| Code | Description | Claims | Beneficiaries | Total Paid |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
34,465 |
25,844 |
$3.08M |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
26,955 |
20,893 |
$2.55M |
| 96361 |
Intravenous infusion, hydration; each additional hour |
11,447 |
6,231 |
$2.31M |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
20,432 |
14,231 |
$1.60M |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
8,455 |
2,285 |
$682K |
| 70450 |
Computed tomography, head or brain; without contrast material |
2,402 |
1,965 |
$535K |
| 0202U |
Oncology (prostate), multianalyte, gene expression profiling |
3,950 |
3,272 |
$526K |
| 43239 |
Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple |
1,132 |
1,047 |
$470K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
7,388 |
6,346 |
$440K |
| 0241U |
Neonatal screening for hereditary disorders, genomic sequence analysis panel |
3,440 |
2,937 |
$439K |
| 80053 |
Comprehensive metabolic panel |
37,149 |
30,178 |
$428K |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
1,546 |
1,280 |
$420K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
4,272 |
3,745 |
$398K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
1,365 |
1,109 |
$376K |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
5,534 |
3,848 |
$363K |
| 96366 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour |
3,264 |
1,565 |
$342K |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
2,974 |
2,410 |
$312K |
| G0378 |
Hospital observation service, per hour |
5,713 |
1,891 |
$260K |
| 97530 |
Therapeutic activities, direct patient contact, each 15 minutes |
2,389 |
1,094 |
$224K |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
3,019 |
1,535 |
$198K |
| 71275 |
Computed tomographic angiography, chest, with contrast material |
629 |
494 |
$181K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
2,568 |
2,221 |
$163K |
| 92507 |
Treatment of speech, language, voice, communication, and/or auditory processing disorder |
1,752 |
647 |
$160K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
50,235 |
36,573 |
$149K |
| 84443 |
Thyroid stimulating hormone (TSH) |
7,112 |
6,354 |
$123K |
| 93306 |
Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete |
424 |
367 |
$109K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
3,067 |
2,686 |
$105K |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
7,358 |
6,278 |
$103K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
1,753 |
1,382 |
$102K |
| 97140 |
Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) |
3,274 |
1,022 |
$98K |
| 96360 |
Intravenous infusion, hydration; initial, 31 minutes to 1 hour |
644 |
503 |
$96K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
412 |
378 |
$91K |
| 97161 |
|
967 |
836 |
$82K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
1,486 |
1,340 |
$73K |
| 80061 |
Lipid panel |
5,092 |
4,709 |
$71K |
| 36415 |
Collection of venous blood by venipuncture |
45,066 |
31,865 |
$60K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
4,104 |
3,754 |
$60K |
| 59025 |
Fetal non-stress test |
519 |
300 |
$48K |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
2,978 |
2,700 |
$45K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
17,118 |
12,508 |
$42K |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
325 |
288 |
$42K |
| 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 |
802 |
700 |
$42K |
| 84484 |
|
15,167 |
9,199 |
$42K |
| 95886 |
|
191 |
174 |
$42K |
| 93010 |
Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only |
6,944 |
5,968 |
$41K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
1,497 |
1,352 |
$40K |
| 87400 |
|
3,284 |
1,531 |
$39K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
4,925 |
3,942 |
$34K |
| 78452 |
Myocardial perfusion imaging, tomographic (SPECT); multiple studies at rest and/or stress |
67 |
53 |
$34K |
| 99291 |
Critical care, evaluation and management of the critically ill patient, first 30-74 minutes |
460 |
377 |
$33K |
| 73564 |
|
456 |
420 |
$32K |
| J0585 |
Injection, onabotulinumtoxina, 1 unit |
78 |
30 |
$29K |
| 84702 |
|
1,308 |
1,017 |
$29K |
| 71046 |
Radiologic examination, chest; 2 views |
1,349 |
1,206 |
$28K |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
5,679 |
4,750 |
$28K |
| 84439 |
|
1,415 |
1,275 |
$24K |
| 86850 |
|
933 |
744 |
$24K |
| 76830 |
Ultrasound, transvaginal |
323 |
283 |
$22K |
| 73030 |
|
586 |
505 |
$22K |
| 71045 |
Radiologic examination, chest; single view |
11,362 |
9,026 |
$21K |
| 71260 |
Computed tomography, thorax, diagnostic; with contrast material |
136 |
107 |
$21K |
| 80069 |
|
4,516 |
2,198 |
$21K |
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
1,234 |
1,067 |
$21K |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
336 |
311 |
$18K |
| 73610 |
|
542 |
434 |
$18K |
| 82607 |
|
1,359 |
1,208 |
$17K |
| 86900 |
|
1,034 |
798 |
$17K |
| 73630 |
|
632 |
552 |
$16K |
| 72131 |
|
335 |
272 |
$16K |
| 45378 |
Colonoscopy, flexible; diagnostic, including collection of specimen(s) |
26 |
25 |
$16K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
5,257 |
3,186 |
$15K |
| 45380 |
Colonoscopy, flexible; with biopsy, single or multiple |
33 |
29 |
$15K |
| 92526 |
|
113 |
49 |
$14K |
| 64615 |
|
31 |
28 |
$14K |
| 83735 |
|
11,711 |
7,886 |
$14K |
| 88142 |
|
666 |
603 |
$13K |
| 82553 |
|
4,375 |
2,850 |
$13K |
| 83540 |
|
2,456 |
2,036 |
$13K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
92 |
84 |
$12K |
| 82728 |
|
1,460 |
1,233 |
$12K |
| 93017 |
|
132 |
104 |
$12K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
304 |
211 |
$12K |
| 85027 |
|
1,135 |
1,057 |
$12K |
| 83550 |
|
2,443 |
2,029 |
$12K |
| 73130 |
|
482 |
407 |
$11K |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
453 |
407 |
$11K |
| 76801 |
|
46 |
41 |
$10K |
| 73110 |
|
295 |
248 |
$10K |
| 80320 |
|
527 |
459 |
$10K |
| 87081 |
|
1,010 |
938 |
$10K |
| 83605 |
|
5,374 |
4,070 |
$9K |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
1,999 |
1,619 |
$9K |
| 72125 |
Computed tomography, cervical spine; without contrast material |
610 |
502 |
$9K |
| 83880 |
|
3,864 |
2,966 |
$9K |
| 72148 |
Magnetic resonance imaging, lumbar spine; without contrast material |
47 |
43 |
$9K |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
8,054 |
6,561 |
$8K |
| 99281 |
Emergency department visit for the evaluation and management, self-limited or minor |
69 |
61 |
$8K |
| 84436 |
|
526 |
481 |
$8K |
| 87661 |
Infectious agent detection by nucleic acid; Trichomonas vaginalis, amplified probe |
351 |
333 |
$8K |
| 87040 |
|
3,210 |
1,620 |
$8K |
| 86901 |
|
1,034 |
798 |
$8K |
| 86803 |
|
321 |
291 |
$7K |
| 81001 |
|
12,006 |
9,847 |
$7K |
| 83970 |
|
327 |
304 |
$7K |
| 86592 |
|
452 |
404 |
$7K |
| 86140 |
|
1,436 |
1,201 |
$7K |
| 84153 |
|
347 |
316 |
$7K |
| 73560 |
|
295 |
233 |
$7K |
| 76642 |
|
44 |
43 |
$7K |
| 71250 |
|
124 |
97 |
$7K |
| 80076 |
|
1,074 |
826 |
$7K |
| 85610 |
|
8,003 |
6,085 |
$7K |
| 97165 |
|
99 |
81 |
$6K |
| 64493 |
|
13 |
13 |
$6K |
| 72100 |
|
117 |
109 |
$5K |
| 82746 |
|
875 |
759 |
$5K |
| 70553 |
Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences |
12 |
12 |
$5K |
| 87624 |
Infectious agent detection by nucleic acid; human papillomavirus (HPV), high-risk types |
171 |
162 |
$5K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
340 |
313 |
$5K |
| 96367 |
|
821 |
539 |
$5K |
| 73502 |
|
135 |
122 |
$5K |
| 85379 |
|
2,525 |
2,083 |
$4K |
| 74018 |
|
115 |
97 |
$4K |
| 87070 |
|
281 |
252 |
$4K |
| 84146 |
|
159 |
150 |
$4K |
| 87651 |
Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe |
1,171 |
1,000 |
$4K |
| 80324 |
|
244 |
230 |
$4K |
| 87186 |
|
843 |
648 |
$4K |
| 70551 |
Magnetic resonance imaging, brain; without contrast material |
14 |
13 |
$4K |
| 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 |
910 |
641 |
$3K |
| 90715 |
|
192 |
155 |
$3K |
| 96375 |
Therapeutic injection; each additional sequential IV push |
13,203 |
6,879 |
$3K |
| 87340 |
|
240 |
220 |
$3K |
| 83690 |
|
8,916 |
7,144 |
$3K |
| 87150 |
|
118 |
89 |
$3K |
| 80359 |
|
363 |
338 |
$3K |
| 82043 |
|
479 |
453 |
$3K |
| J0131 |
Injection, acetaminophen, not otherwise specified,10 mg |
465 |
232 |
$3K |
| 82550 |
|
3,552 |
2,162 |
$3K |
| 80373 |
|
363 |
338 |
$3K |
| 80372 |
|
363 |
338 |
$3K |
| 80365 |
|
363 |
338 |
$3K |
| 80348 |
|
364 |
338 |
$3K |
| 80354 |
|
364 |
338 |
$3K |
| 80361 |
|
363 |
338 |
$3K |
| 80346 |
|
364 |
338 |
$3K |
| 80358 |
|
364 |
338 |
$3K |
| 80353 |
|
364 |
338 |
$3K |
| 82962 |
|
6,006 |
1,762 |
$3K |
| 87634 |
|
34 |
33 |
$3K |
| J1030 |
Injection, methylprednisolone acetate, 40 mg |
274 |
223 |
$3K |
| 82570 |
|
257 |
240 |
$3K |
| 85730 |
|
7,394 |
5,750 |
$2K |
| 73562 |
|
99 |
85 |
$2K |
| 86038 |
|
132 |
105 |
$2K |
| J3490 |
Unclassified drugs |
1,048 |
541 |
$2K |
| 96376 |
|
4,965 |
1,932 |
$2K |
| 81003 |
|
4,740 |
4,157 |
$2K |
| J7030 |
Infusion, normal saline solution , 1000 cc |
17,067 |
9,408 |
$2K |
| 84403 |
|
99 |
83 |
$2K |
| 87625 |
|
44 |
39 |
$2K |
| 83615 |
|
813 |
634 |
$2K |
| 93971 |
|
20 |
16 |
$2K |
| 73721 |
Magnetic resonance imaging, any joint of lower extremity; without contrast material |
12 |
12 |
$2K |
| 99215 |
Prolong outpt/office vis |
89 |
69 |
$2K |
| 85652 |
|
787 |
646 |
$2K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
37 |
33 |
$2K |
| 76536 |
|
15 |
12 |
$2K |
| 84550 |
|
348 |
302 |
$1K |
| 85097 |
|
103 |
80 |
$1K |
| 84100 |
|
373 |
295 |
$1K |
| 72110 |
|
15 |
13 |
$1K |
| J1815 |
Injection, insulin, per 5 units |
263 |
192 |
$961.77 |
| 84703 |
|
592 |
471 |
$957.23 |
| 87798 |
Infectious agent detection by nucleic acid; not otherwise specified, amplified probe, each organism |
32 |
15 |
$943.20 |
| 83001 |
|
31 |
31 |
$905.96 |
| J1756 |
Injection, iron sucrose, 1 mg |
101 |
43 |
$897.64 |
| 76775 |
|
13 |
12 |
$857.61 |
| 80074 |
|
95 |
83 |
$851.51 |
| 96413 |
Chemotherapy administration, intravenous infusion; up to 1 hour, single or initial substance |
20 |
12 |
$838.06 |
| 94664 |
|
1,547 |
1,143 |
$777.38 |
| 81025 |
|
3,247 |
2,771 |
$776.71 |
| 86762 |
|
44 |
40 |
$772.99 |
| 87420 |
|
29 |
26 |
$763.86 |
| 86334 |
|
136 |
112 |
$747.47 |
| 81220 |
CFTR (cystic fibrosis transmembrane conductance regulator) gene analysis; common variants |
14 |
12 |
$728.02 |
| 85045 |
|
455 |
382 |
$727.58 |
| 84156 |
|
116 |
96 |
$697.02 |
| 86431 |
|
69 |
50 |
$678.54 |
| J2272 |
Injection, morphine sulfate (fresenius kabi), not therapeutically equivalent to j2270, up to 10 mg |
1,255 |
648 |
$668.55 |
| 84402 |
|
26 |
25 |
$663.63 |
| 87801 |
Infectious agent detection by nucleic acid; amplified probe, multiple organisms |
16 |
15 |
$615.29 |
| 87430 |
|
803 |
755 |
$606.85 |
| J1010 |
Injection, methylprednisolone acetate, 1 mg |
164 |
156 |
$593.95 |
| 99406 |
|
49 |
39 |
$591.78 |
| 83921 |
|
189 |
160 |
$575.96 |
| G0483 |
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; 22 or more drug class(es), including metabolite(s) if performed |
19 |
13 |
$547.88 |
| 82150 |
|
693 |
573 |
$534.74 |
| 0011A |
|
14 |
13 |
$533.95 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
3,444 |
2,383 |
$526.73 |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
3,144 |
2,579 |
$474.59 |
| 81329 |
|
14 |
12 |
$460.57 |
| 84145 |
|
401 |
294 |
$441.08 |
| 84165 |
|
203 |
170 |
$428.56 |
| 82800 |
|
983 |
749 |
$423.31 |
| 82525 |
|
81 |
70 |
$414.27 |
| 80164 |
|
25 |
25 |
$411.10 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
166 |
134 |
$397.68 |
| 72128 |
|
28 |
24 |
$382.76 |
| J1642 |
Injection, heparin sodium, (heparin lock flush), per 10 units |
1,072 |
566 |
$360.51 |
| 82950 |
|
13 |
12 |
$334.59 |
| 82565 |
|
59 |
44 |
$316.44 |
| 80329 |
|
192 |
173 |
$314.18 |
| J3535 |
Drug administered through a metered dose inhaler |
17 |
12 |
$277.89 |
| J2704 |
Injection, propofol, 10 mg |
3,705 |
2,501 |
$272.39 |
| 82805 |
|
17 |
12 |
$258.47 |
| 72040 |
|
14 |
12 |
$254.83 |
| 84630 |
|
16 |
14 |
$242.67 |
| 74022 |
|
16 |
12 |
$242.27 |
| 82540 |
|
35 |
30 |
$238.03 |
| J2543 |
Injection, piperacillin sodium/tazobactam sodium, 1 gram/0.125 grams (1.125 grams) |
153 |
56 |
$226.89 |
| 80143 |
|
199 |
178 |
$221.83 |
| 84520 |
|
35 |
29 |
$216.71 |
| J1170 |
Injection, hydromorphone, up to 4 mg |
545 |
261 |
$204.34 |
| 82784 |
|
78 |
57 |
$185.74 |
| 82670 |
|
14 |
14 |
$177.69 |
| J2930 |
Injection, methylprednisolone sodium succinate, up to 125 mg |
533 |
244 |
$149.35 |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
6,151 |
4,251 |
$143.55 |
| 83883 |
|
49 |
41 |
$140.16 |
| 82140 |
|
53 |
36 |
$135.26 |
| J0690 |
Injection, cefazolin sodium, 500 mg |
514 |
290 |
$130.96 |
| 85018 |
|
30 |
24 |
$129.36 |
| J3420 |
Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg |
322 |
269 |
$122.89 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
832 |
516 |
$122.70 |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
1,300 |
802 |
$120.84 |
| 73090 |
|
12 |
12 |
$119.97 |
| J3475 |
Injection, magnesium sulfate, per 500 mg |
626 |
425 |
$106.61 |
| C9113 |
Injection, pantoprazole sodium, per vial |
105 |
66 |
$102.81 |
| 84481 |
|
15 |
13 |
$97.99 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
1,252 |
874 |
$93.44 |
| J7120 |
Ringers lactate infusion, up to 1000 cc |
1,230 |
847 |
$83.32 |
| J1200 |
Injection, diphenhydramine hcl, up to 50 mg |
411 |
275 |
$83.20 |
| 82010 |
|
163 |
123 |
$67.14 |
| J2060 |
Injection, lorazepam, 2 mg |
298 |
163 |
$64.68 |
| J2550 |
Injection, promethazine hcl, up to 50 mg |
176 |
103 |
$63.83 |
| J3370 |
Injection, vancomycin hcl, 500 mg |
189 |
90 |
$62.56 |
| J2919 |
Injection, methylprednisolone sodium succinate, 5 mg |
243 |
130 |
$59.24 |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
1,204 |
933 |
$38.44 |
| J7040 |
Infusion, normal saline solution, sterile (500 ml = 1 unit) |
666 |
419 |
$38.40 |
| J7050 |
Infusion, normal saline solution, 250 cc |
657 |
367 |
$28.33 |
| J2270 |
Injection, morphine sulfate, up to 10 mg |
480 |
173 |
$28.06 |
| A9270 |
Non-covered item or service |
6,857 |
623 |
$22.50 |
| 84155 |
|
16 |
14 |
$19.42 |
| 87205 |
|
44 |
29 |
$19.31 |
| J1650 |
Injection, enoxaparin sodium, 10 mg |
42 |
17 |
$18.15 |
| J1956 |
Injection, levofloxacin, 250 mg |
32 |
13 |
$4.62 |
| J2765 |
Injection, metoclopramide hcl, up to 10 mg |
44 |
27 |
$2.26 |
| J3480 |
Injection, potassium chloride, per 2 meq |
63 |
37 |
$1.58 |
| J0780 |
Injection, prochlorperazine, up to 10 mg |
12 |
12 |
$0.89 |
| A9502 |
Technetium tc-99m tetrofosmin, diagnostic, per study dose |
67 |
53 |
$0.00 |
| J1171 |
Injection, hydromorphone, 0.1 mg |
22 |
14 |
$0.00 |
| A9576 |
Injection, gadoteridol, (prohance multipack), per ml |
48 |
38 |
$0.00 |
| J2800 |
Injection, methocarbamol, up to 10 ml |
14 |
12 |
$0.00 |
| 36600 |
|
18 |
12 |
$0.00 |
| T1015 |
Clinic visit/encounter, all-inclusive |
41 |
29 |
$0.00 |
| J0665 |
Injection, bupivicaine, not otherwise specified, 0.5 mg |
15 |
12 |
$0.00 |
| 94760 |
|
55 |
53 |
$0.00 |
| A9579 |
Injection, gadolinium-based magnetic resonance contrast agent, not otherwise specified (nos), per ml |
90 |
80 |
$0.00 |
| 82803 |
|
50 |
38 |
$0.00 |
| J1626 |
Injection, granisetron hydrochloride, 100 mcg |
24 |
12 |
$0.00 |
| J7620 |
Albuterol, up to 2.5 mg and ipratropium bromide, up to 0.5 mg, fda-approved final product, non-compounded, administered through dme |
14 |
13 |
$0.00 |
| 96368 |
|
56 |
46 |
$0.00 |
| J2795 |
Injection, ropivacaine hydrochloride, 1 mg |
20 |
15 |
$0.00 |
| J1940 |
Injection, furosemide, up to 20 mg |
26 |
15 |
$0.00 |