| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99284 |
Emergency department visit for the evaluation and management, high severity |
94,833 |
86,114 |
$22.02M |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
47,276 |
42,262 |
$19.37M |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
65,535 |
60,187 |
$14.62M |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
21,018 |
19,718 |
$12.17M |
| 70553 |
Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences |
13,230 |
12,431 |
$6.97M |
| 70450 |
Computed tomography, head or brain; without contrast material |
23,145 |
21,461 |
$3.64M |
| J2350 |
Injection, ocrelizumab, 1 mg |
254 |
204 |
$3.07M |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
6,248 |
5,786 |
$2.37M |
| 71275 |
Computed tomographic angiography, chest, with contrast material |
5,475 |
5,082 |
$2.32M |
| J2323 |
Injection, natalizumab, 1 mg |
1,090 |
957 |
$2.30M |
| 72125 |
Computed tomography, cervical spine; without contrast material |
8,808 |
8,306 |
$2.27M |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
35,483 |
10,455 |
$1.85M |
| 59025 |
Fetal non-stress test |
12,729 |
9,935 |
$1.53M |
| G0378 |
Hospital observation service, per hour |
28,996 |
14,138 |
$1.28M |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
12,991 |
12,216 |
$1.15M |
| 72131 |
|
3,984 |
3,755 |
$1.14M |
| 93306 |
Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete |
4,611 |
4,256 |
$1.09M |
| 77386 |
|
5,060 |
456 |
$1.04M |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
10,262 |
9,374 |
$1.00M |
| 78452 |
Myocardial perfusion imaging, tomographic (SPECT); multiple studies at rest and/or stress |
881 |
791 |
$953K |
| 49083 |
|
2,757 |
1,297 |
$827K |
| 77334 |
|
1,498 |
1,062 |
$826K |
| 93458 |
|
876 |
784 |
$814K |
| 99291 |
Critical care, evaluation and management of the critically ill patient, first 30-74 minutes |
875 |
798 |
$708K |
| 93970 |
|
2,848 |
2,661 |
$626K |
| 80053 |
Comprehensive metabolic panel |
155,805 |
124,436 |
$617K |
| 70498 |
|
1,772 |
1,642 |
$598K |
| J9271 |
Injection, pembrolizumab, 1 mg |
79 |
64 |
$561K |
| 96413 |
Chemotherapy administration, intravenous infusion; up to 1 hour, single or initial substance |
8,437 |
4,828 |
$525K |
| 74183 |
|
1,819 |
1,695 |
$522K |
| 86832 |
|
1,952 |
1,449 |
$520K |
| 72148 |
Magnetic resonance imaging, lumbar spine; without contrast material |
2,424 |
2,287 |
$483K |
| 97112 |
Therapeutic procedure, each 15 minutes; neuromuscular reeducation of movement, balance, coordination |
16,370 |
5,806 |
$460K |
| 72157 |
|
1,142 |
1,083 |
$425K |
| 10060 |
|
1,783 |
1,693 |
$420K |
| 87633 |
Infectious agent detection by nucleic acid, respiratory virus, 12-25 targets |
2,395 |
2,091 |
$419K |
| 70491 |
|
1,269 |
1,211 |
$417K |
| 72156 |
|
2,058 |
1,920 |
$410K |
| 70551 |
Magnetic resonance imaging, brain; without contrast material |
3,472 |
3,231 |
$404K |
| J9035 |
Injection, bevacizumab, 10 mg |
165 |
65 |
$377K |
| J2469 |
Injection, palonosetron hcl, 25 mcg |
3,028 |
1,744 |
$363K |
| 70544 |
|
1,881 |
1,770 |
$350K |
| 97140 |
Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) |
16,580 |
5,585 |
$340K |
| 97116 |
|
7,834 |
2,920 |
$339K |
| 43239 |
Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple |
1,704 |
1,551 |
$333K |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
16,933 |
13,543 |
$321K |
| P9047 |
Infusion, albumin (human), 25%, 50 ml |
2,355 |
952 |
$294K |
| 72158 |
|
1,080 |
1,018 |
$290K |
| C1713 |
Anchor/screw for opposing bone-to-bone or soft tissue-to-bone (implantable) |
466 |
418 |
$281K |
| 76700 |
Ultrasound, abdominal, real time with image documentation; complete |
3,411 |
3,317 |
$275K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
16,492 |
12,189 |
$275K |
| 47562 |
|
83 |
69 |
$269K |
| 87798 |
Infectious agent detection by nucleic acid; not otherwise specified, amplified probe, each organism |
1,920 |
1,713 |
$266K |
| 71250 |
|
3,609 |
3,363 |
$247K |
| 97535 |
Self-care/home management training, each 15 minutes |
7,533 |
3,324 |
$246K |
| 72141 |
|
2,052 |
1,912 |
$239K |
| 87497 |
|
3,857 |
2,274 |
$238K |
| 88307 |
|
1,949 |
1,804 |
$224K |
| 78815 |
Positron emission tomography (PET) for limited area imaging |
398 |
383 |
$223K |
| 93971 |
|
5,553 |
5,171 |
$203K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
2,784 |
2,640 |
$203K |
| 70496 |
|
2,029 |
1,875 |
$198K |
| 74174 |
|
287 |
273 |
$186K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
10,861 |
10,096 |
$181K |
| 71260 |
Computed tomography, thorax, diagnostic; with contrast material |
4,015 |
3,809 |
$176K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
1,807 |
1,671 |
$176K |
| 80197 |
|
6,625 |
2,945 |
$150K |
| 88341 |
|
2,042 |
1,830 |
$145K |
| 43235 |
|
610 |
570 |
$139K |
| 91010 |
|
582 |
523 |
$129K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
63,852 |
54,743 |
$126K |
| J0585 |
Injection, onabotulinumtoxina, 1 unit |
223 |
204 |
$117K |
| 97162 |
|
4,151 |
3,920 |
$111K |
| 36430 |
|
1,616 |
1,183 |
$108K |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
30,468 |
27,766 |
$108K |
| 96375 |
Therapeutic injection; each additional sequential IV push |
47,502 |
39,224 |
$106K |
| 96361 |
Intravenous infusion, hydration; each additional hour |
22,307 |
18,520 |
$104K |
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
11,300 |
7,169 |
$99K |
| 97530 |
Therapeutic activities, direct patient contact, each 15 minutes |
4,894 |
2,286 |
$99K |
| 77300 |
|
1,451 |
1,193 |
$95K |
| 70486 |
|
3,003 |
2,876 |
$93K |
| 96366 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour |
6,687 |
4,798 |
$91K |
| 36561 |
|
54 |
51 |
$89K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
4,816 |
4,576 |
$89K |
| 45380 |
Colonoscopy, flexible; with biopsy, single or multiple |
208 |
193 |
$88K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
14,178 |
11,443 |
$85K |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
6,629 |
6,236 |
$80K |
| 97163 |
|
4,795 |
4,334 |
$80K |
| 71046 |
Radiologic examination, chest; 2 views |
26,324 |
24,700 |
$79K |
| C9600 |
Percutaneous transcatheter placement of drug eluting intracoronary stent(s), with coronary angioplasty when performed; single major coronary artery or branch |
15 |
12 |
$77K |
| 72197 |
|
355 |
347 |
$76K |
| 72082 |
|
1,331 |
1,278 |
$72K |
| 11042 |
Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm |
428 |
318 |
$70K |
| J2505 |
Injection, pegfilgrastim, 6 mg |
20 |
12 |
$67K |
| A9576 |
Injection, gadoteridol, (prohance multipack), per ml |
7,057 |
6,742 |
$67K |
| 88304 |
|
3,357 |
3,189 |
$65K |
| 84443 |
Thyroid stimulating hormone (TSH) |
10,443 |
9,112 |
$65K |
| 45385 |
Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) |
153 |
145 |
$64K |
| J3490 |
Unclassified drugs |
81,166 |
36,449 |
$64K |
| 72146 |
|
233 |
214 |
$63K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
4,080 |
2,667 |
$61K |
| 93312 |
|
371 |
350 |
$59K |
| 97161 |
|
1,275 |
1,226 |
$58K |
| 77080 |
|
1,620 |
1,513 |
$56K |
| 36591 |
|
7,494 |
4,043 |
$54K |
| 94726 |
|
471 |
443 |
$53K |
| 99281 |
Emergency department visit for the evaluation and management, self-limited or minor |
994 |
944 |
$53K |
| 87507 |
|
520 |
480 |
$52K |
| 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 |
3,337 |
2,747 |
$52K |
| 88173 |
|
1,238 |
1,146 |
$51K |
| 77012 |
|
223 |
201 |
$50K |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
13,968 |
7,878 |
$48K |
| 94010 |
|
1,661 |
1,522 |
$46K |
| 74018 |
|
5,221 |
4,782 |
$46K |
| 82378 |
|
1,628 |
1,356 |
$46K |
| 77301 |
|
17 |
15 |
$44K |
| 99153 |
Mod sedat endo service >5yrs |
4,747 |
4,171 |
$44K |
| 72100 |
|
3,633 |
3,485 |
$43K |
| 62270 |
|
334 |
310 |
$43K |
| 74220 |
|
656 |
610 |
$43K |
| 76536 |
|
754 |
730 |
$42K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
759 |
736 |
$42K |
| 94729 |
|
1,828 |
1,714 |
$41K |
| 82533 |
|
656 |
431 |
$41K |
| C1889 |
Implantable/insertable device, not otherwise classified |
1,283 |
1,112 |
$39K |
| 77373 |
|
41 |
12 |
$38K |
| 87522 |
Neg quan hep c or qual rna |
146 |
121 |
$36K |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
53,019 |
46,813 |
$36K |
| 96367 |
|
5,079 |
3,098 |
$35K |
| 41899 |
Unlisted procedure, dentoalveolar structures |
367 |
321 |
$34K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
3,673 |
3,365 |
$33K |
| 70543 |
|
81 |
77 |
$33K |
| P9016 |
Red blood cells, leukocytes reduced, each unit |
1,151 |
919 |
$33K |
| 77295 |
|
74 |
67 |
$32K |
| 0241U |
Neonatal screening for hereditary disorders, genomic sequence analysis panel |
14,859 |
14,148 |
$31K |
| 96360 |
Intravenous infusion, hydration; initial, 31 minutes to 1 hour |
6,557 |
5,925 |
$30K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
180,423 |
140,752 |
$29K |
| 73562 |
|
5,571 |
4,766 |
$29K |
| 83880 |
|
16,593 |
14,754 |
$29K |
| 72040 |
|
2,242 |
2,122 |
$28K |
| 86920 |
|
2,178 |
1,819 |
$28K |
| C1887 |
Catheter, guiding (may include infusion/perfusion capability) |
2,736 |
2,398 |
$28K |
| 72084 |
|
283 |
273 |
$28K |
| 73130 |
|
3,619 |
3,253 |
$27K |
| 95714 |
|
103 |
37 |
$26K |
| 76642 |
|
1,303 |
1,215 |
$26K |
| 31624 |
|
196 |
176 |
$26K |
| 72128 |
|
2,643 |
2,474 |
$26K |
| 10061 |
|
85 |
82 |
$25K |
| 97166 |
|
2,315 |
2,183 |
$25K |
| 73030 |
|
4,405 |
3,984 |
$25K |
| 87040 |
|
14,763 |
13,566 |
$24K |
| 77470 |
|
113 |
109 |
$24K |
| 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 |
9,059 |
7,321 |
$23K |
| 62328 |
|
85 |
77 |
$23K |
| 97597 |
|
488 |
340 |
$22K |
| 76801 |
|
5,611 |
5,097 |
$22K |
| 93976 |
|
2,193 |
2,079 |
$22K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
34,550 |
28,332 |
$22K |
| 58662 |
|
14 |
14 |
$21K |
| 70250 |
|
2,133 |
1,814 |
$20K |
| 77412 |
|
318 |
49 |
$19K |
| 99152 |
|
6,063 |
5,389 |
$18K |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
30,579 |
27,938 |
$18K |
| 93017 |
|
1,004 |
907 |
$18K |
| 96417 |
|
2,735 |
1,654 |
$17K |
| 77338 |
|
57 |
52 |
$17K |
| 70487 |
|
42 |
37 |
$17K |
| 76775 |
|
661 |
606 |
$17K |
| 71045 |
Radiologic examination, chest; single view |
46,958 |
41,759 |
$17K |
| 93975 |
|
42 |
38 |
$16K |
| 95812 |
|
135 |
124 |
$16K |
| 90935 |
Hemodialysis procedure with single evaluation by a physician |
145 |
79 |
$16K |
| 73721 |
Magnetic resonance imaging, any joint of lower extremity; without contrast material |
103 |
95 |
$16K |
| 70470 |
|
29 |
27 |
$15K |
| 12002 |
|
750 |
727 |
$15K |
| C1874 |
Stent, coated/covered, with delivery system |
60 |
51 |
$14K |
| C1751 |
Catheter, infusion, inserted peripherally, centrally or midline (other than hemodialysis) |
800 |
678 |
$14K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
737 |
511 |
$14K |
| 52332 |
|
19 |
16 |
$13K |
| G0257 |
Unscheduled or emergency dialysis treatment for an esrd patient in a hospital outpatient department that is not certified as an esrd facility |
279 |
179 |
$13K |
| 97167 |
|
3,541 |
3,154 |
$13K |
| 77066 |
Tomosynthesis, mammo |
134 |
118 |
$12K |
| C1769 |
Guide wire |
5,829 |
5,084 |
$12K |
| C8929 |
Transthoracic echocardiography with contrast, or without contrast followed by with contrast, real-time with image documentation (2d), includes m-mode recording, when performed, complete, with spectral doppler echocardiography, and with color flow doppler echocardiography |
89 |
87 |
$12K |
| 96376 |
|
16,400 |
11,938 |
$12K |
| 87075 |
|
3,768 |
2,794 |
$12K |
| J1756 |
Injection, iron sucrose, 1 mg |
745 |
363 |
$12K |
| C1729 |
Catheter, drainage |
1,470 |
960 |
$12K |
| 87210 |
|
4,824 |
4,580 |
$11K |
| 83690 |
|
37,355 |
33,751 |
$11K |
| 92507 |
Treatment of speech, language, voice, communication, and/or auditory processing disorder |
845 |
240 |
$11K |
| 95816 |
|
99 |
93 |
$10K |
| 72193 |
|
24 |
24 |
$10K |
| C1894 |
Introducer/sheath, other than guiding, other than intracardiac electrophysiological, non-laser |
4,538 |
3,998 |
$10K |
| 86833 |
|
1,962 |
1,448 |
$9K |
| 83735 |
|
38,551 |
29,016 |
$9K |
| 97113 |
|
53 |
24 |
$9K |
| 73630 |
|
4,017 |
3,582 |
$9K |
| 70545 |
|
3,168 |
2,946 |
$8K |
| 80061 |
Lipid panel |
2,484 |
2,240 |
$8K |
| 78264 |
|
40 |
39 |
$8K |
| 96415 |
|
2,572 |
1,816 |
$8K |
| 12001 |
|
1,060 |
1,025 |
$8K |
| 97130 |
|
845 |
212 |
$7K |
| 73610 |
|
2,958 |
2,739 |
$7K |
| 82803 |
|
1,428 |
1,270 |
$7K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
44,351 |
35,765 |
$7K |
| 73590 |
|
2,511 |
2,193 |
$7K |
| 86645 |
|
49 |
38 |
$7K |
| 70552 |
|
168 |
154 |
$7K |
| 73700 |
|
147 |
139 |
$7K |
| 76830 |
Ultrasound, transvaginal |
3,808 |
3,627 |
$6K |
| 80050 |
General health panel |
175 |
156 |
$6K |
| 84100 |
|
12,510 |
8,066 |
$6K |
| 87149 |
|
246 |
153 |
$6K |
| 94060 |
|
30 |
29 |
$6K |
| 86900 |
|
20,830 |
18,494 |
$6K |
| 87186 |
|
8,577 |
7,944 |
$6K |
| 85379 |
|
11,407 |
10,623 |
$6K |
| C1726 |
Catheter, balloon dilatation, non-vascular |
279 |
257 |
$6K |
| 99201 |
|
1,672 |
1,598 |
$6K |
| 96125 |
|
81 |
77 |
$6K |
| 80074 |
|
676 |
617 |
$6K |
| 84484 |
|
32,807 |
26,596 |
$5K |
| J2785 |
Injection, regadenoson, 0.1 mg |
762 |
672 |
$5K |
| 36415 |
Collection of venous blood by venipuncture |
178,557 |
131,334 |
$5K |
| 73502 |
|
2,215 |
2,078 |
$5K |
| 0450 |
Emergency room services |
135 |
122 |
$5K |
| 95953 |
|
31 |
12 |
$5K |
| A9270 |
Non-covered item or service |
10,398 |
4,579 |
$5K |
| J0561 |
Injection, penicillin g benzathine, 100,000 units |
129 |
124 |
$5K |
| 80320 |
|
9,362 |
8,411 |
$5K |
| 81025 |
|
36,049 |
33,143 |
$5K |
| 86850 |
|
13,110 |
11,722 |
$5K |
| 84702 |
|
11,075 |
10,050 |
$5K |
| 97165 |
|
223 |
207 |
$5K |
| 73110 |
|
1,719 |
1,580 |
$4K |
| 74019 |
|
1,507 |
1,432 |
$4K |
| M0243 |
Intravenous infusion or subcutaneous injection, casirivimab and imdevimab includes infusion or injection, and post administration monitoring |
217 |
182 |
$4K |
| S2900 |
Surgical techniques requiring use of robotic surgical system (list separately in addition to code for primary procedure) |
111 |
101 |
$4K |
| 94618 |
|
436 |
415 |
$4K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
7,208 |
6,921 |
$4K |
| 12011 |
|
266 |
261 |
$4K |
| 31628 |
|
13 |
13 |
$4K |
| 73120 |
|
366 |
305 |
$4K |
| 76870 |
|
820 |
784 |
$4K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
7,317 |
7,017 |
$4K |
| 73620 |
|
698 |
592 |
$4K |
| 51798 |
|
787 |
731 |
$4K |
| 87070 |
|
6,533 |
5,384 |
$4K |
| J2710 |
Injection, neostigmine methylsulfate, up to 0.5 mg |
2,489 |
2,256 |
$4K |
| 72050 |
|
55 |
53 |
$3K |
| C9399 |
Unclassified drugs or biologicals |
1,795 |
1,576 |
$3K |
| 83605 |
|
43,621 |
38,273 |
$3K |
| 77065 |
Tomosynthesis, mammo |
41 |
32 |
$3K |
| 87799 |
|
578 |
413 |
$3K |
| 73080 |
|
1,117 |
1,049 |
$3K |
| 82728 |
|
2,326 |
2,083 |
$3K |
| J1815 |
Injection, insulin, per 5 units |
11,247 |
5,271 |
$3K |
| 70548 |
|
3,761 |
3,521 |
$3K |
| 36600 |
|
399 |
367 |
$3K |
| 85576 |
|
671 |
633 |
$3K |
| 84145 |
|
18,110 |
16,757 |
$3K |
| 82247 |
|
530 |
362 |
$3K |
| 81001 |
|
66,137 |
59,523 |
$3K |
| 73090 |
|
1,586 |
1,446 |
$2K |
| J3475 |
Injection, magnesium sulfate, per 500 mg |
5,535 |
4,396 |
$2K |
| 97542 |
|
86 |
62 |
$2K |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
1,706 |
1,547 |
$2K |
| 72170 |
|
1,669 |
1,549 |
$2K |
| 73560 |
|
347 |
271 |
$2K |
| 88360 |
|
208 |
193 |
$2K |
| 51702 |
|
55 |
50 |
$2K |
| 76942 |
|
91 |
80 |
$2K |
| 80329 |
|
4,686 |
3,746 |
$2K |
| 70547 |
|
91 |
85 |
$2K |
| 87116 |
|
1,348 |
1,181 |
$2K |
| 77336 |
|
3,513 |
1,747 |
$2K |
| 84703 |
|
8,030 |
7,596 |
$2K |
| 95819 |
|
14 |
14 |
$2K |
| 83970 |
|
37 |
25 |
$2K |
| 82248 |
|
592 |
454 |
$2K |
| 88342 |
|
3,312 |
3,027 |
$2K |
| 86901 |
|
20,829 |
18,492 |
$2K |
| 85027 |
|
19,969 |
16,324 |
$2K |
| 17250 |
|
18 |
15 |
$2K |
| 77001 |
|
417 |
375 |
$2K |
| 85610 |
|
43,916 |
37,043 |
$2K |
| 86141 |
|
12,188 |
11,274 |
$2K |
| 87631 |
|
2,691 |
2,597 |
$1K |
| 72110 |
|
25 |
24 |
$1K |
| 76770 |
|
25 |
24 |
$1K |
| 87651 |
Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe |
3,796 |
3,696 |
$1K |
| 87102 |
|
1,566 |
1,397 |
$1K |
| 71101 |
|
735 |
705 |
$1K |
| 89051 |
|
4,280 |
2,797 |
$1K |
| 86870 |
|
15 |
14 |
$1K |
| 86635 |
|
785 |
651 |
$1K |
| 97129 |
|
860 |
215 |
$1K |
| 85460 |
|
669 |
622 |
$1K |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
49,773 |
40,334 |
$1K |
| J1644 |
Injection, heparin sodium, per 1000 units |
15,446 |
7,195 |
$1K |
| 87081 |
|
4,305 |
4,087 |
$1K |
| 85730 |
|
24,172 |
20,711 |
$1K |
| 82962 |
|
35,535 |
22,048 |
$1K |
| 90715 |
|
4,312 |
4,110 |
$1K |
| 82784 |
|
374 |
343 |
$1K |
| 88185 |
|
12 |
12 |
$1K |
| M0222 |
Intravenous injection, bebtelovimab, includes injection and post administration monitoring |
55 |
53 |
$1K |
| 87502 |
Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets |
2,706 |
2,596 |
$1K |
| J7040 |
Infusion, normal saline solution, sterile (500 ml = 1 unit) |
5,065 |
3,567 |
$1K |
| 76641 |
|
12 |
12 |
$1K |
| 87205 |
|
5,876 |
4,720 |
$1K |
| 88312 |
|
481 |
449 |
$1K |
| J2270 |
Injection, morphine sulfate, up to 10 mg |
30,465 |
22,320 |
$1K |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
35,749 |
31,381 |
$981.52 |
| 84439 |
|
2,171 |
1,964 |
$975.14 |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
38,342 |
34,401 |
$973.96 |
| 74170 |
|
14 |
13 |
$964.23 |
| 73600 |
|
215 |
179 |
$960.75 |
| J7030 |
Infusion, normal saline solution , 1000 cc |
20,527 |
14,800 |
$944.66 |
| 96523 |
|
90 |
70 |
$923.83 |
| 76937 |
|
1,502 |
1,324 |
$923.73 |
| 80321 |
|
62 |
55 |
$918.46 |
| 95813 |
|
13 |
12 |
$917.35 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
4,852 |
4,386 |
$885.34 |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
73 |
71 |
$865.61 |
| G8996 |
Swallowing functional limitation, current status at therapy episode outset and at reporting intervals |
72 |
63 |
$849.10 |
| 93225 |
|
12 |
12 |
$825.00 |
| 82024 |
|
106 |
101 |
$819.23 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
3,634 |
3,510 |
$782.08 |
| 73060 |
|
527 |
496 |
$763.26 |
| C1760 |
Closure device, vascular (implantable/insertable) |
864 |
740 |
$699.00 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
15,408 |
12,995 |
$697.85 |
| J1650 |
Injection, enoxaparin sodium, 10 mg |
6,453 |
3,659 |
$674.13 |
| J2370 |
Injection, phenylephrine hcl, up to 1 ml |
2,594 |
2,237 |
$642.30 |
| 81003 |
|
26,570 |
24,356 |
$641.81 |
| 82550 |
|
14,377 |
12,827 |
$627.34 |
| 84112 |
|
171 |
155 |
$554.36 |
| 82553 |
|
6,231 |
5,551 |
$540.33 |
| 84512 |
|
15,054 |
12,443 |
$535.62 |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
4,486 |
4,305 |
$525.54 |
| 87340 |
|
1,261 |
1,121 |
$517.01 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
29 |
29 |
$509.88 |
| 83615 |
|
5,230 |
4,124 |
$489.48 |
| 85652 |
|
11,475 |
10,663 |
$468.78 |
| 73140 |
|
193 |
188 |
$466.90 |
| 73070 |
|
171 |
156 |
$454.62 |
| 85384 |
|
2,657 |
2,402 |
$417.70 |
| 90686 |
|
893 |
810 |
$403.22 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
20,290 |
16,439 |
$402.48 |
| 87077 |
|
10,820 |
10,050 |
$399.94 |
| 87206 |
|
1,315 |
1,153 |
$385.67 |
| 74022 |
|
1,048 |
990 |
$382.34 |
| 84153 |
|
761 |
648 |
$379.07 |
| 82150 |
|
3,090 |
2,791 |
$350.33 |
| 88112 |
|
293 |
254 |
$349.25 |
| J2997 |
Injection, alteplase recombinant, 1 mg |
60 |
25 |
$347.71 |
| J2704 |
Injection, propofol, 10 mg |
18,891 |
15,909 |
$347.11 |
| 87486 |
|
1,216 |
1,105 |
$343.73 |
| 72070 |
|
42 |
41 |
$337.68 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
5,438 |
5,171 |
$334.17 |
| 87581 |
|
1,216 |
1,105 |
$328.33 |
| J0360 |
Injection, hydralazine hcl, up to 20 mg |
3,042 |
2,251 |
$305.38 |
| 87015 |
|
1,738 |
1,533 |
$301.99 |
| 76377 |
|
402 |
363 |
$301.08 |
| 86308 |
|
2,240 |
2,175 |
$298.27 |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
30,085 |
24,241 |
$296.89 |
| 86706 |
|
969 |
832 |
$295.54 |
| 82607 |
|
1,701 |
1,528 |
$292.05 |
| 92610 |
|
41 |
37 |
$287.12 |
| J2274 |
Injection, morphine sulfate, preservative-free for epidural or intrathecal use, 10 mg |
2,254 |
944 |
$286.00 |
| 29125 |
|
252 |
238 |
$285.21 |
| 77290 |
|
13 |
13 |
$283.15 |
| Q9957 |
Injection, perflutren lipid microspheres, per ml |
349 |
340 |
$283.04 |
| J0690 |
Injection, cefazolin sodium, 500 mg |
9,408 |
7,574 |
$278.31 |
| 87449 |
|
211 |
195 |
$273.40 |
| A9502 |
Technetium tc-99m tetrofosmin, diagnostic, per study dose |
879 |
789 |
$268.06 |
| 84157 |
|
1,808 |
1,578 |
$250.45 |
| 73100 |
|
53 |
45 |
$242.09 |
| 82945 |
|
1,060 |
991 |
$226.22 |
| 83930 |
|
13 |
12 |
$223.66 |
| 85007 |
|
7,536 |
5,862 |
$222.68 |
| 85018 |
|
2,438 |
2,064 |
$220.32 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
1,758 |
1,620 |
$219.01 |
| 80164 |
|
202 |
177 |
$202.15 |
| J2930 |
Injection, methylprednisolone sodium succinate, up to 125 mg |
4,514 |
3,721 |
$200.32 |
| 95700 |
|
248 |
237 |
$195.51 |
| C1788 |
Port, indwelling (implantable) |
42 |
40 |
$193.73 |
| 86480 |
|
97 |
81 |
$188.38 |
| Q0144 |
Azithromycin dihydrate, oral, capsules/powder, 1 gram |
1,564 |
1,383 |
$186.29 |
| A9579 |
Injection, gadolinium-based magnetic resonance contrast agent, not otherwise specified (nos), per ml |
10,817 |
9,861 |
$183.25 |
| J0780 |
Injection, prochlorperazine, up to 10 mg |
3,914 |
3,465 |
$178.11 |
| 80047 |
|
1,319 |
1,154 |
$171.57 |
| 96402 |
|
404 |
356 |
$164.96 |
| J1200 |
Injection, diphenhydramine hcl, up to 50 mg |
13,433 |
10,801 |
$163.15 |
| 87324 |
|
143 |
134 |
$162.56 |
| J1953 |
Injection, levetiracetam, 10 mg |
1,248 |
1,027 |
$154.32 |
| 73552 |
|
135 |
117 |
$152.36 |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
17,874 |
15,859 |
$143.42 |
| 82105 |
|
191 |
168 |
$128.27 |
| 87428 |
|
469 |
451 |
$127.18 |
| 82565 |
|
5,618 |
5,150 |
$123.70 |
| J3480 |
Injection, potassium chloride, per 2 meq |
4,164 |
2,801 |
$117.83 |
| 90732 |
|
241 |
219 |
$112.21 |
| 86304 |
|
478 |
391 |
$111.04 |
| J0330 |
Injection, succinylcholine chloride, up to 20 mg |
3,879 |
3,566 |
$108.04 |
| J1642 |
Injection, heparin sodium, (heparin lock flush), per 10 units |
5,132 |
2,382 |
$107.27 |
| J2765 |
Injection, metoclopramide hcl, up to 10 mg |
7,934 |
7,103 |
$103.11 |
| U0005 |
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, cdc or non-cdc, making use of high throughput technologies, completed within 2 calendar days from date of specimen collection (list separately in addition to either hcpcs code u0003 or u0004) as described by cms-2020-01-r2 |
1,989 |
1,782 |
$100.39 |
| J2060 |
Injection, lorazepam, 2 mg |
7,427 |
6,361 |
$95.75 |
| 82140 |
|
2,701 |
2,438 |
$95.16 |
| 86592 |
|
2,010 |
1,862 |
$94.81 |
| 82570 |
|
5,764 |
3,587 |
$89.89 |
| 84156 |
|
5,445 |
3,260 |
$86.86 |
| 93926 |
|
16 |
14 |
$80.36 |
| J0500 |
Injection, dicyclomine hcl, up to 20 mg |
39 |
39 |
$79.68 |
| J2001 |
Injection, lidocaine hcl for intravenous infusion, 10 mg |
11,580 |
8,371 |
$77.35 |
| J2550 |
Injection, promethazine hcl, up to 50 mg |
5,074 |
4,214 |
$75.62 |
| J3370 |
Injection, vancomycin hcl, 500 mg |
3,561 |
2,283 |
$73.39 |
| J7512 |
Prednisone, immediate release or delayed release, oral, 1 mg |
4,235 |
3,388 |
$72.80 |
| 82009 |
|
2,852 |
2,608 |
$71.62 |
| 93356 |
|
67 |
64 |
$70.96 |
| 82670 |
|
15 |
14 |
$69.81 |
| Q0114 |
Fern test |
1,446 |
1,356 |
$68.38 |
| 84466 |
|
1,727 |
1,563 |
$66.44 |
| 85390 |
|
602 |
571 |
$63.75 |
| 86300 |
|
56 |
50 |
$61.13 |
| 87147 |
|
2,226 |
2,116 |
$57.49 |
| J1956 |
Injection, levofloxacin, 250 mg |
865 |
682 |
$54.00 |
| J2175 |
Injection, meperidine hydrochloride, per 100 mg |
2,841 |
2,582 |
$53.13 |
| J7050 |
Infusion, normal saline solution, 250 cc |
9,334 |
5,174 |
$45.99 |
| 84132 |
|
1,879 |
1,549 |
$44.03 |
| J2800 |
Injection, methocarbamol, up to 10 ml |
451 |
357 |
$36.10 |
| 96368 |
|
1,592 |
1,142 |
$35.92 |
| J8540 |
Dexamethasone, oral, 0.25 mg |
2,766 |
2,428 |
$32.68 |
| 83540 |
|
1,809 |
1,640 |
$32.17 |
| G8978 |
Mobility: walking & moving around functional limitation, current status, at therapy episode outset and at reporting intervals |
1,289 |
1,127 |
$30.02 |
| 84550 |
|
2,403 |
1,974 |
$29.02 |
| 85347 |
|
1,271 |
1,169 |
$28.48 |
| J0702 |
Injection, betamethasone acetate 3 mg and betamethasone sodium phosphate 3 mg |
275 |
176 |
$27.11 |
| 88313 |
|
208 |
195 |
$25.02 |
| 82746 |
|
1,250 |
1,131 |
$14.32 |
| C9113 |
Injection, pantoprazole sodium, per vial |
3,910 |
2,538 |
$13.89 |
| J7120 |
Ringers lactate infusion, up to 1000 cc |
532 |
423 |
$13.86 |
| 86803 |
|
270 |
247 |
$13.41 |
| J1630 |
Injection, haloperidol, up to 5 mg |
412 |
355 |
$12.97 |
| J7060 |
5% dextrose/water (500 ml = 1 unit) |
2,295 |
985 |
$11.44 |
| 87281 |
|
33 |
28 |
$11.26 |
| J2543 |
Injection, piperacillin sodium/tazobactam sodium, 1 gram/0.125 grams (1.125 grams) |
1,425 |
913 |
$10.29 |
| J1170 |
Injection, hydromorphone, up to 4 mg |
1,905 |
1,637 |
$7.20 |
| J1940 |
Injection, furosemide, up to 20 mg |
2,152 |
1,466 |
$6.38 |
| 87420 |
|
338 |
330 |
$4.19 |
| J7999 |
Compounded drug, not otherwise classified |
746 |
596 |
$3.85 |
| J1580 |
Injection, garamycin, gentamicin, up to 80 mg |
706 |
616 |
$2.30 |
| G8979 |
Mobility: walking & moving around functional limitation, projected goal status, at therapy episode outset, at reporting intervals, and at discharge or to end reporting |
1,523 |
1,298 |
$0.04 |
| G8997 |
Swallowing functional limitation, projected goal status, at therapy episode outset, at reporting intervals, and at discharge or to end reporting |
90 |
77 |
$0.02 |
| G8980 |
Mobility: walking & moving around functional limitation, discharge status, at discharge from therapy or to end reporting |
471 |
423 |
$0.01 |
| G8990 |
Other physical or occupational therapy primary functional limitation, current status, at therapy episode outset and at reporting intervals |
14 |
12 |
$0.01 |
| J2371 |
Injection, phenylephrine hydrochloride, 20 micrograms |
341 |
327 |
$0.00 |
| J9045 |
Injection, carboplatin, 50 mg |
222 |
139 |
$0.00 |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
2,777 |
2,632 |
$0.00 |
| P9612 |
Catheterization for collection of specimen, single patient, all places of service |
42 |
41 |
$0.00 |
| 99406 |
|
306 |
296 |
$0.00 |
| 88311 |
|
823 |
773 |
$0.00 |
| 87176 |
|
116 |
110 |
$0.00 |
| 84300 |
|
77 |
67 |
$0.00 |
| C2617 |
Stent, non-coronary, temporary, without delivery system |
191 |
174 |
$0.00 |
| C1725 |
Catheter, transluminal angioplasty, non-laser (may include guidance, infusion/perfusion capability) |
106 |
90 |
$0.00 |
| 64646 |
|
12 |
12 |
$0.00 |
| J3360 |
Injection, diazepam, up to 5 mg |
535 |
498 |
$0.00 |
| J2795 |
Injection, ropivacaine hydrochloride, 1 mg |
123 |
115 |
$0.00 |
| G8988 |
Self care functional limitation, projected goal status, at therapy episode outset, at reporting intervals, and at discharge or to end reporting |
847 |
695 |
$0.00 |
| 80185 |
|
25 |
25 |
$0.00 |
| 64488 |
|
87 |
82 |
$0.00 |
| G0008 |
Administration of influenza virus vaccine |
30 |
26 |
$0.00 |
| J0131 |
Injection, acetaminophen, not otherwise specified,10 mg |
605 |
512 |
$0.00 |
| J0185 |
Injection, aprepitant, 1 mg |
159 |
98 |
$0.00 |
| J2305 |
Injection, nitroglycerin, 5 mg |
109 |
100 |
$0.00 |
| C1781 |
Mesh (implantable) |
98 |
89 |
$0.00 |
| 99407 |
|
37 |
36 |
$0.00 |
| 86704 |
|
61 |
52 |
$0.00 |
| 64430 |
|
83 |
77 |
$0.00 |
| J0697 |
Injection, sterile cefuroxime sodium, per 750 mg |
46 |
36 |
$0.00 |
| 88331 |
|
125 |
116 |
$0.00 |
| 0346T |
|
101 |
95 |
$0.00 |
| J3411 |
Injection, thiamine hcl, 100 mg |
196 |
139 |
$0.00 |
| J2780 |
Injection, ranitidine hydrochloride, 25 mg |
28 |
13 |
$0.00 |
| J1836 |
Injection, metronidazole, 10 mg |
266 |
189 |
$0.00 |
| J2920 |
Injection, methylprednisolone sodium succinate, up to 40 mg |
56 |
32 |
$0.00 |
| G8991 |
Other physical or occupational therapy primary functional limitation, projected goal status, at therapy episode outset, at reporting intervals, and at discharge or to end reporting |
29 |
24 |
$0.00 |
| 90632 |
|
212 |
206 |
$0.00 |
| 97016 |
|
120 |
37 |
$0.00 |
| G8981 |
Changing & maintaining body position functional limitation, current status, at therapy episode outset and at reporting intervals |
153 |
143 |
$0.00 |
| G8982 |
Changing & maintaining body position functional limitation, projected goal status, at therapy episode outset, at reporting intervals, and at discharge or to end reporting |
215 |
196 |
$0.00 |
| J1720 |
Injection, hydrocortisone sodium succinate, up to 100 mg |
31 |
26 |
$0.00 |
| J0456 |
Injection, azithromycin, 500 mg |
132 |
108 |
$0.00 |
| C1753 |
Catheter, intravascular ultrasound |
17 |
14 |
$0.00 |
| 90656 |
|
13 |
13 |
$0.00 |
| A9540 |
Technetium tc-99m macroaggregated albumin, diagnostic, per study dose, up to 10 millicuries |
17 |
12 |
$0.00 |
| G8987 |
Self care functional limitation, current status, at therapy episode outset and at reporting intervals |
788 |
647 |
$0.00 |
| C1730 |
Catheter, electrophysiology, diagnostic, other than 3d mapping (19 or fewer electrodes) |
24 |
24 |
$0.00 |
| J2560 |
Injection, phenobarbital sodium, up to 120 mg |
20 |
14 |
$0.00 |
| J2470 |
Injection, pantoprazole sodium, 40 mg |
137 |
110 |
$0.00 |
| J1790 |
Injection, droperidol, up to 5 mg |
14 |
13 |
$0.00 |
| 88300 |
|
32 |
27 |
$0.00 |
| 77370 |
|
71 |
62 |
$0.00 |
| J9267 |
Injection, paclitaxel, 1 mg |
130 |
67 |
$0.00 |
| Q0247 |
Injection, sotrovimab, 500 mg |
13 |
12 |
$0.00 |
| 84436 |
|
91 |
55 |
$0.00 |
| J2003 |
Injection, lidocaine hydrochloride, 1 mg |
55 |
51 |
$0.00 |
| 87305 |
|
16 |
14 |
$0.00 |
| J0461 |
Injection, atropine sulfate, 0.01 mg |
28 |
24 |
$0.00 |
| Q0222 |
Injection, bebtelovimab, 175 mg |
55 |
53 |
$0.00 |
| 36416 |
|
14 |
13 |
$0.00 |
| 87593 |
|
40 |
40 |
$0.00 |
| J0610 |
Injection, calcium gluconate (fresenius kabi), per 10 ml |
60 |
27 |
$0.00 |
| 86301 |
|
18 |
14 |
$0.00 |
| 86664 |
|
30 |
25 |
$0.00 |
| 86880 |
|
13 |
12 |
$0.00 |
| 88184 |
|
12 |
12 |
$0.00 |
| 80051 |
|
14 |
14 |
$0.00 |
| 82330 |
|
26 |
12 |
$0.00 |
| 93320 |
|
25 |
25 |
$0.00 |
| 87493 |
|
13 |
13 |
$0.00 |
| J2310 |
Injection, naloxone hydrochloride, per 1 mg |
35 |
26 |
$0.00 |
| J1453 |
Injection, fosaprepitant, 1 mg |
1,128 |
742 |
$0.00 |
| 70360 |
|
14 |
13 |
$0.00 |
| J0171 |
Injection, adrenalin, epinephrine, 0.1 mg |
661 |
560 |
$0.00 |
| A9552 |
Fluorodeoxyglucose f-18 fdg, diagnostic, per study dose, up to 45 millicuries |
685 |
660 |
$0.00 |
| G8989 |
Self care functional limitation, discharge status, at discharge from therapy or to end reporting |
256 |
228 |
$0.00 |
| 86038 |
|
25 |
24 |
$0.00 |
| J0640 |
Injection, leucovorin calcium, per 50 mg |
211 |
77 |
$0.00 |
| Q0243 |
Injection, casirivimab and imdevimab, 2400 mg |
234 |
173 |
$0.00 |
| J1596 |
Injection, glycopyrrolate, 0.1 mg |
263 |
256 |
$0.00 |
| 85014 |
|
128 |
105 |
$0.00 |
| J2919 |
Injection, methylprednisolone sodium succinate, 5 mg |
319 |
287 |
$0.00 |
| 77003 |
|
301 |
266 |
$0.00 |
| 86644 |
|
48 |
38 |
$0.00 |
| G8984 |
Carrying, moving & handling objects functional limitation, current status, at therapy episode outset and at reporting intervals |
194 |
180 |
$0.00 |
| 90658 |
|
41 |
39 |
$0.00 |
| J0295 |
Injection, ampicillin sodium/sulbactam sodium, per 1.5 gm |
313 |
208 |
$0.00 |
| 77073 |
|
115 |
115 |
$0.00 |
| 96416 |
|
197 |
117 |
$0.00 |
| 93325 |
|
38 |
36 |
$0.00 |
| 87634 |
|
605 |
572 |
$0.00 |
| 80076 |
|
78 |
72 |
$0.00 |
| J9263 |
Injection, oxaliplatin, 0.5 mg |
55 |
26 |
$0.00 |
| J0665 |
Injection, bupivicaine, not otherwise specified, 0.5 mg |
372 |
347 |
$0.00 |
| Q9966 |
Low osmolar contrast material, 200-299 mg/ml iodine concentration, per ml |
15 |
12 |
$0.00 |
| J9190 |
Injection, fluorouracil, 500 mg |
200 |
91 |
$0.00 |
| G8985 |
Carrying, moving and handling objects, projected goal status, at therapy episode outset, at reporting intervals, and at discharge or to end reporting |
248 |
224 |
$0.00 |
| 82010 |
|
178 |
170 |
$0.00 |
| 77062 |
|
26 |
25 |
$0.00 |
| 84481 |
|
174 |
116 |
$0.00 |
| 86663 |
|
30 |
25 |
$0.00 |
| 76981 |
|
155 |
152 |
$0.00 |
| 88333 |
|
40 |
37 |
$0.00 |
| A9541 |
Technetium tc-99m sulfur colloid, diagnostic, per study dose, up to 20 millicuries |
78 |
77 |
$0.00 |
| 82977 |
|
37 |
13 |
$0.00 |
| Q0239 |
Injection, bamlanivimab-xxxx, 700 mg |
13 |
12 |
$0.00 |
| 86665 |
|
30 |
25 |
$0.00 |
| J1171 |
Injection, hydromorphone, 0.1 mg |
14 |
14 |
$0.00 |
| J2916 |
Injection, sodium ferric gluconate complex in sucrose injection, 12.5 mg |
20 |
12 |
$0.00 |
| 84146 |
|
28 |
26 |
$0.00 |
| J0834 |
Injection, cosyntropin, 0.25 mg |
13 |
12 |
$0.00 |
| 83516 |
|
16 |
12 |
$0.00 |
| J3301 |
Injection, triamcinolone acetonide, not otherwise specified, 10 mg |
29 |
26 |
$0.00 |
| 85045 |
|
50 |
49 |
$0.00 |
| Q0245 |
Injection, bamlanivimab and etesevimab, 2100 mg |
21 |
20 |
$0.00 |
| 92978 |
|
18 |
14 |
$0.00 |
| M0245 |
Intravenous infusion, bamlanivimab and etesevimab, includes infusion and post administration monitoring |
32 |
30 |
$0.00 |
| J2359 |
Injection, olanzapine, 0.5 mg |
24 |
14 |
$0.00 |
| M0239 |
Intravenous infusion, bamlanivimab-xxxx, includes infusion and post administration monitoring |
17 |
14 |
$0.00 |
| 84165 |
|
16 |
15 |
$0.00 |
| M0247 |
Intravenous infusion, sotrovimab, includes infusion and post administration monitoring |
21 |
19 |
$0.00 |
| C1758 |
Catheter, ureteral |
14 |
12 |
$0.00 |
| 77061 |
|
13 |
13 |
$0.00 |