| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
94,112 |
87,897 |
$9.02M |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
16,242 |
14,553 |
$5.28M |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
62,363 |
56,887 |
$4.59M |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
32,806 |
29,510 |
$4.07M |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
23,900 |
22,705 |
$2.34M |
| G0378 |
Hospital observation service, per hour |
5,201 |
4,031 |
$2.32M |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
41,289 |
36,713 |
$2.13M |
| J2426 |
Injection, paliperidone palmitate extended release (invega sustenna), 1 mg |
1,341 |
1,240 |
$1.87M |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
21,820 |
17,650 |
$1.65M |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
11,792 |
11,321 |
$1.59M |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
13,481 |
8,582 |
$1.24M |
| 76819 |
Fetal biophysical profile; without non-stress testing |
10,038 |
6,026 |
$1.08M |
| Q3014 |
Telehealth originating site facility fee |
40,901 |
38,341 |
$1.05M |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
3,777 |
3,539 |
$951K |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
15,595 |
13,984 |
$926K |
| 93306 |
Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete |
1,633 |
1,591 |
$903K |
| 81513 |
|
7,651 |
6,977 |
$837K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
178,598 |
81,446 |
$743K |
| 59025 |
Fetal non-stress test |
6,679 |
4,362 |
$674K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
4,091 |
3,951 |
$576K |
| 80053 |
Comprehensive metabolic panel |
62,774 |
53,425 |
$556K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
84,664 |
71,619 |
$550K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
16,349 |
15,538 |
$527K |
| 87590 |
|
20,877 |
19,099 |
$492K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
2,119 |
2,034 |
$480K |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
2,960 |
2,507 |
$471K |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
2,012 |
1,898 |
$446K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
6,784 |
6,405 |
$425K |
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
37,063 |
28,102 |
$408K |
| 87490 |
|
20,875 |
19,120 |
$407K |
| 86703 |
|
29,450 |
27,270 |
$399K |
| 76811 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, detailed |
1,999 |
1,942 |
$383K |
| 70450 |
Computed tomography, head or brain; without contrast material |
3,995 |
3,640 |
$372K |
| 87481 |
|
14,461 |
6,961 |
$339K |
| 71260 |
Computed tomography, thorax, diagnostic; with contrast material |
2,329 |
2,207 |
$324K |
| J9271 |
Injection, pembrolizumab, 1 mg |
65 |
51 |
$313K |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
5,671 |
5,121 |
$311K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
19,162 |
14,592 |
$309K |
| 86780 |
|
21,694 |
19,938 |
$271K |
| 90686 |
|
37,922 |
37,466 |
$244K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
2,641 |
2,493 |
$239K |
| 80061 |
Lipid panel |
21,344 |
20,496 |
$232K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
28,202 |
26,478 |
$231K |
| 71045 |
Radiologic examination, chest; single view |
10,639 |
9,300 |
$210K |
| 87661 |
Infectious agent detection by nucleic acid; Trichomonas vaginalis, amplified probe |
7,690 |
7,016 |
$209K |
| 86850 |
|
5,662 |
4,909 |
$203K |
| J7030 |
Infusion, normal saline solution , 1000 cc |
12,979 |
4,151 |
$200K |
| 84443 |
Thyroid stimulating hormone (TSH) |
16,083 |
15,134 |
$194K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
9,119 |
4,290 |
$192K |
| 76830 |
Ultrasound, transvaginal |
1,922 |
1,822 |
$192K |
| 90715 |
|
6,415 |
6,171 |
$190K |
| 87653 |
|
5,214 |
5,074 |
$189K |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
1,822 |
1,187 |
$180K |
| 96413 |
Chemotherapy administration, intravenous infusion; up to 1 hour, single or initial substance |
2,234 |
1,368 |
$174K |
| 99215 |
Prolong outpt/office vis |
1,564 |
1,463 |
$173K |
| 84702 |
|
12,211 |
10,745 |
$150K |
| 90651 |
|
3,211 |
3,130 |
$147K |
| 76801 |
|
1,207 |
1,103 |
$140K |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
6,773 |
6,486 |
$133K |
| 72125 |
Computed tomography, cervical spine; without contrast material |
1,608 |
1,464 |
$133K |
| 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 |
2,262 |
1,896 |
$127K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
6,086 |
5,611 |
$126K |
| 81025 |
|
15,255 |
14,076 |
$123K |
| 90677 |
|
7,174 |
7,125 |
$122K |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
15,722 |
14,245 |
$121K |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
2,469 |
1,485 |
$119K |
| 43239 |
Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple |
454 |
427 |
$118K |
| 86762 |
|
8,648 |
7,755 |
$118K |
| J7307 |
Etonogestrel (contraceptive) implant system, including implant and supplies |
171 |
171 |
$116K |
| 76820 |
|
1,816 |
964 |
$114K |
| 0002A |
|
3,227 |
3,211 |
$113K |
| 86803 |
|
10,846 |
9,819 |
$110K |
| 88175 |
Cytopathology, cervical or vaginal, any reporting system; collected in preservative fluid, automated thin layer |
5,879 |
5,567 |
$106K |
| 85027 |
|
18,184 |
16,725 |
$105K |
| 87536 |
|
1,423 |
1,335 |
$104K |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
8,916 |
8,076 |
$102K |
| 84484 |
|
12,630 |
8,805 |
$102K |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
1,207 |
1,159 |
$94K |
| 77066 |
Tomosynthesis, mammo |
586 |
565 |
$90K |
| 87340 |
|
10,838 |
9,824 |
$86K |
| 76642 |
|
905 |
884 |
$83K |
| 83021 |
|
5,215 |
4,529 |
$81K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
12,094 |
9,593 |
$78K |
| 83880 |
|
3,302 |
2,934 |
$78K |
| J0897 |
Injection, denosumab, 1 mg |
143 |
132 |
$77K |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
1,314 |
908 |
$77K |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
3,001 |
2,918 |
$76K |
| 96366 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour |
1,891 |
1,272 |
$74K |
| 82805 |
|
1,264 |
1,111 |
$69K |
| 82948 |
|
19,343 |
9,967 |
$67K |
| 0001A |
|
3,139 |
3,124 |
$67K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
413 |
385 |
$65K |
| 96367 |
|
2,069 |
1,275 |
$65K |
| 81420 |
Fetal chromosomal aneuploidy genomic sequence analysis panel |
66 |
65 |
$64K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
2,227 |
2,136 |
$64K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
2,216 |
2,123 |
$64K |
| 76770 |
|
710 |
692 |
$57K |
| 71046 |
Radiologic examination, chest; 2 views |
1,886 |
1,805 |
$54K |
| 99291 |
Critical care, evaluation and management of the critically ill patient, first 30-74 minutes |
64 |
60 |
$51K |
| 90746 |
|
992 |
958 |
$51K |
| 83655 |
|
2,771 |
2,621 |
$50K |
| 70551 |
Magnetic resonance imaging, brain; without contrast material |
300 |
291 |
$48K |
| 82950 |
|
9,185 |
8,721 |
$46K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
351 |
273 |
$46K |
| 81269 |
|
301 |
286 |
$43K |
| 97162 |
|
895 |
851 |
$43K |
| 90656 |
|
4,721 |
4,680 |
$43K |
| 73630 |
|
1,476 |
1,372 |
$40K |
| 90670 |
|
18,285 |
18,143 |
$38K |
| 0071A |
|
690 |
686 |
$37K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
857 |
819 |
$37K |
| 99281 |
Emergency department visit for the evaluation and management, self-limited or minor |
1,120 |
1,035 |
$36K |
| 72110 |
|
803 |
789 |
$35K |
| 83690 |
|
6,887 |
6,269 |
$35K |
| J7298 |
Levonorgestrel-releasing intrauterine contraceptive system (mirena), 52 mg |
86 |
83 |
$33K |
| 87624 |
Infectious agent detection by nucleic acid; human papillomavirus (HPV), high-risk types |
1,387 |
1,319 |
$33K |
| 76818 |
|
213 |
177 |
$32K |
| 84703 |
|
3,751 |
3,564 |
$32K |
| 90697 |
|
12,859 |
12,805 |
$31K |
| 82728 |
|
3,113 |
2,960 |
$31K |
| 93971 |
|
395 |
365 |
$31K |
| 73030 |
|
1,156 |
1,058 |
$30K |
| 81003 |
|
16,104 |
14,614 |
$29K |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
5,084 |
4,552 |
$29K |
| 83970 |
|
1,471 |
1,413 |
$28K |
| 0241U |
Neonatal screening for hereditary disorders, genomic sequence analysis panel |
2,707 |
2,537 |
$28K |
| 84439 |
|
4,060 |
3,796 |
$28K |
| 94760 |
|
1,746 |
1,049 |
$28K |
| 73130 |
|
911 |
835 |
$27K |
| 86901 |
|
11,570 |
9,821 |
$27K |
| 86900 |
|
11,589 |
9,832 |
$27K |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
4,650 |
3,480 |
$27K |
| 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 |
169 |
125 |
$27K |
| 93017 |
|
78 |
77 |
$27K |
| 86885 |
|
4,747 |
4,430 |
$26K |
| 93970 |
|
162 |
158 |
$25K |
| 80076 |
|
3,262 |
3,089 |
$25K |
| T2101 |
Human breast milk processing, storage and distribution only |
2,159 |
646 |
$25K |
| 84466 |
|
2,867 |
2,673 |
$25K |
| 11982 |
|
242 |
240 |
$25K |
| 0072A |
|
526 |
521 |
$24K |
| 81001 |
|
8,650 |
7,947 |
$23K |
| 73562 |
|
783 |
732 |
$23K |
| J1756 |
Injection, iron sucrose, 1 mg |
234 |
122 |
$23K |
| 83020 |
|
1,905 |
1,775 |
$22K |
| 86140 |
|
4,444 |
4,023 |
$21K |
| 73610 |
|
752 |
694 |
$21K |
| J1644 |
Injection, heparin sodium, per 1000 units |
2,040 |
774 |
$21K |
| 73502 |
|
505 |
471 |
$21K |
| 77065 |
Tomosynthesis, mammo |
144 |
138 |
$20K |
| 83037 |
|
4,294 |
4,152 |
$20K |
| 73564 |
|
550 |
520 |
$20K |
| 86480 |
|
447 |
428 |
$19K |
| 87210 |
|
3,391 |
3,218 |
$18K |
| G0382 |
Level 3 hospital emergency department visit provided in a type b emergency department; (the ed must meet at least one of the following requirements: (1) it is licensed by the state in which it is located under applicable state law as an emergency room or emergency department; (2) it is held out to the public (by name, posted signs, advertising, or other means) as a place that provides care for emergency medical conditions on an urgent basis without requiring a previously scheduled appointment; or (3) during the calendar year immediately preceding the calendar year in which a determination under 42 cfr 489.24 is being made, based on a representative sample of patient visits that occurred during that calendar year, it provides at least one-third of all of its outpatient visits for the treatment of emergency medical conditions on an urgent basis without requiring a previously scheduled appointment) |
320 |
298 |
$18K |
| 0012A |
|
1,078 |
1,074 |
$18K |
| 85014 |
|
5,387 |
5,093 |
$18K |
| 85018 |
|
5,435 |
5,131 |
$18K |
| 84153 |
|
1,280 |
1,222 |
$18K |
| 45380 |
Colonoscopy, flexible; with biopsy, single or multiple |
31 |
30 |
$18K |
| 96417 |
|
452 |
287 |
$17K |
| 0011A |
|
1,168 |
1,160 |
$15K |
| 82607 |
|
1,702 |
1,623 |
$15K |
| 93296 |
|
900 |
864 |
$15K |
| 70553 |
Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences |
52 |
50 |
$15K |
| 97161 |
|
340 |
334 |
$15K |
| 83735 |
|
3,433 |
2,606 |
$14K |
| 85610 |
|
5,905 |
4,815 |
$14K |
| 86361 |
|
645 |
596 |
$14K |
| 58301 |
|
235 |
230 |
$14K |
| 20610 |
|
409 |
377 |
$14K |
| 86706 |
|
1,675 |
1,547 |
$13K |
| 82570 |
|
4,475 |
4,288 |
$13K |
| 72148 |
Magnetic resonance imaging, lumbar spine; without contrast material |
60 |
59 |
$13K |
| 71250 |
|
143 |
141 |
$13K |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
2,221 |
1,611 |
$12K |
| 83540 |
|
2,809 |
2,683 |
$12K |
| 86704 |
|
1,385 |
1,259 |
$12K |
| 74018 |
|
572 |
513 |
$12K |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
2,522 |
1,804 |
$12K |
| 86160 |
|
808 |
398 |
$12K |
| 41899 |
Unlisted procedure, dentoalveolar structures |
73 |
58 |
$12K |
| 94729 |
|
207 |
203 |
$11K |
| 86003 |
|
129 |
74 |
$11K |
| 86708 |
|
1,264 |
1,162 |
$11K |
| 83605 |
|
1,398 |
1,123 |
$11K |
| 73110 |
|
288 |
256 |
$11K |
| J1940 |
Injection, furosemide, up to 20 mg |
1,322 |
702 |
$10K |
| 87040 |
|
1,020 |
576 |
$10K |
| 58300 |
|
151 |
146 |
$10K |
| 92557 |
|
215 |
204 |
$9K |
| 82024 |
|
306 |
234 |
$9K |
| 93225 |
|
50 |
50 |
$9K |
| 96375 |
Therapeutic injection; each additional sequential IV push |
4,792 |
3,690 |
$9K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
639 |
567 |
$9K |
| 82746 |
|
920 |
881 |
$9K |
| J1200 |
Injection, diphenhydramine hcl, up to 50 mg |
1,553 |
1,167 |
$9K |
| 85652 |
|
3,490 |
3,207 |
$8K |
| 82043 |
|
2,846 |
2,782 |
$8K |
| 85730 |
|
2,131 |
1,923 |
$8K |
| 80069 |
|
1,387 |
1,192 |
$8K |
| 82565 |
|
1,385 |
1,325 |
$8K |
| 70491 |
|
42 |
41 |
$8K |
| 90633 |
|
6,877 |
6,827 |
$7K |
| 93880 |
|
68 |
65 |
$7K |
| J2270 |
Injection, morphine sulfate, up to 10 mg |
1,008 |
814 |
$7K |
| 0004A |
|
832 |
832 |
$7K |
| 97166 |
|
140 |
130 |
$7K |
| J1650 |
Injection, enoxaparin sodium, 10 mg |
2,163 |
803 |
$7K |
| 82274 |
|
762 |
752 |
$7K |
| 82947 |
|
1,232 |
1,202 |
$7K |
| 94726 |
|
160 |
156 |
$7K |
| 77080 |
|
477 |
456 |
$7K |
| 96415 |
|
389 |
248 |
$7K |
| 90694 |
|
1,155 |
1,127 |
$7K |
| 87522 |
Neg quan hep c or qual rna |
219 |
205 |
$7K |
| 90837 |
Psychotherapy, 53 minutes with patient |
48 |
39 |
$7K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
806 |
710 |
$7K |
| 82105 |
|
601 |
583 |
$6K |
| 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 |
13 |
13 |
$6K |
| 0124A |
|
257 |
252 |
$6K |
| 0064A |
|
514 |
509 |
$6K |
| 84145 |
|
356 |
319 |
$6K |
| G0433 |
Infectious agent antibody detection by enzyme-linked immunosorbent assay (elisa) technique, hiv-1 and/or hiv-2, screening |
5,383 |
4,965 |
$6K |
| 82550 |
|
1,240 |
1,057 |
$6K |
| 80074 |
|
164 |
151 |
$6K |
| 70498 |
|
37 |
36 |
$5K |
| J2060 |
Injection, lorazepam, 2 mg |
843 |
617 |
$5K |
| 87186 |
|
1,088 |
975 |
$5K |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
1,336 |
1,216 |
$5K |
| 92567 |
|
203 |
193 |
$5K |
| 84156 |
|
2,063 |
1,855 |
$5K |
| 71271 |
|
54 |
53 |
$5K |
| 82247 |
|
1,506 |
1,111 |
$5K |
| 88342 |
|
96 |
82 |
$5K |
| 11042 |
Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm |
36 |
27 |
$5K |
| 82784 |
|
681 |
355 |
$5K |
| J3475 |
Injection, magnesium sulfate, per 500 mg |
221 |
139 |
$5K |
| 0054A |
|
205 |
202 |
$5K |
| 73590 |
|
208 |
194 |
$5K |
| 95886 |
|
95 |
89 |
$5K |
| 51798 |
|
135 |
109 |
$4K |
| 84100 |
|
2,060 |
1,770 |
$4K |
| 64493 |
|
13 |
13 |
$4K |
| 86038 |
|
538 |
457 |
$4K |
| 90791 |
Psychiatric diagnostic evaluation |
20 |
20 |
$4K |
| 85007 |
|
1,556 |
1,148 |
$4K |
| 78452 |
Myocardial perfusion imaging, tomographic (SPECT); multiple studies at rest and/or stress |
13 |
12 |
$4K |
| 87637 |
Infectious agent detection by nucleic acid; SARS-CoV-2, influenza, and RSV |
34 |
34 |
$4K |
| 36415 |
Collection of venous blood by venipuncture |
196,982 |
170,803 |
$4K |
| 82248 |
|
1,321 |
1,049 |
$4K |
| 80164 |
|
465 |
400 |
$4K |
| 96368 |
|
191 |
113 |
$3K |
| A9502 |
Technetium tc-99m tetrofosmin, diagnostic, per study dose |
13 |
12 |
$3K |
| 77336 |
|
66 |
28 |
$3K |
| J3301 |
Injection, triamcinolone acetonide, not otherwise specified, 10 mg |
648 |
608 |
$3K |
| J1642 |
Injection, heparin sodium, (heparin lock flush), per 10 units |
2,358 |
1,585 |
$3K |
| J1726 |
Injection, hydroxyprogesterone caproate, (makena), 10 mg |
115 |
63 |
$3K |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
976 |
911 |
$3K |
| 76641 |
|
17 |
17 |
$3K |
| 80320 |
|
295 |
262 |
$3K |
| 0134A |
|
102 |
99 |
$3K |
| 85379 |
|
404 |
370 |
$3K |
| 82378 |
|
246 |
229 |
$3K |
| 80329 |
|
220 |
153 |
$3K |
| 86334 |
|
184 |
168 |
$3K |
| J3480 |
Injection, potassium chloride, per 2 meq |
141 |
79 |
$3K |
| 11981 |
|
26 |
26 |
$3K |
| 84460 |
|
356 |
350 |
$3K |
| Q0091 |
Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory |
2,699 |
2,322 |
$3K |
| J3370 |
Injection, vancomycin hcl, 500 mg |
143 |
62 |
$2K |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
6,803 |
6,251 |
$2K |
| 90734 |
|
1,191 |
1,182 |
$2K |
| J1790 |
Injection, droperidol, up to 5 mg |
306 |
278 |
$2K |
| 76536 |
|
28 |
28 |
$2K |
| S3620 |
Newborn metabolic screening panel, includes test kit, postage and the laboratory tests specified by the state for inclusion in this panel (e.g., galactose; hemoglobin, electrophoresis; hydroxyprogesterone, 17-d; phenylalanine (pku); and thyroxine, total) |
789 |
778 |
$2K |
| 95816 |
|
16 |
16 |
$2K |
| 86592 |
|
713 |
656 |
$2K |
| 92134 |
|
687 |
668 |
$2K |
| 83615 |
|
534 |
465 |
$2K |
| 73560 |
|
64 |
52 |
$2K |
| 96376 |
|
2,893 |
1,552 |
$2K |
| 82951 |
|
196 |
188 |
$2K |
| J0360 |
Injection, hydralazine hcl, up to 20 mg |
178 |
142 |
$2K |
| 90710 |
|
851 |
851 |
$2K |
| 72200 |
|
40 |
39 |
$2K |
| J0690 |
Injection, cefazolin sodium, 500 mg |
435 |
334 |
$2K |
| 84480 |
|
206 |
188 |
$2K |
| 70496 |
|
13 |
12 |
$2K |
| 84550 |
|
636 |
591 |
$2K |
| 84450 |
|
311 |
300 |
$2K |
| 64615 |
|
12 |
12 |
$2K |
| 90834 |
Psychotherapy, 45 minutes with patient |
15 |
12 |
$2K |
| 82785 |
|
84 |
74 |
$2K |
| 88720 |
|
387 |
315 |
$2K |
| 82140 |
|
174 |
142 |
$2K |
| 83521 |
|
336 |
158 |
$1K |
| J2785 |
Injection, regadenoson, 0.1 mg |
13 |
12 |
$1K |
| 81511 |
|
197 |
184 |
$1K |
| 87077 |
|
299 |
280 |
$1K |
| 96523 |
|
202 |
165 |
$1K |
| 70486 |
|
29 |
28 |
$1K |
| 85660 |
|
230 |
218 |
$1K |
| 86300 |
|
77 |
72 |
$1K |
| 90732 |
|
283 |
276 |
$1K |
| 84165 |
|
196 |
174 |
$1K |
| 90648 |
|
3,695 |
3,661 |
$1K |
| 73552 |
|
58 |
57 |
$1K |
| 82652 |
|
50 |
50 |
$1K |
| 99490 |
Ccm add 20min |
234 |
234 |
$1K |
| G0279 |
Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066) |
351 |
326 |
$1K |
| 67028 |
Intravitreal injection of a pharmacologic agent |
48 |
39 |
$1K |
| J9045 |
Injection, carboplatin, 50 mg |
35 |
25 |
$1K |
| 0052A |
|
31 |
30 |
$1K |
| 94618 |
|
13 |
13 |
$1K |
| 87205 |
|
416 |
361 |
$1K |
| 73080 |
|
42 |
39 |
$1K |
| J8499 |
Prescription drug, oral, non chemotherapeutic, nos |
16,649 |
4,565 |
$1K |
| J1630 |
Injection, haloperidol, up to 5 mg |
136 |
94 |
$1K |
| 0051A |
|
40 |
37 |
$1K |
| 73522 |
|
41 |
41 |
$996.13 |
| 90688 |
|
39 |
39 |
$984.64 |
| 76886 |
|
12 |
12 |
$970.80 |
| 94060 |
|
13 |
13 |
$959.15 |
| 77062 |
|
715 |
697 |
$942.25 |
| J1170 |
Injection, hydromorphone, up to 4 mg |
86 |
55 |
$922.07 |
| 83516 |
|
112 |
72 |
$879.41 |
| J2930 |
Injection, methylprednisolone sodium succinate, up to 125 mg |
83 |
66 |
$869.93 |
| 87338 |
|
111 |
110 |
$869.48 |
| 90681 |
|
7,376 |
7,336 |
$846.70 |
| Q0177 |
Hydroxyzine pamoate, 25 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 |
854 |
587 |
$845.07 |
| 0111A |
|
20 |
19 |
$830.77 |
| 95885 |
|
13 |
12 |
$779.59 |
| 86705 |
|
89 |
86 |
$754.92 |
| 87070 |
|
154 |
129 |
$715.78 |
| 90707 |
|
1,310 |
1,291 |
$712.86 |
| 0003A |
|
217 |
217 |
$705.03 |
| J2765 |
Injection, metoclopramide hcl, up to 10 mg |
96 |
89 |
$688.48 |
| 97116 |
|
28 |
14 |
$670.47 |
| 84403 |
|
43 |
42 |
$664.84 |
| 92083 |
|
13 |
12 |
$636.94 |
| 90716 |
|
1,379 |
1,359 |
$635.32 |
| C9803 |
Hospital outpatient clinic visit specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source |
29 |
27 |
$633.42 |
| 82040 |
|
97 |
96 |
$625.55 |
| 86431 |
|
94 |
91 |
$604.83 |
| 0013A |
|
291 |
291 |
$566.88 |
| 90700 |
|
1,007 |
1,003 |
$566.80 |
| 82977 |
|
113 |
102 |
$561.95 |
| 73060 |
|
29 |
24 |
$525.96 |
| J0500 |
Injection, dicyclomine hcl, up to 20 mg |
13 |
12 |
$505.40 |
| 96401 |
|
22 |
13 |
$482.16 |
| J2704 |
Injection, propofol, 10 mg |
1,225 |
1,130 |
$481.49 |
| J1953 |
Injection, levetiracetam, 10 mg |
18 |
12 |
$474.48 |
| 82952 |
|
150 |
144 |
$415.35 |
| J2919 |
Injection, methylprednisolone sodium succinate, 5 mg |
39 |
33 |
$400.19 |
| J0665 |
Injection, bupivicaine, not otherwise specified, 0.5 mg |
229 |
215 |
$390.57 |
| 90696 |
|
371 |
370 |
$374.91 |
| J1720 |
Injection, hydrocortisone sodium succinate, up to 100 mg |
20 |
12 |
$357.80 |
| 72070 |
|
12 |
12 |
$316.39 |
| S0028 |
Injection, famotidine, 20 mg |
83 |
58 |
$291.00 |
| 86039 |
|
30 |
25 |
$256.08 |
| 90723 |
|
1,730 |
1,721 |
$248.68 |
| 83883 |
|
13 |
13 |
$236.48 |
| 73090 |
|
13 |
12 |
$233.28 |
| 84436 |
|
42 |
29 |
$230.54 |
| 90480 |
|
19 |
17 |
$228.83 |
| 96402 |
|
12 |
12 |
$218.96 |
| 86682 |
|
22 |
20 |
$218.60 |
| 84146 |
|
31 |
28 |
$201.62 |
| 86376 |
|
26 |
26 |
$185.80 |
| 83520 |
|
24 |
12 |
$169.06 |
| 86787 |
|
15 |
14 |
$151.48 |
| J0780 |
Injection, prochlorperazine, up to 10 mg |
14 |
13 |
$142.84 |
| 90653 |
|
313 |
299 |
$141.93 |
| J1596 |
Injection, glycopyrrolate, 0.1 mg |
75 |
70 |
$112.47 |
| 81050 |
|
40 |
38 |
$111.06 |
| 84155 |
|
48 |
39 |
$109.89 |
| 80177 |
|
13 |
12 |
$107.94 |
| A6213 |
Foam dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., with any size adhesive border, each dressing |
18 |
12 |
$102.60 |
| 90620 |
|
131 |
128 |
$98.47 |
| Q9957 |
Injection, perflutren lipid microspheres, per ml |
58 |
57 |
$96.54 |
| 84425 |
|
13 |
13 |
$89.58 |
| 84132 |
|
46 |
42 |
$67.63 |
| 82150 |
|
13 |
12 |
$61.70 |
| 84590 |
|
13 |
13 |
$56.35 |
| 36592 |
|
855 |
723 |
$47.24 |
| A9585 |
Injection, gadobutrol, 0.1 ml |
428 |
414 |
$35.89 |
| 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 |
1,508 |
1,242 |
$30.74 |
| 90461 |
|
214 |
123 |
$14.58 |
| J2371 |
Injection, phenylephrine hydrochloride, 20 micrograms |
42 |
40 |
$13.86 |
| J7512 |
Prednisone, immediate release or delayed release, oral, 1 mg |
270 |
158 |
$6.60 |
| 36416 |
|
5,914 |
5,139 |
$2.65 |
| G0009 |
Administration of pneumococcal vaccine |
568 |
565 |
$0.66 |
| 90680 |
|
1,176 |
1,172 |
$0.09 |
| 90743 |
|
606 |
598 |
$0.05 |
| 91301 |
|
1,195 |
1,165 |
$0.02 |
| G0008 |
Administration of influenza virus vaccine |
2,902 |
2,834 |
$0.00 |
| 91307 |
|
1,606 |
1,458 |
$0.00 |
| 90698 |
|
1,457 |
1,435 |
$0.00 |
| 91305 |
|
471 |
440 |
$0.00 |
| G0103 |
Prostate cancer screening; prostate specific antigen test (psa) |
242 |
242 |
$0.00 |
| J1815 |
Injection, insulin, per 5 units |
151 |
61 |
$0.00 |
| J7060 |
5% dextrose/water (500 ml = 1 unit) |
56 |
24 |
$0.00 |
| G0010 |
Administration of hepatitis b vaccine |
52 |
52 |
$0.00 |
| 90381 |
|
61 |
61 |
$0.00 |
| J2003 |
Injection, lidocaine hydrochloride, 1 mg |
134 |
115 |
$0.00 |
| 91306 |
|
39 |
38 |
$0.00 |
| G0499 |
Hepatitis b screening in non-pregnant, high risk individual includes hepatitis b surface antigen (hbsag), antibodies to hbsag (anti-hbs) and antibodies to hepatitis b core antigen (anti-hbc), and is followed by a neutralizing confirmatory test, when performed, only for an initially reactive hbsag result |
14 |
14 |
$0.00 |
| G0101 |
Cervical or vaginal cancer screening; pelvic and clinical breast examination |
762 |
654 |
$0.00 |
| 91300 |
|
4,486 |
4,082 |
$0.00 |
| 91312 |
|
96 |
95 |
$0.00 |
| 91313 |
|
52 |
52 |
$0.00 |
| M1145 |
Most favored nation (mfn) model drug add-on amount, per dose, (do not bill with line items that have the jw modifier) |
22 |
21 |
$0.00 |
| 90380 |
|
76 |
75 |
$0.00 |
| 91311 |
|
58 |
57 |
$0.00 |