| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
46,342 |
38,985 |
$2.86M |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
29,623 |
24,234 |
$1.89M |
| 96361 |
Intravenous infusion, hydration; each additional hour |
15,651 |
11,827 |
$1.41M |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
18,953 |
16,569 |
$1.20M |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
14,727 |
12,090 |
$862K |
| 80053 |
Comprehensive metabolic panel |
45,005 |
36,127 |
$713K |
| 0241U |
Neonatal screening for hereditary disorders, genomic sequence analysis panel |
14,837 |
12,858 |
$485K |
| 90837 |
Psychotherapy, 53 minutes with patient |
7,581 |
4,974 |
$473K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
15,035 |
12,671 |
$465K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
28,175 |
21,760 |
$452K |
| 43239 |
Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple |
2,453 |
2,176 |
$399K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
12,965 |
11,096 |
$385K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
13,065 |
11,180 |
$385K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
64,121 |
48,339 |
$385K |
| 81001 |
|
42,276 |
34,046 |
$350K |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
10,933 |
5,679 |
$338K |
| 87651 |
Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe |
9,607 |
8,516 |
$319K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
8,533 |
7,343 |
$318K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
13,467 |
11,131 |
$289K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
8,002 |
4,146 |
$285K |
| 96360 |
Intravenous infusion, hydration; initial, 31 minutes to 1 hour |
4,293 |
3,587 |
$276K |
| 45380 |
Colonoscopy, flexible; with biopsy, single or multiple |
2,154 |
1,918 |
$271K |
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
41,180 |
23,867 |
$269K |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
6,387 |
5,596 |
$263K |
| 84443 |
Thyroid stimulating hormone (TSH) |
18,461 |
16,162 |
$251K |
| 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 |
6,945 |
5,641 |
$250K |
| 70450 |
Computed tomography, head or brain; without contrast material |
6,022 |
5,191 |
$233K |
| 80061 |
Lipid panel |
13,775 |
12,311 |
$198K |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
6,105 |
4,193 |
$193K |
| 45385 |
Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) |
1,303 |
1,131 |
$187K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
5,359 |
4,555 |
$177K |
| 81025 |
|
17,469 |
14,617 |
$176K |
| 93306 |
Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete |
2,210 |
1,939 |
$172K |
| 90834 |
Psychotherapy, 45 minutes with patient |
2,874 |
2,081 |
$168K |
| 84702 |
|
5,935 |
4,122 |
$146K |
| 59025 |
Fetal non-stress test |
2,453 |
1,593 |
$136K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
3,344 |
2,742 |
$133K |
| 88175 |
Cytopathology, cervical or vaginal, any reporting system; collected in preservative fluid, automated thin layer |
4,982 |
4,420 |
$132K |
| 82948 |
|
12,416 |
7,035 |
$130K |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
19,890 |
16,401 |
$130K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
13,997 |
12,466 |
$127K |
| 96366 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour |
2,068 |
1,472 |
$127K |
| 87624 |
Infectious agent detection by nucleic acid; human papillomavirus (HPV), high-risk types |
3,654 |
3,232 |
$126K |
| 80306 |
|
7,333 |
6,096 |
$120K |
| 87502 |
Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets |
1,623 |
1,469 |
$119K |
| 71275 |
Computed tomographic angiography, chest, with contrast material |
2,617 |
2,271 |
$113K |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
4,391 |
3,885 |
$112K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
2,680 |
2,302 |
$110K |
| 80055 |
|
1,956 |
1,560 |
$101K |
| 84484 |
|
17,824 |
12,120 |
$96K |
| 78452 |
Myocardial perfusion imaging, tomographic (SPECT); multiple studies at rest and/or stress |
836 |
720 |
$95K |
| 87631 |
|
1,008 |
890 |
$94K |
| 87150 |
|
1,280 |
1,149 |
$84K |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
10,149 |
3,351 |
$81K |
| 80076 |
|
7,512 |
6,383 |
$79K |
| 83880 |
|
4,874 |
3,973 |
$78K |
| 85610 |
|
10,986 |
8,138 |
$73K |
| 87210 |
|
9,705 |
8,370 |
$72K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
2,224 |
1,940 |
$69K |
| 84439 |
|
6,338 |
5,562 |
$63K |
| 85027 |
|
13,347 |
9,609 |
$61K |
| 87081 |
|
2,303 |
2,108 |
$59K |
| 83690 |
|
15,713 |
12,352 |
$59K |
| 86235 |
|
706 |
631 |
$57K |
| 86703 |
|
4,307 |
3,673 |
$57K |
| 83735 |
|
14,647 |
11,025 |
$57K |
| 82805 |
|
3,190 |
2,370 |
$56K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
2,106 |
1,922 |
$55K |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
2,417 |
2,110 |
$55K |
| 85007 |
|
13,074 |
9,432 |
$54K |
| 12001 |
|
585 |
515 |
$52K |
| 93017 |
|
1,303 |
1,130 |
$49K |
| 70553 |
Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences |
561 |
501 |
$48K |
| 81220 |
CFTR (cystic fibrosis transmembrane conductance regulator) gene analysis; common variants |
525 |
419 |
$47K |
| 82565 |
|
5,167 |
4,115 |
$46K |
| 82105 |
|
1,102 |
952 |
$45K |
| 82728 |
|
2,780 |
2,419 |
$44K |
| 87186 |
|
6,359 |
5,469 |
$43K |
| 86803 |
|
3,046 |
2,671 |
$42K |
| 76801 |
|
1,653 |
1,354 |
$41K |
| 72125 |
Computed tomography, cervical spine; without contrast material |
2,633 |
2,298 |
$39K |
| 84145 |
|
3,465 |
2,889 |
$39K |
| 87070 |
|
2,739 |
2,247 |
$39K |
| 71260 |
Computed tomography, thorax, diagnostic; with contrast material |
642 |
569 |
$36K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
2,497 |
2,289 |
$36K |
| 99281 |
Emergency department visit for the evaluation and management, self-limited or minor |
581 |
488 |
$35K |
| 86140 |
|
8,595 |
6,952 |
$35K |
| 93971 |
|
1,360 |
1,148 |
$34K |
| 76830 |
Ultrasound, transvaginal |
1,288 |
1,130 |
$33K |
| 83605 |
|
5,870 |
4,453 |
$32K |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
627 |
519 |
$32K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
1,010 |
842 |
$31K |
| 84703 |
|
4,385 |
3,835 |
$31K |
| 88142 |
|
1,194 |
1,016 |
$31K |
| 82607 |
|
2,439 |
2,159 |
$31K |
| 85379 |
|
4,804 |
4,110 |
$30K |
| 83520 |
|
1,641 |
1,214 |
$27K |
| G0378 |
Hospital observation service, per hour |
1,753 |
1,459 |
$25K |
| 85730 |
|
6,279 |
5,091 |
$24K |
| 99001 |
|
1,215 |
1,104 |
$23K |
| 82247 |
|
550 |
294 |
$22K |
| 87040 |
|
3,743 |
2,001 |
$21K |
| 81003 |
|
2,990 |
2,646 |
$20K |
| 86038 |
|
2,182 |
1,927 |
$20K |
| 71046 |
Radiologic examination, chest; 2 views |
9,459 |
8,124 |
$20K |
| 84153 |
|
1,481 |
1,299 |
$20K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
16,214 |
11,569 |
$19K |
| 72148 |
Magnetic resonance imaging, lumbar spine; without contrast material |
380 |
340 |
$19K |
| 85652 |
|
7,310 |
6,207 |
$18K |
| 82570 |
|
4,119 |
3,565 |
$18K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
431 |
367 |
$18K |
| 87340 |
|
1,802 |
1,558 |
$18K |
| 82043 |
|
2,876 |
2,582 |
$17K |
| 90792 |
Psychiatric diagnostic evaluation with medical services |
422 |
341 |
$17K |
| 71250 |
|
756 |
677 |
$17K |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
1,270 |
1,149 |
$16K |
| 82550 |
|
2,966 |
2,433 |
$16K |
| 94664 |
|
1,145 |
982 |
$15K |
| 36415 |
Collection of venous blood by venipuncture |
111,478 |
73,712 |
$15K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
24,311 |
18,642 |
$15K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
2,199 |
1,874 |
$14K |
| 86850 |
|
3,743 |
3,145 |
$14K |
| 86592 |
|
2,135 |
1,849 |
$14K |
| 83540 |
|
2,625 |
2,297 |
$13K |
| 82950 |
|
1,384 |
1,150 |
$12K |
| 87205 |
|
2,732 |
2,216 |
$12K |
| 82677 |
|
479 |
401 |
$11K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
217 |
194 |
$11K |
| 96367 |
|
396 |
305 |
$11K |
| 84460 |
|
2,430 |
2,009 |
$11K |
| 83970 |
|
505 |
441 |
$11K |
| 83516 |
|
1,077 |
843 |
$11K |
| 86901 |
|
4,342 |
3,649 |
$10K |
| 73721 |
Magnetic resonance imaging, any joint of lower extremity; without contrast material |
177 |
148 |
$10K |
| 84132 |
|
1,263 |
928 |
$10K |
| 86003 |
|
119 |
100 |
$10K |
| 82248 |
|
3,252 |
2,468 |
$9K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
791 |
756 |
$9K |
| 86900 |
|
4,344 |
3,650 |
$9K |
| 86481 |
|
126 |
112 |
$9K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
997 |
934 |
$9K |
| 84550 |
|
1,603 |
1,333 |
$8K |
| 83550 |
|
1,443 |
1,256 |
$8K |
| 99215 |
Prolong outpt/office vis |
767 |
660 |
$8K |
| 20610 |
|
607 |
491 |
$8K |
| 86200 |
|
823 |
721 |
$8K |
| 76775 |
|
331 |
293 |
$8K |
| 97162 |
|
984 |
806 |
$8K |
| 86225 |
|
769 |
683 |
$7K |
| 86336 |
|
479 |
401 |
$7K |
| 93975 |
|
197 |
176 |
$7K |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
18,902 |
14,730 |
$7K |
| 83655 |
|
327 |
305 |
$7K |
| 71045 |
Radiologic examination, chest; single view |
11,207 |
9,346 |
$7K |
| 84146 |
|
269 |
223 |
$7K |
| 86787 |
|
912 |
744 |
$7K |
| 85018 |
|
1,737 |
1,351 |
$7K |
| 90715 |
|
1,219 |
1,083 |
$6K |
| 70486 |
|
311 |
264 |
$6K |
| 73564 |
|
2,341 |
1,833 |
$6K |
| 0012A |
|
432 |
334 |
$6K |
| 82746 |
|
524 |
471 |
$6K |
| 84112 |
|
73 |
54 |
$6K |
| 0011A |
|
446 |
364 |
$5K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
681 |
539 |
$5K |
| 84450 |
|
1,133 |
901 |
$5K |
| 86696 |
|
273 |
219 |
$5K |
| 82947 |
|
954 |
752 |
$5K |
| 86160 |
|
223 |
199 |
$5K |
| 87798 |
Infectious agent detection by nucleic acid; not otherwise specified, amplified probe, each organism |
191 |
148 |
$5K |
| 73030 |
|
2,277 |
1,862 |
$5K |
| 94060 |
|
174 |
147 |
$4K |
| 73630 |
|
3,046 |
2,468 |
$4K |
| 84403 |
|
163 |
143 |
$4K |
| 87077 |
|
802 |
703 |
$4K |
| 90688 |
|
388 |
346 |
$4K |
| G0482 |
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; 15-21 drug class(es), including metabolite(s) if performed |
43 |
40 |
$4K |
| 97140 |
Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) |
574 |
247 |
$4K |
| 73610 |
|
2,271 |
1,898 |
$4K |
| 84100 |
|
1,546 |
1,129 |
$4K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
256 |
245 |
$4K |
| 80329 |
|
818 |
666 |
$4K |
| 90791 |
Psychiatric diagnostic evaluation |
245 |
166 |
$3K |
| 84481 |
|
307 |
259 |
$3K |
| 86308 |
|
343 |
305 |
$3K |
| 83615 |
|
717 |
565 |
$3K |
| 95806 |
|
24 |
24 |
$3K |
| 90853 |
Group psychotherapy (other than of a multiple-family group) |
84 |
14 |
$3K |
| 92507 |
Treatment of speech, language, voice, communication, and/or auditory processing disorder |
477 |
148 |
$3K |
| 93458 |
|
13 |
12 |
$3K |
| 86480 |
|
47 |
44 |
$3K |
| 97161 |
|
352 |
299 |
$3K |
| 82150 |
|
662 |
532 |
$3K |
| 10060 |
|
37 |
36 |
$3K |
| 85014 |
|
848 |
677 |
$3K |
| 86812 |
|
178 |
158 |
$3K |
| 96413 |
Chemotherapy administration, intravenous infusion; up to 1 hour, single or initial substance |
664 |
417 |
$2K |
| 70551 |
Magnetic resonance imaging, brain; without contrast material |
63 |
59 |
$2K |
| 11720 |
|
433 |
405 |
$2K |
| 11721 |
|
594 |
541 |
$2K |
| 70498 |
|
57 |
49 |
$2K |
| 74018 |
|
801 |
666 |
$2K |
| 86695 |
|
112 |
91 |
$2K |
| 87506 |
|
12 |
12 |
$2K |
| 82010 |
|
511 |
385 |
$2K |
| 96375 |
Therapeutic injection; each additional sequential IV push |
14,618 |
10,774 |
$2K |
| 83921 |
|
132 |
108 |
$2K |
| 73130 |
|
1,681 |
1,386 |
$2K |
| 70491 |
|
52 |
41 |
$2K |
| 82784 |
|
100 |
89 |
$2K |
| 92134 |
|
725 |
636 |
$2K |
| 85045 |
|
208 |
122 |
$2K |
| 86431 |
|
438 |
281 |
$2K |
| 90832 |
Psychotherapy, 30 minutes with patient |
123 |
89 |
$2K |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
2,523 |
2,050 |
$1K |
| 0064A |
|
264 |
174 |
$1K |
| 87641 |
|
67 |
63 |
$1K |
| 12011 |
|
27 |
26 |
$1K |
| 90899 |
|
19 |
14 |
$1K |
| C9803 |
Hospital outpatient clinic visit specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source |
138 |
121 |
$1K |
| 82272 |
|
109 |
100 |
$1K |
| 86318 |
|
96 |
87 |
$1K |
| 12002 |
|
13 |
12 |
$1K |
| 86704 |
|
109 |
96 |
$1K |
| 96376 |
|
5,788 |
3,758 |
$1K |
| J2001 |
Injection, lidocaine hcl for intravenous infusion, 10 mg |
13,756 |
7,011 |
$1K |
| 84295 |
|
95 |
72 |
$1K |
| 90833 |
Psychotherapy, 30 minutes with patient when performed with an E&M service (add-on) |
18 |
16 |
$1K |
| 76641 |
|
52 |
38 |
$1K |
| 0071A |
|
84 |
51 |
$943.86 |
| 73502 |
|
663 |
593 |
$889.77 |
| 73110 |
|
1,287 |
1,051 |
$861.22 |
| 84156 |
|
299 |
237 |
$838.89 |
| 70496 |
|
31 |
25 |
$823.88 |
| 84155 |
|
61 |
49 |
$787.62 |
| J2270 |
Injection, morphine sulfate, up to 10 mg |
2,872 |
2,014 |
$759.76 |
| 95816 |
|
16 |
15 |
$758.80 |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
6,778 |
4,904 |
$748.55 |
| G0103 |
Prostate cancer screening; prostate specific antigen test (psa) |
57 |
50 |
$727.00 |
| 82553 |
|
142 |
123 |
$708.06 |
| 0072A |
|
84 |
48 |
$680.53 |
| P9021 |
Red blood cells, each unit |
19 |
15 |
$668.35 |
| 76700 |
Ultrasound, abdominal, real time with image documentation; complete |
14 |
13 |
$627.66 |
| 73562 |
|
514 |
410 |
$621.64 |
| 83721 |
|
94 |
79 |
$572.59 |
| 97530 |
Therapeutic activities, direct patient contact, each 15 minutes |
149 |
71 |
$568.21 |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
12,042 |
10,234 |
$537.23 |
| G0481 |
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; 8-14 drug class(es), including metabolite(s) if performed |
17 |
16 |
$525.08 |
| 99397 |
|
49 |
49 |
$519.01 |
| 36430 |
|
16 |
14 |
$514.92 |
| 80164 |
|
28 |
24 |
$473.38 |
| 36591 |
|
281 |
119 |
$466.58 |
| 82785 |
|
30 |
27 |
$453.56 |
| 86039 |
|
44 |
38 |
$452.64 |
| 83001 |
|
27 |
26 |
$430.10 |
| 73140 |
|
581 |
482 |
$425.95 |
| 0004A |
|
47 |
35 |
$418.71 |
| 90662 |
|
491 |
425 |
$406.58 |
| 87661 |
Infectious agent detection by nucleic acid; Trichomonas vaginalis, amplified probe |
16 |
13 |
$400.89 |
| 85049 |
|
29 |
24 |
$395.35 |
| 93296 |
|
75 |
64 |
$385.86 |
| 86162 |
|
17 |
14 |
$332.43 |
| 72110 |
|
12 |
12 |
$329.73 |
| G2066 |
Interrogation device evaluation(s), (remote) up to 30 days; implantable cardiovascular physiologic monitor system, implantable loop recorder system, or subcutaneous cardiac rhythm monitor system, remote data acquisition(s), receipt of transmissions and technician review, technical support and distribution of results |
13 |
12 |
$319.78 |
| 80050 |
General health panel |
155 |
141 |
$316.07 |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
41 |
41 |
$313.25 |
| 86255 |
|
12 |
12 |
$292.02 |
| 80320 |
|
967 |
737 |
$275.22 |
| J7030 |
Infusion, normal saline solution , 1000 cc |
19,292 |
14,307 |
$250.39 |
| 73080 |
|
327 |
267 |
$242.83 |
| A9577 |
Injection, gadobenate dimeglumine (multihance), per ml |
1,506 |
1,300 |
$232.27 |
| 84165 |
|
28 |
24 |
$229.12 |
| J2704 |
Injection, propofol, 10 mg |
12,879 |
6,352 |
$221.96 |
| 72100 |
|
83 |
78 |
$214.03 |
| 84238 |
|
14 |
12 |
$213.46 |
| 86762 |
|
15 |
13 |
$180.80 |
| 94762 |
|
14 |
14 |
$168.37 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
7,521 |
5,752 |
$165.28 |
| 0001A |
|
59 |
40 |
$154.12 |
| 86708 |
|
14 |
12 |
$142.16 |
| 0002A |
|
57 |
36 |
$141.79 |
| J1030 |
Injection, methylprednisolone acetate, 40 mg |
336 |
299 |
$136.96 |
| 91322 |
|
36 |
31 |
$128.73 |
| 97165 |
|
12 |
12 |
$121.94 |
| 98960 |
|
74 |
61 |
$118.83 |
| G0008 |
Administration of influenza virus vaccine |
724 |
634 |
$108.76 |
| 88313 |
|
879 |
682 |
$107.87 |
| J1170 |
Injection, hydromorphone, up to 4 mg |
9,733 |
6,175 |
$102.61 |
| J7512 |
Prednisone, immediate release or delayed release, oral, 1 mg |
1,472 |
1,195 |
$100.71 |
| 82533 |
|
13 |
12 |
$88.10 |
| 82310 |
|
68 |
54 |
$82.94 |
| 90480 |
|
37 |
32 |
$79.88 |
| 90677 |
|
14 |
12 |
$77.89 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
4,853 |
3,571 |
$73.56 |
| J2765 |
Injection, metoclopramide hcl, up to 10 mg |
2,052 |
1,666 |
$59.86 |
| J7050 |
Infusion, normal saline solution, 250 cc |
3,401 |
1,670 |
$58.43 |
| J7120 |
Ringers lactate infusion, up to 1000 cc |
8,913 |
7,054 |
$57.14 |
| 73590 |
|
118 |
90 |
$56.40 |
| 80178 |
|
14 |
12 |
$55.45 |
| 69210 |
|
57 |
45 |
$53.23 |
| 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 |
4,300 |
3,702 |
$52.92 |
| J2785 |
Injection, regadenoson, 0.1 mg |
447 |
370 |
$43.14 |
| J3475 |
Injection, magnesium sulfate, per 500 mg |
1,514 |
1,158 |
$40.50 |
| 88312 |
|
793 |
675 |
$33.90 |
| 51701 |
|
57 |
53 |
$33.23 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
13,350 |
10,387 |
$32.90 |
| 17000 |
|
13 |
12 |
$32.20 |
| 99406 |
|
31 |
27 |
$29.97 |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
15,354 |
11,114 |
$27.08 |
| 0134A |
|
46 |
32 |
$26.95 |
| C1894 |
Introducer/sheath, other than guiding, other than intracardiac electrophysiological, non-laser |
277 |
198 |
$25.83 |
| 51702 |
|
157 |
116 |
$23.58 |
| J2175 |
Injection, meperidine hydrochloride, per 100 mg |
425 |
369 |
$19.37 |
| 86920 |
|
57 |
42 |
$17.92 |
| 84520 |
|
25 |
12 |
$17.33 |
| C1769 |
Guide wire |
1,149 |
732 |
$14.55 |
| J7040 |
Infusion, normal saline solution, sterile (500 ml = 1 unit) |
2,398 |
1,338 |
$13.66 |
| J0690 |
Injection, cefazolin sodium, 500 mg |
3,076 |
2,060 |
$11.80 |
| A4364 |
Adhesive, liquid or equal, any type, per oz |
299 |
241 |
$10.99 |
| A9500 |
Technetium tc-99m sestamibi, diagnostic, per study dose |
803 |
696 |
$10.59 |
| J1642 |
Injection, heparin sodium, (heparin lock flush), per 10 units |
948 |
508 |
$9.23 |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
8,166 |
6,388 |
$9.07 |
| J3420 |
Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg |
318 |
253 |
$7.67 |
| J1644 |
Injection, heparin sodium, per 1000 units |
967 |
439 |
$7.47 |
| 85048 |
|
13 |
12 |
$6.95 |
| G0009 |
Administration of pneumococcal vaccine |
63 |
56 |
$6.91 |
| J3490 |
Unclassified drugs |
6,224 |
3,684 |
$6.43 |
| 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 |
1,095 |
897 |
$5.49 |
| J1815 |
Injection, insulin, per 5 units |
897 |
529 |
$3.76 |
| J2060 |
Injection, lorazepam, 2 mg |
2,240 |
1,739 |
$3.64 |
| J0131 |
Injection, acetaminophen, not otherwise specified,10 mg |
3,399 |
2,368 |
$2.94 |
| J1200 |
Injection, diphenhydramine hcl, up to 50 mg |
3,556 |
2,623 |
$2.16 |
| C9113 |
Injection, pantoprazole sodium, per vial |
62 |
44 |
$2.08 |
| J0780 |
Injection, prochlorperazine, up to 10 mg |
616 |
519 |
$1.92 |
| J1790 |
Injection, droperidol, up to 5 mg |
363 |
293 |
$1.86 |
| A9270 |
Non-covered item or service |
1,723 |
461 |
$1.56 |
| A4649 |
Surgical supply; miscellaneous |
77 |
62 |
$1.36 |
| J2930 |
Injection, methylprednisolone sodium succinate, up to 125 mg |
235 |
202 |
$0.68 |
| J1040 |
Injection, methylprednisolone acetate, 80 mg |
159 |
126 |
$0.37 |
| J3480 |
Injection, potassium chloride, per 2 meq |
105 |
81 |
$0.35 |
| J7060 |
5% dextrose/water (500 ml = 1 unit) |
113 |
81 |
$0.34 |
| J1596 |
Injection, glycopyrrolate, 0.1 mg |
57 |
45 |
$0.09 |
| G8978 |
Mobility: walking & moving around functional limitation, current status, at therapy episode outset and at reporting intervals |
212 |
148 |
$0.00 |
| Q9966 |
Low osmolar contrast material, 200-299 mg/ml iodine concentration, per ml |
62 |
56 |
$0.00 |
| J0171 |
Injection, adrenalin, epinephrine, 0.1 mg |
164 |
118 |
$0.00 |
| J1650 |
Injection, enoxaparin sodium, 10 mg |
713 |
313 |
$0.00 |
| J2710 |
Injection, neostigmine methylsulfate, up to 0.5 mg |
984 |
806 |
$0.00 |
| C1713 |
Anchor/screw for opposing bone-to-bone or soft tissue-to-bone (implantable) |
67 |
51 |
$0.00 |
| S0119 |
Ondansetron, oral, 4 mg (for circumstances falling under the medicare statute, use hcpcs q code) |
168 |
150 |
$0.00 |
| J2919 |
Injection, methylprednisolone sodium succinate, 5 mg |
32 |
27 |
$0.00 |
| G8979 |
Mobility: walking & moving around functional limitation, projected goal status, at therapy episode outset, at reporting intervals, and at discharge or to end reporting |
239 |
169 |
$0.00 |
| G1004 |
Clinical decision support mechanism national decision support company, as defined by the medicare appropriate use criteria program |
99 |
78 |
$0.00 |
| J3370 |
Injection, vancomycin hcl, 500 mg |
30 |
24 |
$0.00 |
| J3301 |
Injection, triamcinolone acetonide, not otherwise specified, 10 mg |
36 |
28 |
$0.00 |
| J7643 |
Glycopyrrolate, inhalation solution, compounded product, administered through dme, unit dose form, per milligram |
13 |
12 |
$0.00 |
| Q9957 |
Injection, perflutren lipid microspheres, per ml |
13 |
12 |
$0.00 |
| 92083 |
|
25 |
24 |
$0.00 |
| J1171 |
Injection, hydromorphone, 0.1 mg |
65 |
48 |
$0.00 |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
32 |
24 |
$0.00 |
| J3372 |
Injection, vancomycin hcl (xellia), not therapeutically equivalent to j3370, 500 mg |
24 |
12 |
$0.00 |
| 67028 |
Intravitreal injection of a pharmacologic agent |
12 |
12 |
$0.00 |
| J0330 |
Injection, succinylcholine chloride, up to 20 mg |
1,693 |
736 |
$0.00 |
| C9399 |
Unclassified drugs or biologicals |
79 |
62 |
$0.00 |
| J2795 |
Injection, ropivacaine hydrochloride, 1 mg |
52 |
26 |
$0.00 |
| C1773 |
Retrieval device, insertable (used to retrieve fractured medical devices) |
39 |
31 |
$0.00 |
| J2003 |
Injection, lidocaine hydrochloride, 1 mg |
103 |
72 |
$0.00 |
| A4217 |
Sterile water/saline, 500 ml |
22 |
16 |
$0.00 |
| 88108 |
|
13 |
12 |
$0.00 |
| A9579 |
Injection, gadolinium-based magnetic resonance contrast agent, not otherwise specified (nos), per ml |
167 |
153 |
$0.00 |
| 71101 |
|
35 |
32 |
$0.00 |
| J2370 |
Injection, phenylephrine hcl, up to 1 ml |
152 |
81 |
$0.00 |
| J1940 |
Injection, furosemide, up to 20 mg |
14 |
12 |
$0.00 |
| A6222 |
Gauze, impregnated with other than water, normal saline, or hydrogel, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
63 |
54 |
$0.00 |
| 72170 |
|
57 |
50 |
$0.00 |
| 99496 |
|
18 |
15 |
$0.00 |
| J1630 |
Injection, haloperidol, up to 5 mg |
15 |
12 |
$0.00 |
| J2543 |
Injection, piperacillin sodium/tazobactam sodium, 1 gram/0.125 grams (1.125 grams) |
43 |
26 |
$0.00 |
| J1010 |
Injection, methylprednisolone acetate, 1 mg |
49 |
43 |
$0.00 |
| 76819 |
Fetal biophysical profile; without non-stress testing |
19 |
12 |
$0.00 |