| Code | Description | Claims | Beneficiaries | Total Paid |
| 0450 |
Emergency room services |
294,228 |
254,117 |
$14.80M |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
94,333 |
84,782 |
$4.68M |
| 99281 |
Emergency department visit for the evaluation and management, self-limited or minor |
28,217 |
23,278 |
$4.18M |
| 0241U |
Neonatal screening for hereditary disorders, genomic sequence analysis panel |
36,825 |
34,628 |
$3.34M |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
208,298 |
176,925 |
$3.05M |
| 70450 |
Computed tomography, head or brain; without contrast material |
26,560 |
24,855 |
$2.74M |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
103,774 |
92,984 |
$2.64M |
| 96375 |
Therapeutic injection; each additional sequential IV push |
72,596 |
64,078 |
$2.54M |
| Z7502 |
|
63,986 |
63,601 |
$2.46M |
| 74160 |
|
10,607 |
9,818 |
$1.92M |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
8,300 |
7,997 |
$1.82M |
| 0762 |
|
14,260 |
7,355 |
$1.76M |
| 85610 |
|
135,333 |
123,242 |
$1.67M |
| 80048 |
Basic metabolic panel (calcium, ionized) |
207,976 |
174,591 |
$1.63M |
| 96361 |
Intravenous infusion, hydration; each additional hour |
74,181 |
66,692 |
$1.51M |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
29,683 |
26,826 |
$1.47M |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
5,981 |
5,394 |
$1.28M |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
41,301 |
37,120 |
$1.10M |
| 96360 |
Intravenous infusion, hydration; initial, 31 minutes to 1 hour |
19,437 |
18,688 |
$1.02M |
| 71275 |
Computed tomographic angiography, chest, with contrast material |
4,944 |
4,655 |
$936K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
7,713 |
7,401 |
$925K |
| 80076 |
|
137,445 |
122,778 |
$912K |
| 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 |
18,514 |
16,151 |
$903K |
| 71045 |
Radiologic examination, chest; single view |
78,796 |
72,801 |
$897K |
| 83880 |
|
34,543 |
32,222 |
$893K |
| 83690 |
|
118,730 |
107,041 |
$836K |
| 0301 |
|
10,774 |
9,055 |
$802K |
| 0250 |
|
168,874 |
72,324 |
$796K |
| 84484 |
|
65,840 |
57,254 |
$757K |
| J7030 |
Infusion, normal saline solution , 1000 cc |
94,998 |
81,603 |
$667K |
| U0002 |
2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc |
14,079 |
13,192 |
$657K |
| 99199 |
Unlisted special service, procedure or report |
15,898 |
13,800 |
$650K |
| Z7610 |
|
53,743 |
30,218 |
$589K |
| 0160 |
|
5,713 |
3,303 |
$577K |
| 72125 |
Computed tomography, cervical spine; without contrast material |
3,413 |
3,327 |
$543K |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
6,400 |
5,923 |
$513K |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
75,167 |
66,271 |
$491K |
| 71046 |
Radiologic examination, chest; 2 views |
22,480 |
21,282 |
$477K |
| 76700 |
Ultrasound, abdominal, real time with image documentation; complete |
5,965 |
5,702 |
$459K |
| 74150 |
|
3,512 |
3,339 |
$434K |
| 93971 |
|
4,129 |
3,919 |
$421K |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
7,289 |
6,898 |
$416K |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
6,956 |
6,650 |
$393K |
| 76801 |
|
7,322 |
6,332 |
$391K |
| 76830 |
Ultrasound, transvaginal |
6,117 |
5,826 |
$386K |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
51,008 |
47,007 |
$379K |
| 0119 |
|
287 |
256 |
$363K |
| J2270 |
Injection, morphine sulfate, up to 10 mg |
46,687 |
40,146 |
$341K |
| 70486 |
|
2,577 |
2,484 |
$334K |
| 93970 |
|
2,036 |
1,959 |
$329K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
11,605 |
11,220 |
$323K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
11,668 |
11,277 |
$322K |
| J3490 |
Unclassified drugs |
78,573 |
41,250 |
$310K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
6,770 |
5,973 |
$307K |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
49,992 |
46,714 |
$302K |
| 84702 |
|
29,926 |
27,498 |
$296K |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
4,706 |
4,219 |
$288K |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
13,131 |
11,112 |
$272K |
| 81001 |
|
78,764 |
72,989 |
$262K |
| 93306 |
Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete |
1,525 |
1,461 |
$237K |
| 82947 |
|
33,986 |
25,583 |
$236K |
| 0270 |
|
63,554 |
32,268 |
$212K |
| 70551 |
Magnetic resonance imaging, brain; without contrast material |
1,006 |
961 |
$202K |
| 87040 |
|
11,893 |
11,293 |
$175K |
| 72100 |
|
5,360 |
5,174 |
$162K |
| 96366 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour |
2,751 |
2,265 |
$162K |
| 73630 |
|
6,083 |
5,693 |
$153K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
3,335 |
3,082 |
$148K |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
26,371 |
24,177 |
$147K |
| 96376 |
|
5,933 |
5,217 |
$135K |
| 73610 |
|
5,212 |
4,965 |
$126K |
| 73130 |
|
4,819 |
4,521 |
$125K |
| 0761 |
|
4,505 |
3,791 |
$125K |
| 83605 |
|
12,486 |
11,603 |
$121K |
| 73562 |
|
4,728 |
4,378 |
$120K |
| 73030 |
|
5,093 |
4,798 |
$117K |
| 36415 |
Collection of venous blood by venipuncture |
79,063 |
66,045 |
$113K |
| 85730 |
|
17,358 |
16,678 |
$104K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
6,760 |
6,349 |
$95K |
| 70496 |
|
543 |
522 |
$94K |
| J1815 |
Injection, insulin, per 5 units |
11,661 |
6,139 |
$93K |
| J1650 |
Injection, enoxaparin sodium, 10 mg |
3,044 |
1,636 |
$92K |
| 87631 |
|
2,191 |
2,161 |
$91K |
| 90715 |
|
2,977 |
2,937 |
$90K |
| 87186 |
|
12,414 |
11,878 |
$89K |
| 72131 |
|
691 |
675 |
$85K |
| 73564 |
|
2,446 |
2,348 |
$83K |
| 73110 |
|
2,842 |
2,696 |
$83K |
| 85379 |
|
8,372 |
8,082 |
$77K |
| 10060 |
|
1,888 |
1,771 |
$77K |
| 71260 |
Computed tomography, thorax, diagnostic; with contrast material |
487 |
476 |
$73K |
| J1170 |
Injection, hydromorphone, up to 4 mg |
10,083 |
7,839 |
$71K |
| 0420 |
|
1,690 |
1,052 |
$70K |
| 81003 |
|
28,861 |
27,211 |
$69K |
| 70491 |
|
451 |
438 |
$69K |
| 82803 |
|
4,625 |
4,387 |
$66K |
| 73502 |
|
2,391 |
2,254 |
$65K |
| 80305 |
|
5,678 |
4,828 |
$63K |
| 80053 |
Comprehensive metabolic panel |
6,486 |
6,243 |
$63K |
| 73590 |
|
2,642 |
2,503 |
$63K |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
4,646 |
4,439 |
$63K |
| 74022 |
|
1,776 |
1,699 |
$63K |
| 73080 |
|
2,094 |
1,999 |
$60K |
| 74018 |
|
3,214 |
2,992 |
$60K |
| J1200 |
Injection, diphenhydramine hcl, up to 50 mg |
11,064 |
9,332 |
$59K |
| 83735 |
|
8,985 |
7,501 |
$59K |
| 76870 |
|
1,320 |
1,259 |
$58K |
| J2060 |
Injection, lorazepam, 2 mg |
10,099 |
8,247 |
$57K |
| J2274 |
Injection, morphine sulfate, preservative-free for epidural or intrathecal use, 10 mg |
3,560 |
3,235 |
$52K |
| 70498 |
|
348 |
337 |
$51K |
| J7042 |
5% dextrose/normal saline (500 ml = 1 unit) |
678 |
532 |
$50K |
| 94644 |
|
2,624 |
2,506 |
$45K |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
23,554 |
22,665 |
$44K |
| 87077 |
|
6,488 |
6,190 |
$41K |
| 73140 |
|
2,078 |
1,984 |
$40K |
| J1644 |
Injection, heparin sodium, per 1000 units |
3,102 |
1,323 |
$40K |
| 84443 |
Thyroid stimulating hormone (TSH) |
3,084 |
2,951 |
$38K |
| 80061 |
Lipid panel |
4,487 |
4,225 |
$37K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
1,143 |
1,031 |
$36K |
| 72040 |
|
1,364 |
1,328 |
$35K |
| 86900 |
|
3,075 |
2,990 |
$34K |
| 82550 |
|
6,098 |
5,636 |
$33K |
| J7040 |
Infusion, normal saline solution, sterile (500 ml = 1 unit) |
1,364 |
1,214 |
$32K |
| J2930 |
Injection, methylprednisolone sodium succinate, up to 125 mg |
3,383 |
3,172 |
$32K |
| 73090 |
|
1,683 |
1,596 |
$32K |
| J1630 |
Injection, haloperidol, up to 5 mg |
5,371 |
4,384 |
$31K |
| 12002 |
|
446 |
444 |
$30K |
| 86850 |
|
6,827 |
6,612 |
$30K |
| J3370 |
Injection, vancomycin hcl, 500 mg |
2,064 |
1,398 |
$28K |
| J2765 |
Injection, metoclopramide hcl, up to 10 mg |
5,495 |
4,974 |
$26K |
| 99221 |
|
421 |
342 |
$26K |
| 86140 |
|
5,283 |
5,141 |
$25K |
| J2543 |
Injection, piperacillin sodium/tazobactam sodium, 1 gram/0.125 grams (1.125 grams) |
1,934 |
1,555 |
$24K |
| 97802 |
|
397 |
380 |
$23K |
| 71250 |
|
176 |
171 |
$22K |
| J0561 |
Injection, penicillin g benzathine, 100,000 units |
213 |
208 |
$22K |
| 12001 |
|
168 |
166 |
$22K |
| 84100 |
|
4,028 |
3,201 |
$21K |
| 87210 |
|
6,208 |
5,992 |
$21K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
2,640 |
2,563 |
$21K |
| 86901 |
|
7,059 |
6,824 |
$20K |
| G0378 |
Hospital observation service, per hour |
102 |
78 |
$20K |
| 87070 |
|
3,056 |
2,945 |
$20K |
| 29125 |
|
623 |
607 |
$19K |
| J0360 |
Injection, hydralazine hcl, up to 20 mg |
2,176 |
1,887 |
$19K |
| 76770 |
|
270 |
260 |
$18K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
451 |
436 |
$18K |
| 59025 |
Fetal non-stress test |
1,643 |
1,323 |
$17K |
| J2001 |
Injection, lidocaine hcl for intravenous infusion, 10 mg |
4,783 |
4,667 |
$17K |
| Z9725 |
|
384 |
383 |
$17K |
| 85652 |
|
7,359 |
3,985 |
$16K |
| J7060 |
5% dextrose/water (500 ml = 1 unit) |
2,992 |
2,500 |
$16K |
| J1953 |
Injection, levetiracetam, 10 mg |
1,699 |
1,485 |
$16K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
4,024 |
3,949 |
$16K |
| J1940 |
Injection, furosemide, up to 20 mg |
3,610 |
2,501 |
$15K |
| 70480 |
|
109 |
106 |
$15K |
| 80074 |
|
360 |
340 |
$15K |
| 29515 |
|
465 |
453 |
$15K |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
3,027 |
2,872 |
$14K |
| 96367 |
|
477 |
443 |
$14K |
| 70547 |
|
114 |
108 |
$14K |
| J0780 |
Injection, prochlorperazine, up to 10 mg |
1,369 |
1,319 |
$13K |
| J1171 |
Injection, hydromorphone, 0.1 mg |
287 |
238 |
$13K |
| 59050 |
|
2,051 |
1,693 |
$13K |
| 70544 |
|
123 |
116 |
$12K |
| 72070 |
|
472 |
460 |
$12K |
| 0760 |
|
626 |
572 |
$12K |
| 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 |
6,244 |
6,091 |
$12K |
| A4649 |
Surgical supply; miscellaneous |
12,140 |
6,813 |
$12K |
| 73552 |
|
548 |
513 |
$11K |
| 99499 |
|
38 |
24 |
$11K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
205 |
200 |
$11K |
| 93880 |
|
84 |
81 |
$11K |
| 73060 |
|
435 |
423 |
$10K |
| 97750 |
|
268 |
254 |
$9K |
| 97161 |
|
219 |
215 |
$9K |
| 81025 |
|
1,850 |
1,814 |
$8K |
| 90686 |
|
561 |
548 |
$8K |
| 87184 |
|
1,600 |
1,516 |
$8K |
| J7120 |
Ringers lactate infusion, up to 1000 cc |
1,543 |
1,177 |
$8K |
| 0324 |
|
698 |
655 |
$7K |
| 99070 |
|
3,518 |
1,352 |
$7K |
| J3475 |
Injection, magnesium sulfate, per 500 mg |
1,563 |
1,399 |
$7K |
| 73660 |
|
448 |
429 |
$7K |
| 11042 |
Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm |
303 |
156 |
$7K |
| J1741 |
Injection, ibuprofen, 100 mg |
631 |
608 |
$7K |
| 84145 |
|
409 |
397 |
$7K |
| J0461 |
Injection, atropine sulfate, 0.01 mg |
863 |
835 |
$7K |
| 84439 |
|
882 |
850 |
$6K |
| 70360 |
|
218 |
216 |
$6K |
| 80185 |
|
542 |
483 |
$6K |
| 70487 |
|
47 |
47 |
$6K |
| 82805 |
|
176 |
166 |
$6K |
| 73700 |
|
49 |
48 |
$6K |
| C9113 |
Injection, pantoprazole sodium, per vial |
1,018 |
768 |
$5K |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
611 |
530 |
$5K |
| J3480 |
Injection, potassium chloride, per 2 meq |
300 |
226 |
$4K |
| 71101 |
|
154 |
150 |
$4K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
696 |
648 |
$4K |
| 76641 |
|
67 |
64 |
$4K |
| 71020 |
|
191 |
131 |
$4K |
| 76819 |
Fetal biophysical profile; without non-stress testing |
110 |
92 |
$3K |
| 82140 |
|
318 |
293 |
$3K |
| 84481 |
|
276 |
251 |
$3K |
| A9270 |
Non-covered item or service |
1,679 |
601 |
$3K |
| J2358 |
Injection, olanzapine, long-acting, 1 mg |
72 |
62 |
$3K |
| 0636 |
|
1,584 |
1,379 |
$3K |
| 71010 |
|
325 |
307 |
$3K |
| 82728 |
|
303 |
296 |
$3K |
| J7512 |
Prednisone, immediate release or delayed release, oral, 1 mg |
1,108 |
1,020 |
$3K |
| J2920 |
Injection, methylprednisolone sodium succinate, up to 40 mg |
265 |
232 |
$3K |
| J1956 |
Injection, levofloxacin, 250 mg |
98 |
81 |
$3K |
| 72128 |
|
13 |
12 |
$2K |
| 86701 |
|
288 |
282 |
$2K |
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
193 |
155 |
$2K |
| 72192 |
|
13 |
13 |
$2K |
| J2919 |
Injection, methylprednisolone sodium succinate, 5 mg |
368 |
337 |
$2K |
| J2550 |
Injection, promethazine hcl, up to 50 mg |
278 |
268 |
$2K |
| Z7500 |
|
51 |
43 |
$2K |
| 93000 |
|
56 |
53 |
$2K |
| 12011 |
|
49 |
48 |
$2K |
| 83615 |
|
333 |
325 |
$2K |
| 70490 |
|
14 |
14 |
$2K |
| J7050 |
Infusion, normal saline solution, 250 cc |
447 |
371 |
$2K |
| J3360 |
Injection, diazepam, up to 5 mg |
107 |
95 |
$1K |
| 72148 |
Magnetic resonance imaging, lumbar spine; without contrast material |
12 |
12 |
$1K |
| J0456 |
Injection, azithromycin, 500 mg |
294 |
257 |
$1K |
| J8540 |
Dexamethasone, oral, 0.25 mg |
554 |
537 |
$1K |
| 86592 |
|
421 |
407 |
$1K |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
103 |
91 |
$1K |
| A0429 |
Ambulance service, basic life support, emergency transport (bls-emergency) |
34 |
28 |
$1K |
| J1165 |
Injection, phenytoin sodium, per 50 mg |
109 |
98 |
$1K |
| 87081 |
|
374 |
351 |
$1K |
| 87205 |
|
410 |
388 |
$1K |
| J0171 |
Injection, adrenalin, epinephrine, 0.1 mg |
40 |
38 |
$1K |
| 90656 |
|
30 |
30 |
$970.18 |
| 90935 |
Hemodialysis procedure with single evaluation by a physician |
38 |
24 |
$839.56 |
| J7510 |
Prednisolone oral, per 5 mg |
160 |
160 |
$797.59 |
| 27502 |
|
12 |
12 |
$787.19 |
| J2470 |
Injection, pantoprazole sodium, 40 mg |
176 |
142 |
$745.45 |
| 85007 |
|
854 |
788 |
$685.94 |
| 86922 |
|
25 |
25 |
$662.76 |
| 84550 |
|
146 |
141 |
$652.57 |
| 90714 |
|
60 |
59 |
$652.56 |
| 94664 |
|
94 |
61 |
$639.29 |
| 73000 |
|
25 |
24 |
$619.43 |
| J2003 |
Injection, lidocaine hydrochloride, 1 mg |
88 |
88 |
$494.69 |
| 86308 |
|
129 |
128 |
$410.44 |
| 97162 |
|
15 |
15 |
$388.27 |
| 72170 |
|
32 |
26 |
$380.33 |
| 87181 |
|
301 |
278 |
$358.90 |
| J0295 |
Injection, ampicillin sodium/sulbactam sodium, per 1.5 gm |
56 |
42 |
$333.15 |
| 92558 |
|
115 |
115 |
$330.05 |
| 0430 |
|
15 |
12 |
$321.44 |
| Q2039 |
Influenza virus vaccine, not otherwise specified |
18 |
13 |
$316.04 |
| J3410 |
Injection, hydroxyzine hcl, up to 25 mg |
28 |
26 |
$303.84 |
| 73560 |
|
14 |
12 |
$284.43 |
| 36600 |
|
35 |
30 |
$271.86 |
| 85044 |
|
78 |
64 |
$263.10 |
| 87169 |
|
97 |
93 |
$238.20 |
| 0320 |
|
49 |
44 |
$229.52 |
| 0300 |
|
422 |
377 |
$226.99 |
| 85027 |
|
59 |
54 |
$223.62 |
| 84478 |
|
43 |
42 |
$198.25 |
| 83540 |
|
42 |
39 |
$190.26 |
| 82746 |
|
25 |
24 |
$173.81 |
| S0119 |
Ondansetron, oral, 4 mg (for circumstances falling under the medicare statute, use hcpcs q code) |
57 |
56 |
$167.48 |
| J0690 |
Injection, cefazolin sodium, 500 mg |
49 |
40 |
$133.66 |
| 10061 |
|
14 |
14 |
$120.00 |
| 0259 |
|
71 |
70 |
$114.40 |
| 86593 |
|
21 |
21 |
$90.24 |
| 99072 |
|
253 |
145 |
$73.47 |
| 0310 |
|
316 |
294 |
$49.60 |
| 0410 |
|
13 |
13 |
$49.10 |
| 85651 |
|
22 |
22 |
$46.11 |
| 0730 |
|
204 |
188 |
$29.84 |
| 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 |
59 |
53 |
$8.35 |
| Q9963 |
High osmolar contrast material, 350-399 mg/ml iodine concentration, per ml |
14 |
14 |
$3.80 |
| 0307 |
|
141 |
129 |
$0.00 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
92 |
90 |
$0.00 |
| 0306 |
|
191 |
175 |
$0.00 |
| 0305 |
|
29 |
27 |
$0.00 |
| J7613 |
Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg |
91 |
77 |
$0.00 |
| S9445 |
Patient education, not otherwise classified, non-physician provider, individual, per session |
429 |
192 |
$0.00 |
| 20553 |
|
159 |
149 |
$0.00 |
| 0949 |
|
27 |
24 |
$0.00 |
| Q4051 |
Splint supplies, miscellaneous (includes thermoplastics, strapping, fasteners, padding and other supplies) |
44 |
20 |
$0.00 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
129 |
120 |
$0.00 |
| 0258 |
|
26 |
26 |
$0.00 |
| 0302 |
|
68 |
57 |
$0.00 |
| J3301 |
Injection, triamcinolone acetonide, not otherwise specified, 10 mg |
24 |
24 |
$0.00 |
| Q0144 |
Azithromycin dihydrate, oral, capsules/powder, 1 gram |
84 |
80 |
$0.00 |
| 96413 |
Chemotherapy administration, intravenous infusion; up to 1 hour, single or initial substance |
62 |
48 |
$0.00 |
| 0402 |
|
15 |
15 |
$0.00 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
27 |
15 |
$0.00 |
| 72275 |
|
12 |
12 |
$0.00 |