| Code | Description | Claims | Beneficiaries | Total Paid |
| 96361 |
Intravenous infusion, hydration; each additional hour |
21,397 |
15,113 |
$6.09M |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
44,454 |
40,953 |
$5.19M |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
39,202 |
34,750 |
$5.05M |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
21,762 |
18,659 |
$2.90M |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
8,227 |
6,975 |
$1.96M |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
15,695 |
14,612 |
$1.55M |
| 70450 |
Computed tomography, head or brain; without contrast material |
6,545 |
5,572 |
$1.51M |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
15,938 |
4,956 |
$944K |
| G0378 |
Hospital observation service, per hour |
13,728 |
5,096 |
$760K |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
4,948 |
3,294 |
$585K |
| 96360 |
Intravenous infusion, hydration; initial, 31 minutes to 1 hour |
2,743 |
2,116 |
$555K |
| 71275 |
Computed tomographic angiography, chest, with contrast material |
1,735 |
1,365 |
$461K |
| 97112 |
Therapeutic procedure, each 15 minutes; neuromuscular reeducation of movement, balance, coordination |
5,670 |
1,774 |
$397K |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
3,414 |
2,591 |
$390K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
1,697 |
1,390 |
$389K |
| 96366 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour |
1,775 |
959 |
$356K |
| 43239 |
Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple |
909 |
739 |
$349K |
| 92507 |
Treatment of speech, language, voice, communication, and/or auditory processing disorder |
4,695 |
1,723 |
$326K |
| 93306 |
Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete |
1,409 |
1,194 |
$307K |
| 80053 |
Comprehensive metabolic panel |
36,364 |
28,094 |
$299K |
| 59025 |
Fetal non-stress test |
1,948 |
1,415 |
$242K |
| 96413 |
Chemotherapy administration, intravenous infusion; up to 1 hour, single or initial substance |
1,433 |
787 |
$226K |
| 78452 |
Myocardial perfusion imaging, tomographic (SPECT); multiple studies at rest and/or stress |
539 |
429 |
$221K |
| 87636 |
Infectious agent detection by nucleic acid; SARS-CoV-2 and influenza virus types A and B |
11,315 |
9,731 |
$193K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
28,925 |
22,433 |
$172K |
| 93976 |
|
1,206 |
933 |
$161K |
| 95806 |
|
307 |
273 |
$160K |
| 71260 |
Computed tomography, thorax, diagnostic; with contrast material |
861 |
710 |
$136K |
| 64493 |
|
285 |
265 |
$122K |
| 84484 |
|
24,921 |
19,244 |
$116K |
| 97140 |
Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) |
3,391 |
1,276 |
$114K |
| 45385 |
Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) |
212 |
159 |
$113K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
704 |
542 |
$105K |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
6,967 |
5,835 |
$105K |
| 97113 |
|
1,608 |
494 |
$104K |
| 45380 |
Colonoscopy, flexible; with biopsy, single or multiple |
281 |
228 |
$96K |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
1,151 |
942 |
$93K |
| 95811 |
|
153 |
134 |
$93K |
| 70553 |
Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences |
366 |
302 |
$86K |
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
1,690 |
1,118 |
$85K |
| 69436 |
Tympanostomy (requiring insertion of ventilating tube), general anesthesia |
84 |
73 |
$78K |
| 97162 |
|
1,986 |
1,612 |
$77K |
| 72148 |
Magnetic resonance imaging, lumbar spine; without contrast material |
549 |
490 |
$76K |
| 71046 |
Radiologic examination, chest; 2 views |
3,921 |
3,547 |
$72K |
| 97530 |
Therapeutic activities, direct patient contact, each 15 minutes |
2,244 |
1,227 |
$65K |
| 78815 |
Positron emission tomography (PET) for limited area imaging |
125 |
109 |
$64K |
| 72100 |
|
1,520 |
1,357 |
$63K |
| 99281 |
Emergency department visit for the evaluation and management, self-limited or minor |
539 |
456 |
$61K |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
1,284 |
1,167 |
$61K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
652 |
507 |
$60K |
| 71271 |
|
323 |
299 |
$59K |
| 70496 |
|
226 |
171 |
$58K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
645 |
499 |
$57K |
| 93017 |
|
725 |
586 |
$57K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
66,690 |
52,450 |
$57K |
| 97166 |
|
1,035 |
835 |
$56K |
| 82805 |
|
2,036 |
1,604 |
$55K |
| 71250 |
|
738 |
651 |
$55K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
1,362 |
888 |
$54K |
| 71045 |
Radiologic examination, chest; single view |
22,887 |
19,677 |
$49K |
| 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 |
258 |
257 |
$47K |
| 12001 |
|
293 |
270 |
$47K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
486 |
355 |
$46K |
| 87502 |
Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets |
2,859 |
2,648 |
$46K |
| 72125 |
Computed tomography, cervical spine; without contrast material |
1,533 |
1,287 |
$45K |
| J3490 |
Unclassified drugs |
4,456 |
2,278 |
$44K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
30,936 |
25,682 |
$42K |
| 45378 |
Colonoscopy, flexible; diagnostic, including collection of specimen(s) |
125 |
89 |
$40K |
| 93971 |
|
601 |
493 |
$39K |
| 36415 |
Collection of venous blood by venipuncture |
71,934 |
51,803 |
$39K |
| 97161 |
|
947 |
785 |
$39K |
| 76830 |
Ultrasound, transvaginal |
848 |
684 |
$39K |
| 76536 |
|
417 |
372 |
$38K |
| 70551 |
Magnetic resonance imaging, brain; without contrast material |
234 |
194 |
$36K |
| 72141 |
|
250 |
229 |
$36K |
| 96367 |
|
560 |
348 |
$36K |
| 73030 |
|
1,235 |
1,069 |
$35K |
| 73130 |
|
1,243 |
1,046 |
$35K |
| 73110 |
|
911 |
759 |
$35K |
| 94060 |
|
367 |
329 |
$34K |
| 73610 |
|
1,190 |
987 |
$34K |
| 73630 |
|
1,320 |
1,167 |
$33K |
| 72040 |
|
622 |
552 |
$33K |
| 73564 |
|
519 |
488 |
$32K |
| 94726 |
|
574 |
522 |
$31K |
| 74018 |
|
798 |
706 |
$30K |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
27,667 |
23,526 |
$29K |
| 72131 |
|
485 |
384 |
$29K |
| 36591 |
|
1,073 |
631 |
$28K |
| 76642 |
|
242 |
213 |
$27K |
| 94729 |
|
627 |
574 |
$27K |
| 84443 |
Thyroid stimulating hormone (TSH) |
4,890 |
4,118 |
$26K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
210 |
166 |
$25K |
| 93970 |
|
190 |
158 |
$23K |
| 73560 |
|
1,303 |
1,106 |
$23K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
557 |
411 |
$23K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
9,864 |
5,496 |
$23K |
| 73502 |
|
740 |
667 |
$23K |
| 97116 |
|
1,039 |
524 |
$23K |
| 96375 |
Therapeutic injection; each additional sequential IV push |
20,829 |
15,451 |
$21K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
1,294 |
1,177 |
$21K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
2,864 |
2,488 |
$20K |
| 70486 |
|
336 |
280 |
$20K |
| 70491 |
|
79 |
54 |
$19K |
| 86900 |
|
1,495 |
1,163 |
$18K |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
1,071 |
982 |
$17K |
| 73080 |
|
509 |
418 |
$17K |
| 80076 |
|
2,175 |
1,891 |
$16K |
| 85027 |
|
5,710 |
3,529 |
$16K |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
2,834 |
2,337 |
$15K |
| 86850 |
|
1,393 |
1,078 |
$15K |
| 76801 |
|
462 |
346 |
$14K |
| 80061 |
Lipid panel |
2,429 |
2,127 |
$14K |
| 81001 |
|
34,790 |
30,284 |
$13K |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
10,090 |
8,788 |
$13K |
| 66984 |
Extracapsular cataract removal with insertion of intraocular lens prosthesis |
37 |
26 |
$13K |
| 73562 |
|
206 |
181 |
$12K |
| 72072 |
|
308 |
280 |
$12K |
| 97163 |
|
248 |
208 |
$12K |
| 73721 |
Magnetic resonance imaging, any joint of lower extremity; without contrast material |
57 |
53 |
$12K |
| 76770 |
|
63 |
43 |
$12K |
| 70498 |
|
241 |
186 |
$11K |
| 96376 |
|
4,663 |
2,313 |
$11K |
| 72050 |
|
259 |
241 |
$11K |
| 96415 |
|
37 |
24 |
$11K |
| 87651 |
Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe |
2,740 |
2,283 |
$11K |
| 12011 |
|
58 |
53 |
$10K |
| 85610 |
|
6,640 |
4,814 |
$10K |
| 97535 |
Self-care/home management training, each 15 minutes |
505 |
309 |
$10K |
| 82607 |
|
1,192 |
1,024 |
$10K |
| 80069 |
|
1,264 |
728 |
$10K |
| 36416 |
|
1,365 |
885 |
$9K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
998 |
850 |
$9K |
| 73700 |
|
74 |
59 |
$9K |
| 80320 |
|
685 |
631 |
$9K |
| U0002 |
2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc |
5,455 |
4,938 |
$9K |
| 94010 |
|
103 |
97 |
$8K |
| 72110 |
|
184 |
173 |
$8K |
| 85379 |
|
1,948 |
1,635 |
$8K |
| 82248 |
|
17,692 |
15,169 |
$8K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
998 |
850 |
$8K |
| J3535 |
Drug administered through a metered dose inhaler |
606 |
414 |
$8K |
| 84439 |
|
1,053 |
890 |
$8K |
| 73590 |
|
411 |
353 |
$7K |
| 83690 |
|
21,774 |
18,436 |
$7K |
| 88307 |
|
51 |
42 |
$7K |
| 83880 |
|
2,534 |
2,039 |
$7K |
| 83735 |
|
6,081 |
4,286 |
$7K |
| 90715 |
|
452 |
363 |
$7K |
| 86703 |
|
420 |
380 |
$7K |
| 99152 |
|
635 |
497 |
$7K |
| C1726 |
Catheter, balloon dilatation, non-vascular |
646 |
515 |
$6K |
| 82728 |
|
789 |
706 |
$6K |
| 87661 |
Infectious agent detection by nucleic acid; Trichomonas vaginalis, amplified probe |
846 |
703 |
$6K |
| 84703 |
|
7,933 |
6,354 |
$6K |
| 0202U |
Oncology (prostate), multianalyte, gene expression profiling |
44 |
42 |
$6K |
| 76700 |
Ultrasound, abdominal, real time with image documentation; complete |
33 |
28 |
$6K |
| 88341 |
|
90 |
66 |
$6K |
| 73090 |
|
268 |
222 |
$5K |
| 86901 |
|
1,495 |
1,163 |
$5K |
| 86140 |
|
788 |
612 |
$5K |
| 80051 |
|
5,105 |
4,386 |
$5K |
| J1642 |
Injection, heparin sodium, (heparin lock flush), per 10 units |
4,308 |
1,938 |
$5K |
| 84702 |
|
1,119 |
824 |
$5K |
| 76811 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, detailed |
27 |
27 |
$5K |
| 94618 |
|
70 |
66 |
$4K |
| 82077 |
|
2,741 |
2,056 |
$4K |
| J1815 |
Injection, insulin, per 5 units |
1,678 |
678 |
$4K |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
13,126 |
10,981 |
$4K |
| 83540 |
|
842 |
756 |
$4K |
| 87420 |
|
1,211 |
1,052 |
$3K |
| 87510 |
|
555 |
461 |
$3K |
| 82746 |
|
799 |
660 |
$3K |
| 88342 |
|
571 |
429 |
$3K |
| 83550 |
|
811 |
729 |
$3K |
| 86803 |
|
297 |
267 |
$3K |
| 87081 |
|
3,043 |
2,893 |
$3K |
| A9500 |
Technetium tc-99m sestamibi, diagnostic, per study dose |
560 |
439 |
$3K |
| 76377 |
|
833 |
691 |
$3K |
| J2785 |
Injection, regadenoson, 0.1 mg |
459 |
359 |
$3K |
| 87077 |
|
1,102 |
876 |
$3K |
| J7999 |
Compounded drug, not otherwise classified |
337 |
207 |
$3K |
| J1170 |
Injection, hydromorphone, up to 4 mg |
3,803 |
1,856 |
$3K |
| 96417 |
|
88 |
36 |
$3K |
| J7030 |
Infusion, normal saline solution , 1000 cc |
17,702 |
12,573 |
$2K |
| 96523 |
|
77 |
70 |
$2K |
| 72128 |
|
53 |
44 |
$2K |
| 73221 |
|
13 |
12 |
$2K |
| 87506 |
|
18 |
12 |
$2K |
| 73140 |
|
63 |
54 |
$2K |
| 74022 |
|
270 |
228 |
$2K |
| C1769 |
Guide wire |
315 |
227 |
$2K |
| 82570 |
|
636 |
554 |
$2K |
| 87480 |
|
555 |
461 |
$2K |
| 88304 |
|
786 |
614 |
$2K |
| 85007 |
|
921 |
656 |
$2K |
| 87186 |
|
1,007 |
818 |
$2K |
| 82565 |
|
5,222 |
4,480 |
$2K |
| 92523 |
|
18 |
15 |
$2K |
| 84153 |
|
272 |
243 |
$2K |
| 85652 |
|
799 |
639 |
$2K |
| 12002 |
|
12 |
12 |
$2K |
| 84100 |
|
974 |
622 |
$2K |
| 96368 |
|
74 |
43 |
$2K |
| 73060 |
|
109 |
97 |
$2K |
| 87070 |
|
550 |
386 |
$1K |
| J2270 |
Injection, morphine sulfate, up to 10 mg |
3,273 |
2,126 |
$1K |
| 73552 |
|
108 |
98 |
$1K |
| 87040 |
|
991 |
755 |
$1K |
| J2469 |
Injection, palonosetron hcl, 25 mcg |
255 |
114 |
$1K |
| 83605 |
|
1,382 |
1,035 |
$1K |
| J1650 |
Injection, enoxaparin sodium, 10 mg |
2,347 |
902 |
$1K |
| 82947 |
|
5,080 |
4,366 |
$1K |
| J1756 |
Injection, iron sucrose, 1 mg |
32 |
13 |
$1K |
| J2543 |
Injection, piperacillin sodium/tazobactam sodium, 1 gram/0.125 grams (1.125 grams) |
332 |
126 |
$1K |
| 84520 |
|
5,089 |
4,384 |
$1K |
| J7120 |
Ringers lactate infusion, up to 1000 cc |
6,613 |
4,765 |
$1K |
| L4360 |
Walking boot, pneumatic and/or vacuum, with or without joints, with or without interface material, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise |
12 |
12 |
$1K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
493 |
385 |
$1K |
| 97802 |
|
12 |
12 |
$1K |
| 85730 |
|
670 |
562 |
$1K |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
12,092 |
9,300 |
$942.61 |
| 87660 |
|
76 |
73 |
$889.64 |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
12 |
12 |
$843.33 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
3,914 |
3,739 |
$834.68 |
| J2704 |
Injection, propofol, 10 mg |
8,063 |
6,331 |
$824.87 |
| A9552 |
Fluorodeoxyglucose f-18 fdg, diagnostic, per study dose, up to 45 millicuries |
112 |
97 |
$810.00 |
| C1894 |
Introducer/sheath, other than guiding, other than intracardiac electrophysiological, non-laser |
412 |
329 |
$799.96 |
| 84550 |
|
172 |
147 |
$750.86 |
| 87205 |
|
624 |
452 |
$718.32 |
| 72081 |
|
12 |
12 |
$714.50 |
| 99153 |
Mod sedat endo service >5yrs |
187 |
157 |
$711.52 |
| A9575 |
Injection, gadoterate meglumine, 0.1 ml |
754 |
633 |
$709.96 |
| 85018 |
|
1,809 |
1,416 |
$705.97 |
| J2930 |
Injection, methylprednisolone sodium succinate, up to 125 mg |
1,141 |
829 |
$679.98 |
| J2272 |
Injection, morphine sulfate (fresenius kabi), not therapeutically equivalent to j2270, up to 10 mg |
350 |
199 |
$677.00 |
| 82043 |
|
162 |
151 |
$644.37 |
| 86780 |
|
60 |
54 |
$587.22 |
| 29125 |
|
70 |
53 |
$571.07 |
| 82550 |
|
430 |
325 |
$569.88 |
| 83615 |
|
191 |
146 |
$555.49 |
| 83970 |
|
102 |
90 |
$534.69 |
| 86038 |
|
15 |
13 |
$531.41 |
| 97597 |
|
17 |
14 |
$500.17 |
| 86308 |
|
107 |
86 |
$472.02 |
| 80179 |
|
203 |
152 |
$470.80 |
| J0690 |
Injection, cefazolin sodium, 500 mg |
2,221 |
1,481 |
$458.96 |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
17,787 |
13,276 |
$447.99 |
| 80143 |
|
182 |
134 |
$402.50 |
| 84156 |
|
259 |
220 |
$392.94 |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
4,828 |
2,973 |
$356.30 |
| 81025 |
|
2,894 |
2,654 |
$347.96 |
| J2360 |
Injection, orphenadrine citrate, up to 60 mg |
447 |
360 |
$345.81 |
| C9113 |
Injection, pantoprazole sodium, per vial |
266 |
134 |
$343.97 |
| J1644 |
Injection, heparin sodium, per 1000 units |
1,525 |
659 |
$291.45 |
| 85014 |
|
168 |
133 |
$286.76 |
| 76870 |
|
12 |
12 |
$276.37 |
| J1200 |
Injection, diphenhydramine hcl, up to 50 mg |
2,805 |
1,957 |
$273.75 |
| J2919 |
Injection, methylprednisolone sodium succinate, 5 mg |
390 |
293 |
$266.12 |
| J7050 |
Infusion, normal saline solution, 250 cc |
2,994 |
1,385 |
$243.92 |
| 87075 |
|
168 |
100 |
$220.07 |
| 71101 |
|
19 |
15 |
$217.93 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
3,644 |
2,395 |
$217.27 |
| 99406 |
|
15 |
12 |
$216.60 |
| 87340 |
|
27 |
27 |
$209.84 |
| 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 |
259 |
258 |
$191.68 |
| 82140 |
|
156 |
100 |
$187.88 |
| J2765 |
Injection, metoclopramide hcl, up to 10 mg |
1,784 |
1,279 |
$181.15 |
| J3360 |
Injection, diazepam, up to 5 mg |
105 |
63 |
$175.08 |
| J0665 |
Injection, bupivicaine, not otherwise specified, 0.5 mg |
1,329 |
727 |
$156.02 |
| 83655 |
|
14 |
12 |
$146.48 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
750 |
493 |
$130.13 |
| J0360 |
Injection, hydralazine hcl, up to 20 mg |
157 |
109 |
$103.73 |
| 20985 |
|
20 |
12 |
$103.27 |
| J7512 |
Prednisone, immediate release or delayed release, oral, 1 mg |
1,088 |
757 |
$100.38 |
| 64494 |
|
264 |
246 |
$99.04 |
| 86592 |
|
36 |
24 |
$97.78 |
| J3370 |
Injection, vancomycin hcl, 500 mg |
121 |
57 |
$94.01 |
| J0330 |
Injection, succinylcholine chloride, up to 20 mg |
1,380 |
882 |
$88.65 |
| J1790 |
Injection, droperidol, up to 5 mg |
275 |
169 |
$72.42 |
| 82784 |
|
15 |
12 |
$68.53 |
| 84132 |
|
56 |
41 |
$65.95 |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
3,735 |
2,795 |
$65.77 |
| J3480 |
Injection, potassium chloride, per 2 meq |
380 |
197 |
$63.58 |
| 82270 |
|
35 |
31 |
$54.00 |
| J7040 |
Infusion, normal saline solution, sterile (500 ml = 1 unit) |
635 |
353 |
$51.79 |
| 87147 |
|
17 |
13 |
$51.71 |
| J1940 |
Injection, furosemide, up to 20 mg |
193 |
80 |
$50.93 |
| 84460 |
|
32 |
27 |
$48.08 |
| J0736 |
Injection, clindamycin phosphate, 300 mg |
61 |
37 |
$46.71 |
| J7510 |
Prednisolone oral, per 5 mg |
143 |
116 |
$45.40 |
| 80074 |
|
12 |
12 |
$43.93 |
| C1887 |
Catheter, guiding (may include infusion/perfusion capability) |
39 |
27 |
$40.32 |
| J2060 |
Injection, lorazepam, 2 mg |
262 |
165 |
$39.32 |
| J2471 |
Injection, pantoprazole (hikma), not therapeutically equivalent to j2470, 40 mg |
153 |
99 |
$37.31 |
| 80178 |
|
18 |
12 |
$32.57 |
| J0780 |
Injection, prochlorperazine, up to 10 mg |
84 |
54 |
$31.97 |
| 82010 |
|
122 |
88 |
$29.41 |
| J2710 |
Injection, neostigmine methylsulfate, up to 0.5 mg |
108 |
59 |
$27.52 |
| 84450 |
|
17 |
14 |
$20.50 |
| J1596 |
Injection, glycopyrrolate, 0.1 mg |
206 |
176 |
$18.40 |
| J3475 |
Injection, magnesium sulfate, per 500 mg |
101 |
61 |
$14.41 |
| J1630 |
Injection, haloperidol, up to 5 mg |
31 |
12 |
$12.43 |
| Q9966 |
Low osmolar contrast material, 200-299 mg/ml iodine concentration, per ml |
124 |
114 |
$12.15 |
| 81002 |
|
708 |
662 |
$4.55 |
| J1171 |
Injection, hydromorphone, 0.1 mg |
85 |
61 |
$0.90 |
| 51701 |
|
60 |
50 |
$0.00 |
| J1040 |
Injection, methylprednisolone acetate, 80 mg |
595 |
559 |
$0.00 |
| C9399 |
Unclassified drugs or biologicals |
19 |
16 |
$0.00 |
| J2370 |
Injection, phenylephrine hcl, up to 1 ml |
40 |
26 |
$0.00 |
| J0173 |
Injection, epinephrine (belcher), not therapeutically equivalent to j0171, 0.1 mg |
19 |
14 |
$0.00 |
| C1725 |
Catheter, transluminal angioplasty, non-laser (may include guidance, infusion/perfusion capability) |
12 |
12 |
$0.00 |