| Code | Description | Claims | Beneficiaries | Total Paid |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
68,971 |
63,618 |
$11.54M |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
36,121 |
32,954 |
$6.38M |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
177,443 |
158,070 |
$6.10M |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
53,914 |
50,447 |
$5.66M |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
68,895 |
58,584 |
$2.05M |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
28,580 |
26,108 |
$1.09M |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
19,007 |
17,365 |
$991K |
| 87502 |
Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets |
14,468 |
13,100 |
$884K |
| 80053 |
Comprehensive metabolic panel |
97,770 |
84,341 |
$664K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
18,329 |
16,359 |
$543K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
105,933 |
91,198 |
$542K |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
24,926 |
20,672 |
$540K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
18,421 |
16,356 |
$536K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
39,439 |
35,778 |
$470K |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
22,256 |
19,620 |
$414K |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
5,441 |
4,986 |
$395K |
| 93306 |
Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete |
2,184 |
2,066 |
$392K |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
15,751 |
4,157 |
$389K |
| 71045 |
Radiologic examination, chest; single view |
21,955 |
19,972 |
$349K |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
7,570 |
6,846 |
$347K |
| 76819 |
Fetal biophysical profile; without non-stress testing |
8,165 |
5,856 |
$299K |
| 81514 |
|
2,457 |
2,057 |
$281K |
| 96375 |
Therapeutic injection; each additional sequential IV push |
16,554 |
13,138 |
$276K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
1,801 |
1,626 |
$274K |
| 70450 |
Computed tomography, head or brain; without contrast material |
3,381 |
3,059 |
$245K |
| 36415 |
Collection of venous blood by venipuncture |
115,559 |
97,094 |
$244K |
| 59025 |
Fetal non-stress test |
2,714 |
2,253 |
$229K |
| 99215 |
Prolong outpt/office vis |
4,396 |
4,087 |
$229K |
| 96361 |
Intravenous infusion, hydration; each additional hour |
18,130 |
13,633 |
$229K |
| 83880 |
|
10,061 |
9,180 |
$228K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
6,950 |
6,337 |
$223K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
19,051 |
16,055 |
$199K |
| 80074 |
|
5,843 |
5,164 |
$189K |
| 81025 |
|
29,272 |
26,532 |
$184K |
| 87481 |
|
2,818 |
2,444 |
$170K |
| 84484 |
|
22,429 |
17,773 |
$165K |
| 93303 |
Transthoracic echocardiography for congenital cardiac anomalies, follow-up or limited study |
1,039 |
927 |
$164K |
| 86803 |
|
14,796 |
13,220 |
$158K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
6,840 |
5,503 |
$156K |
| 92507 |
Treatment of speech, language, voice, communication, and/or auditory processing disorder |
5,050 |
1,724 |
$148K |
| 80050 |
General health panel |
3,464 |
3,059 |
$127K |
| 88175 |
Cytopathology, cervical or vaginal, any reporting system; collected in preservative fluid, automated thin layer |
6,021 |
5,448 |
$124K |
| 99291 |
Critical care, evaluation and management of the critically ill patient, first 30-74 minutes |
199 |
192 |
$122K |
| 87801 |
Infectious agent detection by nucleic acid; amplified probe, multiple organisms |
2,636 |
2,439 |
$119K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
2,150 |
2,031 |
$116K |
| 80061 |
Lipid panel |
11,917 |
10,654 |
$110K |
| M0243 |
Intravenous infusion or subcutaneous injection, casirivimab and imdevimab includes infusion or injection, and post administration monitoring |
493 |
309 |
$110K |
| 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 |
2,667 |
2,170 |
$109K |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
3,786 |
2,851 |
$103K |
| 86703 |
|
9,538 |
8,760 |
$96K |
| 96413 |
Chemotherapy administration, intravenous infusion; up to 1 hour, single or initial substance |
1,629 |
957 |
$94K |
| 71046 |
Radiologic examination, chest; 2 views |
4,421 |
4,110 |
$90K |
| G0378 |
Hospital observation service, per hour |
640 |
305 |
$86K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
12,613 |
11,252 |
$83K |
| 93320 |
|
1,047 |
927 |
$80K |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
398 |
343 |
$79K |
| 93325 |
|
1,065 |
948 |
$74K |
| 81000 |
|
26,871 |
24,113 |
$72K |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
1,946 |
1,740 |
$72K |
| 43239 |
Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple |
310 |
266 |
$71K |
| 87661 |
Infectious agent detection by nucleic acid; Trichomonas vaginalis, amplified probe |
2,684 |
2,445 |
$68K |
| 87624 |
Infectious agent detection by nucleic acid; human papillomavirus (HPV), high-risk types |
2,369 |
2,169 |
$67K |
| 83690 |
|
12,937 |
11,660 |
$63K |
| 76801 |
|
1,192 |
1,097 |
$60K |
| 87651 |
Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe |
2,028 |
1,833 |
$59K |
| 84443 |
Thyroid stimulating hormone (TSH) |
4,846 |
4,225 |
$58K |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
1,308 |
1,199 |
$58K |
| 95819 |
|
530 |
503 |
$55K |
| 86003 |
|
1,016 |
466 |
$51K |
| 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 |
687 |
586 |
$47K |
| 86592 |
|
11,755 |
10,564 |
$42K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
1,171 |
1,127 |
$41K |
| 0001A |
|
1,145 |
1,127 |
$36K |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
5,283 |
4,677 |
$34K |
| 81003 |
|
20,902 |
18,659 |
$34K |
| J3490 |
Unclassified drugs |
3,042 |
2,237 |
$33K |
| 97530 |
Therapeutic activities, direct patient contact, each 15 minutes |
1,231 |
482 |
$29K |
| 0002A |
|
872 |
819 |
$28K |
| 69436 |
Tympanostomy (requiring insertion of ventilating tube), general anesthesia |
104 |
76 |
$25K |
| 87480 |
|
1,263 |
1,109 |
$24K |
| 87660 |
|
1,263 |
1,109 |
$24K |
| 87510 |
|
1,263 |
1,109 |
$24K |
| G0108 |
Diabetes outpatient self-management training services, individual, per 30 minutes |
876 |
732 |
$24K |
| 84439 |
|
3,469 |
2,813 |
$23K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
728 |
679 |
$23K |
| 82728 |
|
2,578 |
2,326 |
$22K |
| 96360 |
Intravenous infusion, hydration; initial, 31 minutes to 1 hour |
1,026 |
749 |
$22K |
| 74018 |
|
841 |
714 |
$20K |
| 87634 |
|
316 |
287 |
$20K |
| 76830 |
Ultrasound, transvaginal |
489 |
460 |
$19K |
| 87081 |
|
2,905 |
2,678 |
$19K |
| 73630 |
|
951 |
843 |
$18K |
| 84466 |
|
2,319 |
2,106 |
$17K |
| 19318 |
|
25 |
25 |
$17K |
| 99281 |
Emergency department visit for the evaluation and management, self-limited or minor |
228 |
219 |
$16K |
| 84481 |
|
1,794 |
1,426 |
$16K |
| 86762 |
|
1,318 |
1,146 |
$15K |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
11,948 |
10,439 |
$15K |
| 83516 |
|
1,539 |
473 |
$14K |
| J1756 |
Injection, iron sucrose, 1 mg |
304 |
92 |
$14K |
| 92134 |
|
810 |
715 |
$14K |
| 45380 |
Colonoscopy, flexible; with biopsy, single or multiple |
42 |
37 |
$13K |
| 84702 |
|
958 |
799 |
$12K |
| 90715 |
|
770 |
686 |
$11K |
| 80197 |
|
1,306 |
752 |
$11K |
| 76770 |
|
227 |
212 |
$11K |
| 20610 |
|
179 |
134 |
$11K |
| 73564 |
|
460 |
417 |
$10K |
| 86140 |
|
3,260 |
2,926 |
$10K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
659 |
625 |
$9K |
| 64721 |
|
35 |
30 |
$9K |
| 86850 |
|
1,692 |
1,468 |
$9K |
| 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 |
475 |
373 |
$9K |
| 95004 |
Percutaneous tests with allergenic extracts, immediate type reaction |
31 |
31 |
$9K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
212 |
202 |
$9K |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
5,259 |
4,747 |
$9K |
| 83540 |
|
2,339 |
2,119 |
$9K |
| 87340 |
|
871 |
794 |
$8K |
| 51798 |
|
158 |
122 |
$8K |
| 96367 |
|
467 |
266 |
$7K |
| 87400 |
|
1,028 |
511 |
$7K |
| 82550 |
|
1,801 |
1,656 |
$7K |
| 83655 |
|
590 |
557 |
$7K |
| 62323 |
|
24 |
24 |
$7K |
| 31575 |
|
13 |
13 |
$6K |
| 86593 |
|
1,575 |
1,373 |
$6K |
| J2469 |
Injection, palonosetron hcl, 25 mcg |
159 |
96 |
$6K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
97 |
96 |
$6K |
| 64483 |
|
46 |
40 |
$5K |
| J2270 |
Injection, morphine sulfate, up to 10 mg |
3,930 |
3,421 |
$5K |
| 95816 |
|
41 |
39 |
$5K |
| 20611 |
|
16 |
13 |
$5K |
| 83021 |
|
297 |
271 |
$5K |
| 87653 |
|
129 |
125 |
$4K |
| 82962 |
|
1,947 |
1,738 |
$4K |
| 86900 |
|
1,678 |
1,456 |
$4K |
| 86901 |
|
1,732 |
1,455 |
$4K |
| C1713 |
Anchor/screw for opposing bone-to-bone or soft tissue-to-bone (implantable) |
15 |
12 |
$4K |
| U0002 |
2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc |
117 |
106 |
$4K |
| J1030 |
Injection, methylprednisolone acetate, 40 mg |
842 |
772 |
$4K |
| 85610 |
|
1,674 |
1,429 |
$4K |
| 80055 |
|
198 |
174 |
$4K |
| 74019 |
|
157 |
143 |
$4K |
| 93017 |
|
91 |
86 |
$4K |
| 83735 |
|
868 |
752 |
$4K |
| 90686 |
|
601 |
537 |
$4K |
| 82950 |
|
787 |
739 |
$4K |
| 85027 |
|
699 |
642 |
$4K |
| 73030 |
|
179 |
163 |
$4K |
| 83020 |
|
327 |
273 |
$3K |
| 93296 |
|
683 |
586 |
$3K |
| 73130 |
|
194 |
176 |
$3K |
| 86300 |
|
181 |
171 |
$3K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
481 |
428 |
$3K |
| 82378 |
|
205 |
194 |
$3K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
206 |
95 |
$3K |
| 45385 |
Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) |
23 |
13 |
$3K |
| 83605 |
|
449 |
378 |
$3K |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
127 |
115 |
$3K |
| 82570 |
|
827 |
745 |
$3K |
| 95806 |
|
28 |
26 |
$3K |
| 77336 |
|
61 |
24 |
$3K |
| J7120 |
Ringers lactate infusion, up to 1000 cc |
5,251 |
4,298 |
$3K |
| 87210 |
|
574 |
492 |
$3K |
| 83615 |
|
791 |
697 |
$3K |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
131 |
110 |
$3K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
65 |
62 |
$2K |
| 96376 |
|
198 |
132 |
$2K |
| 86696 |
|
143 |
132 |
$2K |
| 85652 |
|
1,647 |
1,484 |
$2K |
| 96417 |
|
173 |
107 |
$2K |
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
11,337 |
8,071 |
$2K |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
4,040 |
3,459 |
$2K |
| J1642 |
Injection, heparin sodium, (heparin lock flush), per 10 units |
2,411 |
1,480 |
$2K |
| 94761 |
|
258 |
210 |
$2K |
| 82043 |
|
404 |
381 |
$2K |
| 82784 |
|
294 |
225 |
$2K |
| 83993 |
|
121 |
110 |
$2K |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
198 |
190 |
$2K |
| 76820 |
|
56 |
40 |
$2K |
| J7030 |
Infusion, normal saline solution , 1000 cc |
1,500 |
1,342 |
$2K |
| 72082 |
|
26 |
26 |
$2K |
| 97802 |
|
168 |
156 |
$2K |
| 80076 |
|
234 |
220 |
$2K |
| 86364 |
|
348 |
136 |
$2K |
| 82607 |
|
180 |
151 |
$2K |
| 86769 |
|
100 |
31 |
$2K |
| 86695 |
|
143 |
132 |
$2K |
| 97803 |
|
259 |
244 |
$2K |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
1,976 |
1,194 |
$2K |
| 72100 |
|
61 |
55 |
$2K |
| 85018 |
|
659 |
626 |
$2K |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
3,767 |
3,146 |
$2K |
| 97161 |
|
28 |
27 |
$2K |
| 92567 |
|
151 |
131 |
$2K |
| 73562 |
|
69 |
64 |
$1K |
| 80069 |
|
381 |
346 |
$1K |
| 96415 |
|
60 |
37 |
$1K |
| 82785 |
|
113 |
96 |
$1K |
| 99152 |
|
347 |
275 |
$1K |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
729 |
578 |
$1K |
| 85730 |
|
357 |
308 |
$1K |
| 83525 |
|
116 |
103 |
$1K |
| 0031A |
|
76 |
65 |
$1K |
| 94010 |
|
39 |
39 |
$1K |
| 78452 |
Myocardial perfusion imaging, tomographic (SPECT); multiple studies at rest and/or stress |
13 |
13 |
$1K |
| 90661 |
|
169 |
160 |
$1K |
| 82542 |
|
61 |
42 |
$1K |
| 80179 |
|
86 |
85 |
$995.68 |
| 11721 |
|
215 |
183 |
$982.83 |
| 80177 |
|
87 |
83 |
$979.71 |
| 80320 |
|
87 |
66 |
$971.12 |
| 81002 |
|
364 |
317 |
$922.87 |
| 94060 |
|
24 |
24 |
$916.90 |
| 85651 |
|
390 |
351 |
$906.81 |
| 82105 |
|
106 |
94 |
$882.14 |
| J3301 |
Injection, triamcinolone acetonide, not otherwise specified, 10 mg |
235 |
214 |
$879.37 |
| 85660 |
|
191 |
158 |
$832.01 |
| 83970 |
|
40 |
36 |
$795.50 |
| 90834 |
Psychotherapy, 45 minutes with patient |
64 |
40 |
$781.34 |
| 82746 |
|
88 |
80 |
$748.58 |
| 84156 |
|
394 |
353 |
$714.25 |
| J1010 |
Injection, methylprednisolone acetate, 1 mg |
202 |
164 |
$688.58 |
| 27096 |
|
15 |
13 |
$683.86 |
| 87040 |
|
104 |
53 |
$635.90 |
| J0665 |
Injection, bupivicaine, not otherwise specified, 0.5 mg |
945 |
808 |
$616.40 |
| 36000 |
|
36 |
25 |
$579.82 |
| 87807 |
|
48 |
42 |
$544.51 |
| 87522 |
Neg quan hep c or qual rna |
17 |
13 |
$521.39 |
| 86160 |
|
78 |
39 |
$482.40 |
| 73610 |
|
27 |
25 |
$478.55 |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
20 |
15 |
$455.08 |
| 69210 |
|
14 |
13 |
$453.45 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
99 |
92 |
$428.90 |
| 82150 |
|
75 |
67 |
$381.48 |
| 99415 |
Prolong outpt/office vis |
554 |
302 |
$372.61 |
| 90656 |
|
90 |
77 |
$370.91 |
| J2930 |
Injection, methylprednisolone sodium succinate, up to 125 mg |
188 |
124 |
$319.75 |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
27 |
27 |
$318.64 |
| 96366 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour |
26 |
12 |
$316.36 |
| 96161 |
|
35 |
31 |
$302.44 |
| 95886 |
|
25 |
24 |
$301.26 |
| 85379 |
|
49 |
40 |
$299.79 |
| 93880 |
|
14 |
13 |
$293.89 |
| 84100 |
|
98 |
74 |
$269.76 |
| 81001 |
|
62 |
61 |
$263.64 |
| 82948 |
|
134 |
112 |
$250.07 |
| J1200 |
Injection, diphenhydramine hcl, up to 50 mg |
324 |
221 |
$244.56 |
| 84146 |
|
15 |
12 |
$236.05 |
| 86225 |
|
32 |
26 |
$231.90 |
| 83001 |
|
20 |
14 |
$226.12 |
| 84153 |
|
17 |
13 |
$223.63 |
| 85045 |
|
103 |
94 |
$202.10 |
| 94729 |
|
31 |
26 |
$193.76 |
| 86038 |
|
25 |
24 |
$178.00 |
| Q9966 |
Low osmolar contrast material, 200-299 mg/ml iodine concentration, per ml |
1,644 |
1,436 |
$175.54 |
| J2704 |
Injection, propofol, 10 mg |
4,017 |
3,319 |
$155.03 |
| J2550 |
Injection, promethazine hcl, up to 50 mg |
169 |
146 |
$147.89 |
| 86706 |
|
29 |
25 |
$146.22 |
| J1170 |
Injection, hydromorphone, up to 4 mg |
84 |
77 |
$140.24 |
| A9585 |
Injection, gadobutrol, 0.1 ml |
29 |
27 |
$135.38 |
| 99416 |
Prolong outpt/office vis |
210 |
143 |
$130.10 |
| J1040 |
Injection, methylprednisolone acetate, 80 mg |
29 |
27 |
$128.96 |
| 87338 |
|
17 |
17 |
$111.62 |
| 84480 |
|
16 |
14 |
$110.97 |
| 87088 |
|
15 |
13 |
$106.77 |
| 83010 |
|
14 |
13 |
$104.68 |
| 96127 |
|
37 |
31 |
$104.66 |
| 0352U |
|
21 |
17 |
$86.73 |
| 82977 |
|
19 |
12 |
$80.34 |
| 87147 |
|
16 |
12 |
$60.93 |
| J7050 |
Infusion, normal saline solution, 250 cc |
41 |
24 |
$59.82 |
| Q0111 |
Wet mounts, including preparations of vaginal, cervical or skin specimens |
57 |
49 |
$55.07 |
| J0702 |
Injection, betamethasone acetate 3 mg and betamethasone sodium phosphate 3 mg |
15 |
13 |
$38.74 |
| J0690 |
Injection, cefazolin sodium, 500 mg |
247 |
199 |
$35.89 |
| 90480 |
|
16 |
13 |
$28.13 |
| 94726 |
|
12 |
12 |
$25.90 |
| J2003 |
Injection, lidocaine hydrochloride, 1 mg |
14 |
12 |
$1.99 |
| 00813 |
|
57 |
55 |
$0.00 |
| J2001 |
Injection, lidocaine hcl for intravenous infusion, 10 mg |
35 |
28 |
$0.00 |
| 82657 |
|
13 |
13 |
$0.00 |
| 91303 |
|
65 |
64 |
$0.00 |
| 00126 |
|
14 |
12 |
$0.00 |
| 99490 |
Ccm add 20min |
628 |
626 |
$0.00 |
| 91300 |
|
1,876 |
1,674 |
$0.00 |
| 01810 |
|
40 |
35 |
$0.00 |
| Q0244 |
Injection, casirivimab and imdevimab, 1200 mg |
311 |
268 |
$0.00 |
| 00402 |
|
25 |
25 |
$0.00 |