| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
118,361 |
106,347 |
$27.91M |
| 0450 |
Emergency room services |
116,022 |
101,185 |
$26.58M |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
10,313 |
9,550 |
$1.96M |
| G0383 |
Level 4 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) |
6,221 |
5,276 |
$1.49M |
| 0360 |
|
6,327 |
3,334 |
$726K |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
2,482 |
2,428 |
$584K |
| Z7502 |
|
15,153 |
15,015 |
$565K |
| 99070 |
|
91,945 |
53,840 |
$509K |
| 93458 |
|
515 |
487 |
$460K |
| 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) |
1,706 |
1,486 |
$406K |
| 0272 |
|
6,179 |
5,838 |
$395K |
| 99281 |
Emergency department visit for the evaluation and management, self-limited or minor |
1,295 |
1,244 |
$311K |
| 99221 |
|
2,041 |
1,978 |
$302K |
| 0710 |
|
3,975 |
3,720 |
$296K |
| G0384 |
Level 5 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) |
1,017 |
955 |
$245K |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
1,603 |
1,542 |
$215K |
| 0370 |
|
122 |
120 |
$209K |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
5,334 |
5,190 |
$186K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
1,088 |
1,071 |
$175K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
6,047 |
5,907 |
$151K |
| G0381 |
Level 2 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) |
547 |
493 |
$131K |
| J3490 |
Unclassified drugs |
14,734 |
10,514 |
$103K |
| 99231 |
Subsequent hospital care, per day, straightforward or low complexity |
1,494 |
1,432 |
$81K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
1,794 |
1,734 |
$77K |
| 99218 |
|
509 |
506 |
$77K |
| 99238 |
Hospital discharge day management, 30 minutes or less |
2,100 |
2,040 |
$72K |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
32,702 |
20,077 |
$68K |
| 99152 |
|
1,223 |
1,198 |
$61K |
| 99232 |
Subsequent hospital care, per day, moderate complexity |
1,013 |
973 |
$56K |
| 77336 |
|
82 |
27 |
$51K |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
17,620 |
17,010 |
$49K |
| 88312 |
|
2,353 |
2,296 |
$47K |
| 80053 |
Comprehensive metabolic panel |
103,426 |
91,450 |
$40K |
| 88307 |
|
854 |
824 |
$39K |
| 43239 |
Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple |
1,351 |
1,332 |
$38K |
| 85027 |
|
125,399 |
108,595 |
$33K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
57,803 |
52,461 |
$31K |
| 93798 |
|
1,347 |
311 |
$30K |
| 0762 |
|
1,506 |
1,398 |
$26K |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
33,167 |
30,754 |
$26K |
| 99217 |
|
522 |
521 |
$24K |
| 99153 |
Mod sedat endo service >5yrs |
822 |
805 |
$23K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
19,439 |
17,904 |
$23K |
| 71045 |
Radiologic examination, chest; single view |
48,435 |
45,027 |
$22K |
| 70450 |
Computed tomography, head or brain; without contrast material |
14,773 |
14,271 |
$21K |
| 99224 |
|
358 |
353 |
$20K |
| 0250 |
|
68,538 |
43,556 |
$20K |
| 93306 |
Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete |
627 |
609 |
$20K |
| 82803 |
|
2,053 |
1,938 |
$19K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
343 |
315 |
$18K |
| 88304 |
|
1,575 |
1,511 |
$18K |
| 76642 |
|
274 |
236 |
$17K |
| 71275 |
Computed tomographic angiography, chest, with contrast material |
2,563 |
2,513 |
$17K |
| 96361 |
Intravenous infusion, hydration; each additional hour |
22,195 |
19,562 |
$16K |
| G0378 |
Hospital observation service, per hour |
2,589 |
2,390 |
$15K |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
6,796 |
6,380 |
$15K |
| 47562 |
|
60 |
52 |
$15K |
| 76937 |
|
731 |
673 |
$14K |
| 45380 |
Colonoscopy, flexible; with biopsy, single or multiple |
543 |
536 |
$13K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
3,472 |
3,328 |
$13K |
| 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 |
267 |
258 |
$13K |
| 99225 |
|
222 |
222 |
$13K |
| 58558 |
|
119 |
118 |
$12K |
| G0380 |
Level 1 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) |
42 |
42 |
$10K |
| 77300 |
|
15 |
12 |
$10K |
| 0270 |
|
1,921 |
1,767 |
$10K |
| 73610 |
|
5,157 |
4,851 |
$9K |
| Z7610 |
|
883 |
795 |
$9K |
| 77334 |
|
17 |
12 |
$9K |
| 73630 |
|
5,572 |
5,118 |
$8K |
| 75572 |
|
39 |
39 |
$8K |
| U0002 |
2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc |
170 |
152 |
$8K |
| 86923 |
|
82 |
78 |
$8K |
| 71260 |
Computed tomography, thorax, diagnostic; with contrast material |
2,101 |
2,065 |
$8K |
| 88341 |
|
76 |
69 |
$7K |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
13,141 |
11,655 |
$7K |
| 96375 |
Therapeutic injection; each additional sequential IV push |
16,719 |
14,790 |
$7K |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
4,148 |
4,020 |
$7K |
| J7030 |
Infusion, normal saline solution , 1000 cc |
11,682 |
10,305 |
$7K |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
7,028 |
5,141 |
$6K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
174 |
160 |
$6K |
| J1170 |
Injection, hydromorphone, up to 4 mg |
7,900 |
6,483 |
$6K |
| 93970 |
|
471 |
452 |
$6K |
| 73562 |
|
5,446 |
4,945 |
$5K |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
133 |
133 |
$5K |
| 86920 |
|
48 |
44 |
$5K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
30,351 |
27,094 |
$5K |
| 73502 |
|
1,689 |
1,649 |
$5K |
| J1815 |
Injection, insulin, per 5 units |
2,939 |
1,951 |
$4K |
| 45385 |
Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) |
124 |
121 |
$4K |
| 85610 |
|
16,194 |
14,968 |
$4K |
| 93971 |
|
3,166 |
3,070 |
$4K |
| 83690 |
|
70,221 |
63,843 |
$4K |
| 76819 |
Fetal biophysical profile; without non-stress testing |
3,261 |
2,561 |
$4K |
| 72125 |
Computed tomography, cervical spine; without contrast material |
4,941 |
4,811 |
$4K |
| 96360 |
Intravenous infusion, hydration; initial, 31 minutes to 1 hour |
6,998 |
6,776 |
$4K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
43 |
41 |
$4K |
| 71046 |
Radiologic examination, chest; 2 views |
6,024 |
5,846 |
$4K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
7,907 |
7,429 |
$4K |
| 86850 |
|
8,015 |
7,726 |
$4K |
| 77066 |
Tomosynthesis, mammo |
25 |
25 |
$4K |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
7,676 |
7,453 |
$4K |
| 73590 |
|
2,198 |
2,027 |
$4K |
| 91035 |
|
24 |
24 |
$4K |
| J1644 |
Injection, heparin sodium, per 1000 units |
4,329 |
2,503 |
$3K |
| 88342 |
|
230 |
218 |
$3K |
| 58661 |
|
15 |
15 |
$3K |
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
586 |
453 |
$3K |
| 73552 |
|
450 |
435 |
$3K |
| 87070 |
|
827 |
774 |
$3K |
| 73110 |
|
3,272 |
3,046 |
$3K |
| 86901 |
|
13,685 |
12,957 |
$3K |
| 76830 |
Ultrasound, transvaginal |
5,405 |
5,052 |
$3K |
| 99215 |
Prolong outpt/office vis |
43 |
43 |
$3K |
| 85730 |
|
11,830 |
11,107 |
$3K |
| 86900 |
|
13,677 |
12,953 |
$3K |
| 71250 |
|
72 |
71 |
$3K |
| 77065 |
Tomosynthesis, mammo |
25 |
25 |
$3K |
| 87077 |
|
551 |
539 |
$3K |
| J2175 |
Injection, meperidine hydrochloride, per 100 mg |
490 |
450 |
$3K |
| 88313 |
|
121 |
118 |
$3K |
| 96366 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour |
1,243 |
1,035 |
$3K |
| 76641 |
|
21 |
12 |
$3K |
| 73030 |
|
3,491 |
3,326 |
$2K |
| 84484 |
|
48,259 |
41,873 |
$2K |
| 0682 |
|
320 |
314 |
$2K |
| J2270 |
Injection, morphine sulfate, up to 10 mg |
8,939 |
7,804 |
$2K |
| 73080 |
|
2,372 |
2,246 |
$2K |
| 80061 |
Lipid panel |
2,621 |
2,497 |
$2K |
| 73130 |
|
4,255 |
3,949 |
$2K |
| 83735 |
|
6,880 |
5,194 |
$2K |
| 83880 |
|
9,989 |
9,300 |
$2K |
| 96376 |
|
1,581 |
1,231 |
$2K |
| 87186 |
|
2,648 |
2,579 |
$2K |
| 72100 |
|
2,195 |
2,151 |
$2K |
| 0510 |
|
49 |
49 |
$2K |
| P9016 |
Red blood cells, leukocytes reduced, each unit |
61 |
51 |
$2K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
2,914 |
2,735 |
$1K |
| A9505 |
Thallium tl-201 thallous chloride, diagnostic, per millicurie |
32 |
31 |
$1K |
| 84703 |
|
42,041 |
38,661 |
$1K |
| 84443 |
Thyroid stimulating hormone (TSH) |
4,441 |
4,269 |
$1K |
| 87633 |
Infectious agent detection by nucleic acid, respiratory virus, 12-25 targets |
247 |
246 |
$1K |
| 70496 |
|
521 |
517 |
$1K |
| 73090 |
|
1,857 |
1,765 |
$1K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
3,131 |
3,052 |
$1K |
| 74018 |
|
1,361 |
1,308 |
$1K |
| 84100 |
|
4,590 |
3,114 |
$1K |
| 76770 |
|
137 |
133 |
$1K |
| 87205 |
|
691 |
647 |
$1K |
| 70486 |
|
1,718 |
1,681 |
$1K |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
41,321 |
23,961 |
$1K |
| J7120 |
Ringers lactate infusion, up to 1000 cc |
22,802 |
21,100 |
$1K |
| J7040 |
Infusion, normal saline solution, sterile (500 ml = 1 unit) |
1,312 |
1,217 |
$1K |
| 78452 |
Myocardial perfusion imaging, tomographic (SPECT); multiple studies at rest and/or stress |
33 |
32 |
$1K |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
1,658 |
1,480 |
$1K |
| J2785 |
Injection, regadenoson, 0.1 mg |
43 |
40 |
$995.16 |
| J0690 |
Injection, cefazolin sodium, 500 mg |
716 |
580 |
$981.06 |
| 88302 |
|
42 |
42 |
$923.12 |
| 72040 |
|
1,022 |
998 |
$906.50 |
| 83605 |
|
6,577 |
5,638 |
$842.04 |
| 81001 |
|
32,944 |
30,967 |
$832.39 |
| A9500 |
Technetium tc-99m sestamibi, diagnostic, per study dose |
102 |
82 |
$826.59 |
| 80074 |
|
340 |
314 |
$786.94 |
| 72131 |
|
375 |
365 |
$733.62 |
| 70498 |
|
609 |
604 |
$713.12 |
| G0279 |
Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066) |
13 |
13 |
$701.45 |
| 87040 |
|
6,683 |
5,777 |
$647.75 |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
1,806 |
1,659 |
$641.06 |
| 74174 |
|
12 |
12 |
$627.02 |
| 12002 |
|
833 |
823 |
$585.16 |
| 76801 |
|
2,933 |
2,644 |
$575.76 |
| 73060 |
|
351 |
332 |
$574.70 |
| 45378 |
Colonoscopy, flexible; diagnostic, including collection of specimen(s) |
14 |
14 |
$553.98 |
| 12001 |
|
1,669 |
1,640 |
$506.44 |
| 93017 |
|
89 |
81 |
$483.68 |
| 82140 |
|
1,155 |
963 |
$483.24 |
| 10060 |
|
1,070 |
1,025 |
$479.44 |
| 73560 |
|
47 |
41 |
$464.21 |
| J7070 |
Infusion, d5w, 1000 cc |
49 |
48 |
$463.74 |
| 87486 |
|
258 |
256 |
$440.63 |
| 80197 |
|
97 |
50 |
$438.96 |
| 84439 |
|
2,365 |
2,286 |
$438.19 |
| Q9966 |
Low osmolar contrast material, 200-299 mg/ml iodine concentration, per ml |
79 |
62 |
$433.73 |
| 87502 |
Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets |
720 |
687 |
$421.23 |
| 29515 |
|
414 |
385 |
$413.47 |
| 82553 |
|
312 |
237 |
$405.85 |
| 82150 |
|
3,968 |
3,764 |
$377.48 |
| 0258 |
|
510 |
364 |
$373.71 |
| 84702 |
|
8,176 |
6,890 |
$370.54 |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
16,057 |
14,398 |
$368.40 |
| 85384 |
|
1,260 |
1,174 |
$367.71 |
| J1650 |
Injection, enoxaparin sodium, 10 mg |
1,202 |
874 |
$327.78 |
| 72170 |
|
237 |
236 |
$319.15 |
| 76870 |
|
706 |
673 |
$313.98 |
| 82550 |
|
1,895 |
1,720 |
$304.04 |
| 88300 |
|
114 |
109 |
$277.15 |
| 73140 |
|
1,261 |
1,237 |
$275.66 |
| J1200 |
Injection, diphenhydramine hcl, up to 50 mg |
3,669 |
3,395 |
$273.68 |
| 70491 |
|
73 |
70 |
$269.51 |
| 72050 |
|
209 |
208 |
$252.30 |
| 86140 |
|
3,393 |
2,926 |
$233.97 |
| 87581 |
|
250 |
249 |
$223.14 |
| 87798 |
Infectious agent detection by nucleic acid; not otherwise specified, amplified probe, each organism |
247 |
246 |
$223.14 |
| 82570 |
|
1,118 |
816 |
$218.24 |
| 29125 |
|
1,238 |
1,193 |
$218.01 |
| J0360 |
Injection, hydralazine hcl, up to 20 mg |
190 |
161 |
$213.10 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
9,160 |
8,517 |
$212.57 |
| 90715 |
|
1,879 |
1,838 |
$187.03 |
| 87631 |
|
2,256 |
2,215 |
$177.10 |
| 87497 |
|
22 |
12 |
$171.02 |
| 84156 |
|
1,270 |
882 |
$166.49 |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
872 |
838 |
$163.16 |
| 59025 |
Fetal non-stress test |
167 |
158 |
$152.42 |
| 96367 |
|
247 |
227 |
$150.22 |
| J2704 |
Injection, propofol, 10 mg |
66 |
55 |
$132.05 |
| 12011 |
|
1,228 |
1,196 |
$131.99 |
| J2765 |
Injection, metoclopramide hcl, up to 10 mg |
3,023 |
2,784 |
$129.47 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
6,102 |
4,322 |
$117.14 |
| 85652 |
|
2,806 |
2,314 |
$113.05 |
| 87088 |
|
2,477 |
2,414 |
$110.61 |
| 84550 |
|
1,441 |
1,262 |
$102.82 |
| 82728 |
|
661 |
633 |
$98.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
4,023 |
3,942 |
$93.21 |
| 82607 |
|
179 |
166 |
$92.76 |
| 82746 |
|
123 |
112 |
$92.22 |
| 80076 |
|
927 |
794 |
$90.65 |
| J0780 |
Injection, prochlorperazine, up to 10 mg |
2,234 |
2,176 |
$90.51 |
| 94664 |
|
171 |
115 |
$89.82 |
| 85379 |
|
2,483 |
2,424 |
$84.96 |
| J2003 |
Injection, lidocaine hydrochloride, 1 mg |
33 |
32 |
$84.00 |
| 84145 |
|
51 |
43 |
$77.28 |
| 84134 |
|
50 |
41 |
$72.35 |
| 83615 |
|
866 |
821 |
$70.58 |
| A9585 |
Injection, gadobutrol, 0.1 ml |
21 |
12 |
$65.05 |
| J2930 |
Injection, methylprednisolone sodium succinate, up to 125 mg |
1,366 |
1,262 |
$63.98 |
| 74019 |
|
217 |
213 |
$58.50 |
| 0259 |
|
135 |
97 |
$51.12 |
| 83550 |
|
140 |
128 |
$47.94 |
| 83540 |
|
158 |
142 |
$39.84 |
| 86780 |
|
220 |
209 |
$39.67 |
| 81003 |
|
970 |
910 |
$38.26 |
| J1940 |
Injection, furosemide, up to 20 mg |
374 |
261 |
$35.28 |
| 90714 |
|
953 |
946 |
$32.47 |
| 87210 |
|
2,436 |
2,374 |
$30.92 |
| J2060 |
Injection, lorazepam, 2 mg |
2,259 |
2,008 |
$21.46 |
| J1171 |
Injection, hydromorphone, 0.1 mg |
126 |
103 |
$21.15 |
| 82248 |
|
42 |
36 |
$20.48 |
| 87800 |
|
590 |
560 |
$19.39 |
| J2550 |
Injection, promethazine hcl, up to 50 mg |
57 |
53 |
$17.50 |
| J7050 |
Infusion, normal saline solution, 250 cc |
2,178 |
1,905 |
$17.39 |
| 82565 |
|
216 |
187 |
$15.99 |
| J2919 |
Injection, methylprednisolone sodium succinate, 5 mg |
142 |
119 |
$14.25 |
| A9270 |
Non-covered item or service |
4,890 |
1,295 |
$10.54 |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
1,679 |
1,657 |
$10.00 |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
1,681 |
1,659 |
$10.00 |
| J7512 |
Prednisone, immediate release or delayed release, oral, 1 mg |
902 |
842 |
$6.45 |
| 82330 |
|
12 |
12 |
$4.95 |
| J3475 |
Injection, magnesium sulfate, per 500 mg |
163 |
152 |
$3.40 |
| J1630 |
Injection, haloperidol, up to 5 mg |
401 |
345 |
$0.99 |
| J1836 |
Injection, metronidazole, 10 mg |
91 |
72 |
$0.48 |
| 96368 |
|
71 |
71 |
$0.00 |
| J1790 |
Injection, droperidol, up to 5 mg |
127 |
118 |
$0.00 |
| J0456 |
Injection, azithromycin, 500 mg |
49 |
40 |
$0.00 |
| J8540 |
Dexamethasone, oral, 0.25 mg |
412 |
403 |
$0.00 |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
27 |
27 |
$0.00 |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
123 |
117 |
$0.00 |
| 73660 |
|
14 |
13 |
$0.00 |
| C1769 |
Guide wire |
62 |
62 |
$0.00 |
| 72128 |
|
13 |
13 |
$0.00 |
| 12013 |
|
12 |
12 |
$0.00 |
| Q4051 |
Splint supplies, miscellaneous (includes thermoplastics, strapping, fasteners, padding and other supplies) |
29 |
19 |
$0.00 |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
15 |
12 |
$0.00 |
| 76604 |
|
41 |
41 |
$0.00 |
| J2470 |
Injection, pantoprazole sodium, 40 mg |
31 |
29 |
$0.00 |
| 86592 |
|
13 |
12 |
$0.00 |
| 84132 |
|
12 |
12 |
$0.00 |
| 87483 |
|
17 |
16 |
$0.00 |
| 82010 |
|
665 |
631 |
$0.00 |
| J7510 |
Prednisolone oral, per 5 mg |
303 |
295 |
$0.00 |
| 72070 |
|
744 |
734 |
$0.00 |
| 0681 |
|
1,245 |
1,236 |
$0.00 |
| 76376 |
|
160 |
143 |
$0.00 |
| C1894 |
Introducer/sheath, other than guiding, other than intracardiac electrophysiological, non-laser |
49 |
48 |
$0.00 |
| 0637 |
|
191 |
57 |
$0.00 |
| Q0114 |
Fern test |
348 |
317 |
$0.00 |
| 80164 |
|
79 |
69 |
$0.00 |
| 70360 |
|
43 |
42 |
$0.00 |
| 29105 |
|
14 |
13 |
$0.00 |
| 71010 |
|
20 |
19 |
$0.00 |
| 87150 |
|
12 |
12 |
$0.00 |
| 69200 |
|
12 |
12 |
$0.00 |
| 51702 |
|
37 |
36 |
$0.00 |
| 93308 |
|
12 |
12 |
$0.00 |
| 72110 |
|
25 |
25 |
$0.00 |
| 84295 |
|
12 |
12 |
$0.00 |
| S0077 |
Injection, clindamycin phosphate, 300 mg |
13 |
12 |
$0.00 |