |
520 |
411 |
$2K |
| 84703 |
|
898 |
813 |
$2K |
| C9113 |
Injection, pantoprazole sodium, per vial |
1,506 |
897 |
$2K |
| C1769 |
Guide wire |
182 |
138 |
$2K |
| J1644 |
Injection, heparin sodium, per 1000 units |
2,122 |
534 |
$2K |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
3,258 |
2,304 |
$2K |
| G0283 |
Electrical stimulation (unattended), to one or more areas for indication(s) other than wound care, as part of a therapy plan of care |
119 |
25 |
$2K |
| 82552 |
|
177 |
171 |
$2K |
| J7040 |
Infusion, normal saline solution, sterile (500 ml = 1 unit) |
1,293 |
1,096 |
$2K |
| 74022 |
|
50 |
50 |
$1K |
| 83550 |
|
700 |
607 |
$1K |
| C1751 |
Catheter, infusion, inserted peripherally, centrally or midline (other than hemodialysis) |
121 |
119 |
$1K |
| 77080 |
|
52 |
41 |
$1K |
| J2930 |
Injection, methylprednisolone sodium succinate, up to 125 mg |
1,083 |
943 |
$1K |
| 11042 |
Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm |
38 |
13 |
$1K |
| 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 |
32 |
32 |
$1K |
| 92523 |
|
15 |
13 |
$1K |
| Q9966 |
Low osmolar contrast material, 200-299 mg/ml iodine concentration, per ml |
217 |
216 |
$1K |
| OP258 |
|
1,963 |
1,467 |
$1K |
| OP278 |
|
12 |
12 |
$1K |
| 72100 |
|
67 |
67 |
$1K |
| J2272 |
Injection, morphine sulfate (fresenius kabi), not therapeutically equivalent to j2270, up to 10 mg |
1,386 |
827 |
$1K |
| J1200 |
Injection, diphenhydramine hcl, up to 50 mg |
2,062 |
1,592 |
$1K |
| J2060 |
Injection, lorazepam, 2 mg |
1,152 |
778 |
$999.30 |
| 85652 |
|
1,180 |
1,056 |
$981.20 |
| 82553 |
|
452 |
377 |
$951.45 |
| 70498 |
|
29 |
24 |
$929.52 |
| OP720 |
|
102 |
82 |
$921.87 |
| 73090 |
|
27 |
24 |
$921.07 |
| J1170 |
Injection, hydromorphone, up to 4 mg |
1,091 |
659 |
$892.05 |
| D0230 |
Intraoral - periapical each additional radiographic image |
287 |
243 |
$731.51 |
| 70496 |
|
30 |
25 |
$720.66 |
| 93979 |
|
12 |
12 |
$698.12 |
| M0245 |
Intravenous infusion, bamlanivimab and etesevimab, includes infusion and post administration monitoring |
16 |
14 |
$674.46 |
| A4615 |
Cannula, nasal |
1,639 |
1,509 |
$666.35 |
| 73560 |
|
15 |
15 |
$659.00 |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
28 |
28 |
$570.99 |
| A9575 |
Injection, gadoterate meglumine, 0.1 ml |
64 |
54 |
$530.87 |
| D2331 |
|
15 |
13 |
$528.50 |
| 83540 |
|
174 |
169 |
$526.00 |
| 73562 |
|
14 |
13 |
$524.93 |
| 74240 |
|
15 |
14 |
$522.39 |
| J7512 |
Prednisone, immediate release or delayed release, oral, 1 mg |
1,876 |
1,331 |
$517.33 |
| 88304 |
|
62 |
49 |
$501.85 |
| C1894 |
Introducer/sheath, other than guiding, other than intracardiac electrophysiological, non-laser |
122 |
90 |
$457.27 |
| 87205 |
|
248 |
204 |
$431.65 |
| 99152 |
|
48 |
35 |
$416.04 |
| J1596 |
Injection, glycopyrrolate, 0.1 mg |
29 |
28 |
$405.79 |
| 93880 |
|
16 |
12 |
$392.95 |
| 94760 |
|
43 |
26 |
$341.13 |
| J0134 |
Injection, acetaminophen (fresenius kabi), not therapeutically equivalent to j0131, 10 mg |
176 |
135 |
$337.17 |
| J2919 |
Injection, methylprednisolone sodium succinate, 5 mg |
205 |
162 |
$298.43 |
| 85651 |
|
121 |
112 |
$278.82 |
| D0270 |
|
146 |
145 |
$243.00 |
| J3370 |
Injection, vancomycin hcl, 500 mg |
60 |
37 |
$231.15 |
| 87147 |
|
258 |
229 |
$230.92 |
| 73140 |
|
17 |
15 |
$212.51 |
| 84145 |
|
37 |
30 |
$199.04 |
| 82247 |
|
41 |
15 |
$198.60 |
| J0665 |
Injection, bupivicaine, not otherwise specified, 0.5 mg |
291 |
236 |
$196.65 |
| 88307 |
|
20 |
13 |
$177.00 |
| J2470 |
Injection, pantoprazole sodium, 40 mg |
125 |
85 |
$169.80 |
| 87390 |
|
28 |
28 |
$161.26 |
| 99153 |
Mod sedat endo service >5yrs |
18 |
12 |
$160.71 |
| J2543 |
Injection, piperacillin sodium/tazobactam sodium, 1 gram/0.125 grams (1.125 grams) |
159 |
73 |
$151.55 |
| J3480 |
Injection, potassium chloride, per 2 meq |
118 |
56 |
$150.70 |
| J1815 |
Injection, insulin, per 5 units |
591 |
248 |
$127.84 |
| J0360 |
Injection, hydralazine hcl, up to 20 mg |
112 |
74 |
$118.47 |
| D1206 |
Topical application of fluoride varnish |
14 |
14 |
$117.50 |
| J3411 |
Injection, thiamine hcl, 100 mg |
68 |
41 |
$113.07 |
| Q9963 |
High osmolar contrast material, 350-399 mg/ml iodine concentration, per ml |
73 |
71 |
$106.84 |
| J2003 |
Injection, lidocaine hydrochloride, 1 mg |
134 |
122 |
$85.91 |
| 82010 |
|
31 |
26 |
$83.57 |
| D0272 |
Bitewings - two radiographic images |
14 |
14 |
$82.50 |
| 82570 |
|
13 |
13 |
$73.53 |
| J0136 |
Injection, acetaminophen (b braun), not therapeutically equivalent to j0131, 10 mg |
53 |
43 |
$68.95 |
| 84550 |
|
17 |
12 |
$62.01 |
| J0744 |
Injection, ciprofloxacin for intravenous infusion, 200 mg |
42 |
12 |
$58.66 |
| J0330 |
Injection, succinylcholine chloride, up to 20 mg |
12 |
12 |
$57.94 |
| J7510 |
Prednisolone oral, per 5 mg |
105 |
91 |
$52.36 |
| J7070 |
Infusion, d5w, 1000 cc |
149 |
63 |
$27.58 |
| 86592 |
|
28 |
24 |
$26.07 |
| J1642 |
Injection, heparin sodium, (heparin lock flush), per 10 units |
36 |
12 |
$24.00 |
| J8540 |
Dexamethasone, oral, 0.25 mg |
15 |
12 |
$22.65 |
| J1630 |
Injection, haloperidol, up to 5 mg |
54 |
37 |
$21.87 |
| 83615 |
|
19 |
12 |
$16.80 |
| J1171 |
Injection, hydromorphone, 0.1 mg |
19 |
14 |
$16.31 |
| 82803 |
|
16 |
12 |
$7.10 |
| J2004 |
Injection, lidocaine hcl with epinephrine, 1 mg |
13 |
13 |
$4.68 |
| J2305 |
Injection, nitroglycerin, 5 mg |
18 |
12 |
$4.25 |
| Q0222 |
Injection, bebtelovimab, 175 mg |
57 |
46 |
$3.00 |
| J1836 |
Injection, metronidazole, 10 mg |
27 |
13 |
$1.30 |
| J2371 |
Injection, phenylephrine hydrochloride, 20 micrograms |
61 |
40 |
$0.00 |
| J0687 |
Injection, cefazolin sodium (wg critical care), not therapeutically equivalent to j0690, 500 mg |
93 |
71 |
$0.00 |
| J1920 |
Injection, labetalol hydrochloride, 5 mg |
23 |
14 |
$0.00 |
| A6197 |
Alginate or other fiber gelling dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., each dressing |
35 |
13 |
$0.00 |
| G1004 |
Clinical decision support mechanism national decision support company, as defined by the medicare appropriate use criteria program |
848 |
475 |
$0.00 |
| A6212 |
Foam dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing |
24 |
12 |
$0.00 |