| Code | Description | Claims | Beneficiaries | Total Paid |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
33,384 |
29,715 |
$2.74M |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
39,221 |
31,281 |
$2.31M |
| 80053 |
Comprehensive metabolic panel |
50,979 |
37,040 |
$885K |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
18,634 |
14,227 |
$849K |
| 70450 |
Computed tomography, head or brain; without contrast material |
10,183 |
7,795 |
$619K |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
5,212 |
4,422 |
$588K |
| 36415 |
Collection of venous blood by venipuncture |
80,717 |
53,994 |
$491K |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
5,363 |
4,802 |
$419K |
| 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 |
11,007 |
8,009 |
$399K |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
8,740 |
6,955 |
$380K |
| 92507 |
Treatment of speech, language, voice, communication, and/or auditory processing disorder |
3,590 |
1,004 |
$358K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
24,753 |
16,544 |
$353K |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
8,170 |
2,141 |
$345K |
| 81003 |
|
34,483 |
28,073 |
$238K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
2,205 |
1,859 |
$225K |
| 59899 |
|
3,105 |
2,263 |
$192K |
| C1729 |
Catheter, drainage |
647 |
290 |
$185K |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
2,102 |
818 |
$173K |
| 71275 |
Computed tomographic angiography, chest, with contrast material |
1,448 |
1,194 |
$150K |
| G0378 |
Hospital observation service, per hour |
18,166 |
7,232 |
$143K |
| 87631 |
|
3,587 |
3,235 |
$143K |
| 11042 |
Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm |
3,074 |
1,226 |
$131K |
| 99281 |
Emergency department visit for the evaluation and management, self-limited or minor |
1,357 |
1,224 |
$114K |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
7,210 |
5,996 |
$113K |
| 96360 |
Intravenous infusion, hydration; initial, 31 minutes to 1 hour |
2,728 |
2,181 |
$109K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
8,427 |
6,466 |
$101K |
| 0202U |
Oncology (prostate), multianalyte, gene expression profiling |
1,301 |
1,230 |
$97K |
| 0241U |
Neonatal screening for hereditary disorders, genomic sequence analysis panel |
8,440 |
7,626 |
$93K |
| 81025 |
|
4,069 |
3,597 |
$92K |
| 72125 |
Computed tomography, cervical spine; without contrast material |
2,036 |
1,446 |
$90K |
| 93306 |
Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete |
1,827 |
1,452 |
$90K |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
5,140 |
3,068 |
$90K |
| 82948 |
|
16,981 |
5,131 |
$89K |
| 97530 |
Therapeutic activities, direct patient contact, each 15 minutes |
1,438 |
555 |
$89K |
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
3,727 |
2,412 |
$78K |
| 96367 |
|
2,063 |
758 |
$73K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
7,900 |
7,258 |
$69K |
| 97112 |
Therapeutic procedure, each 15 minutes; neuromuscular reeducation of movement, balance, coordination |
1,177 |
405 |
$69K |
| 96361 |
Intravenous infusion, hydration; each additional hour |
1,221 |
956 |
$63K |
| 80047 |
|
15,752 |
11,759 |
$58K |
| 97140 |
Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) |
2,861 |
791 |
$57K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
83,609 |
59,398 |
$56K |
| 84484 |
|
25,399 |
15,323 |
$54K |
| 76819 |
Fetal biophysical profile; without non-stress testing |
756 |
564 |
$53K |
| J7050 |
Infusion, normal saline solution, 250 cc |
2,585 |
1,466 |
$50K |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
14,931 |
11,887 |
$46K |
| 84443 |
Thyroid stimulating hormone (TSH) |
16,978 |
13,667 |
$38K |
| 84702 |
|
4,685 |
3,718 |
$36K |
| 73610 |
|
1,285 |
1,096 |
$36K |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
2,573 |
2,130 |
$36K |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
5,856 |
4,711 |
$34K |
| 97162 |
|
745 |
634 |
$33K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
1,836 |
1,660 |
$33K |
| 96413 |
Chemotherapy administration, intravenous infusion; up to 1 hour, single or initial substance |
1,752 |
948 |
$32K |
| 87070 |
|
3,036 |
2,388 |
$31K |
| 87480 |
|
5,371 |
4,891 |
$31K |
| 73562 |
|
1,932 |
1,572 |
$30K |
| 73630 |
|
1,601 |
1,390 |
$29K |
| 70486 |
|
769 |
598 |
$27K |
| 73110 |
|
883 |
765 |
$27K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
29,376 |
22,152 |
$27K |
| 73130 |
|
1,130 |
952 |
$27K |
| J1200 |
Injection, diphenhydramine hcl, up to 50 mg |
3,632 |
2,205 |
$26K |
| 71046 |
Radiologic examination, chest; 2 views |
7,278 |
6,228 |
$26K |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
3,607 |
2,725 |
$25K |
| 97163 |
|
1,398 |
1,198 |
$25K |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
4,625 |
3,430 |
$25K |
| 36591 |
|
1,573 |
715 |
$24K |
| 87651 |
Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe |
5,622 |
5,206 |
$23K |
| C1769 |
Guide wire |
1,210 |
829 |
$22K |
| 87624 |
Infectious agent detection by nucleic acid; human papillomavirus (HPV), high-risk types |
862 |
817 |
$21K |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
13,458 |
9,493 |
$21K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
2,116 |
1,736 |
$20K |
| 71045 |
Radiologic examination, chest; single view |
14,282 |
11,357 |
$20K |
| G0257 |
Unscheduled or emergency dialysis treatment for an esrd patient in a hospital outpatient department that is not certified as an esrd facility |
56 |
12 |
$20K |
| 73030 |
|
1,507 |
1,129 |
$19K |
| J2001 |
Injection, lidocaine hcl for intravenous infusion, 10 mg |
3,159 |
2,457 |
$19K |
| 96375 |
Therapeutic injection; each additional sequential IV push |
2,686 |
1,710 |
$18K |
| 83735 |
|
13,566 |
9,101 |
$17K |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
1,277 |
1,134 |
$17K |
| 72040 |
|
1,597 |
1,153 |
$16K |
| U0002 |
2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc |
908 |
733 |
$16K |
| 85660 |
|
576 |
522 |
$15K |
| 87502 |
Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets |
1,203 |
1,047 |
$15K |
| 85610 |
|
14,549 |
8,752 |
$15K |
| 72100 |
|
2,534 |
1,941 |
$15K |
| 97116 |
|
833 |
399 |
$14K |
| 87641 |
|
2,454 |
1,917 |
$14K |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
3,689 |
2,583 |
$14K |
| 93971 |
|
1,538 |
1,250 |
$13K |
| 83880 |
|
11,166 |
7,592 |
$13K |
| 80076 |
|
4,277 |
3,588 |
$13K |
| 80061 |
Lipid panel |
15,432 |
12,388 |
$13K |
| 85027 |
|
12,114 |
8,626 |
$13K |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
8,452 |
6,615 |
$12K |
| A9270 |
Non-covered item or service |
6,216 |
2,181 |
$12K |
| 73140 |
|
237 |
206 |
$12K |
| 96366 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour |
260 |
85 |
$12K |
| 86780 |
|
1,584 |
1,498 |
$12K |
| 49083 |
|
369 |
151 |
$11K |
| 73080 |
|
389 |
318 |
$11K |
| 11043 |
|
475 |
184 |
$11K |
| 86140 |
|
3,817 |
2,952 |
$10K |
| 85652 |
|
3,274 |
2,512 |
$10K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
12,362 |
10,115 |
$10K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
7,913 |
7,266 |
$9K |
| J2710 |
Injection, neostigmine methylsulfate, up to 0.5 mg |
169 |
125 |
$9K |
| 87186 |
|
6,507 |
4,959 |
$8K |
| J0690 |
Injection, cefazolin sodium, 500 mg |
2,336 |
1,673 |
$8K |
| 74022 |
|
1,555 |
1,379 |
$8K |
| G0123 |
Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, screening by cytotechnologist under physician supervision |
1,532 |
1,442 |
$8K |
| 87077 |
|
7,601 |
5,920 |
$8K |
| 86850 |
|
4,283 |
3,622 |
$8K |
| 99291 |
Critical care, evaluation and management of the critically ill patient, first 30-74 minutes |
89 |
73 |
$8K |
| 97014 |
|
109 |
53 |
$7K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
552 |
477 |
$7K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
389 |
345 |
$6K |
| 83970 |
|
1,225 |
964 |
$6K |
| 76801 |
|
2,115 |
1,718 |
$6K |
| G0471 |
Collection of venous blood by venipuncture or urine sample by catheterization from an individual in a skilled nursing facility (snf) or by a laboratory on behalf of a home health agency (hha) |
16,590 |
6,190 |
$6K |
| J1644 |
Injection, heparin sodium, per 1000 units |
1,064 |
522 |
$6K |
| 74018 |
|
719 |
633 |
$6K |
| 85730 |
|
6,135 |
4,721 |
$5K |
| J3480 |
Injection, potassium chloride, per 2 meq |
192 |
102 |
$5K |
| 73502 |
|
826 |
615 |
$5K |
| 84703 |
|
8,695 |
7,555 |
$5K |
| 86900 |
|
4,696 |
3,957 |
$5K |
| C1894 |
Introducer/sheath, other than guiding, other than intracardiac electrophysiological, non-laser |
570 |
392 |
$5K |
| 82247 |
|
1,368 |
854 |
$5K |
| 86803 |
|
2,433 |
2,246 |
$5K |
| 84145 |
|
3,612 |
2,505 |
$5K |
| 84100 |
|
2,696 |
1,805 |
$5K |
| 87205 |
|
3,207 |
2,516 |
$4K |
| 87040 |
|
3,046 |
2,435 |
$4K |
| 80074 |
|
464 |
410 |
$4K |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
3,496 |
2,319 |
$4K |
| 80055 |
|
146 |
140 |
$4K |
| 83605 |
|
2,102 |
1,615 |
$4K |
| 82728 |
|
3,203 |
2,564 |
$4K |
| 82330 |
|
9,765 |
7,626 |
$4K |
| 88342 |
|
950 |
778 |
$4K |
| M0243 |
Intravenous infusion or subcutaneous injection, casirivimab and imdevimab includes infusion or injection, and post administration monitoring |
166 |
135 |
$4K |
| 82950 |
|
1,317 |
1,275 |
$4K |
| 12001 |
|
288 |
217 |
$4K |
| J1815 |
Injection, insulin, per 5 units |
3,465 |
1,594 |
$4K |
| 87510 |
|
5,338 |
4,856 |
$4K |
| J1170 |
Injection, hydromorphone, up to 4 mg |
5,403 |
3,570 |
$4K |
| 84156 |
|
1,715 |
1,338 |
$3K |
| 82607 |
|
4,499 |
3,541 |
$3K |
| 84481 |
|
694 |
578 |
$3K |
| 71101 |
|
140 |
112 |
$3K |
| 70491 |
|
14 |
12 |
$3K |
| P9603 |
Travel allowance one way in connection with medically necessary laboratory specimen collection drawn from home bound or nursing home bound patient; prorated miles actually travelled |
19,235 |
8,573 |
$3K |
| 82105 |
|
920 |
857 |
$3K |
| 87075 |
|
1,367 |
1,012 |
$3K |
| 86901 |
|
4,700 |
3,957 |
$3K |
| 87633 |
Infectious agent detection by nucleic acid, respiratory virus, 12-25 targets |
140 |
120 |
$3K |
| J2765 |
Injection, metoclopramide hcl, up to 10 mg |
2,143 |
1,712 |
$3K |
| 87660 |
|
5,504 |
5,013 |
$3K |
| 87640 |
|
819 |
654 |
$3K |
| 87081 |
|
1,071 |
1,031 |
$3K |
| 82274 |
|
401 |
316 |
$3K |
| 80164 |
|
1,354 |
973 |
$3K |
| G8979 |
Mobility: walking & moving around functional limitation, projected goal status, at therapy episode outset, at reporting intervals, and at discharge or to end reporting |
125 |
114 |
$3K |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
3,556 |
3,354 |
$3K |
| 81001 |
|
5,363 |
4,040 |
$2K |
| 90791 |
Psychiatric diagnostic evaluation |
718 |
593 |
$2K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
1,205 |
886 |
$2K |
| J0330 |
Injection, succinylcholine chloride, up to 20 mg |
450 |
352 |
$2K |
| 97161 |
|
49 |
43 |
$2K |
| 72072 |
|
266 |
203 |
$2K |
| G8978 |
Mobility: walking & moving around functional limitation, current status, at therapy episode outset and at reporting intervals |
90 |
83 |
$2K |
| 93970 |
|
326 |
250 |
$2K |
| 83690 |
|
11,900 |
9,708 |
$2K |
| 85380 |
|
2,833 |
2,395 |
$2K |
| 86308 |
|
195 |
181 |
$2K |
| 90715 |
|
1,231 |
994 |
$2K |
| 29125 |
|
591 |
522 |
$2K |
| 0100U |
|
102 |
73 |
$2K |
| 84112 |
|
28 |
26 |
$2K |
| J1650 |
Injection, enoxaparin sodium, 10 mg |
3,139 |
1,355 |
$2K |
| 86592 |
|
1,313 |
1,218 |
$1K |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
3,447 |
2,806 |
$1K |
| 83540 |
|
3,278 |
2,637 |
$1K |
| 85004 |
|
1,061 |
718 |
$1K |
| 84439 |
|
4,612 |
3,667 |
$1K |
| 76830 |
Ultrasound, transvaginal |
1,625 |
1,455 |
$1K |
| 76770 |
|
61 |
52 |
$1K |
| 83550 |
|
2,622 |
2,116 |
$1K |
| 88341 |
|
173 |
140 |
$1K |
| J2270 |
Injection, morphine sulfate, up to 10 mg |
3,645 |
2,672 |
$1K |
| 82077 |
|
628 |
503 |
$1K |
| 73590 |
|
123 |
95 |
$1K |
| J7512 |
Prednisone, immediate release or delayed release, oral, 1 mg |
1,983 |
1,325 |
$1K |
| 73090 |
|
128 |
95 |
$1K |
| 12011 |
|
153 |
136 |
$1K |
| 77336 |
|
27 |
12 |
$1K |
| J2060 |
Injection, lorazepam, 2 mg |
2,723 |
1,971 |
$1K |
| 82043 |
|
2,531 |
2,114 |
$1K |
| 82746 |
|
3,083 |
2,469 |
$1K |
| 86762 |
|
995 |
937 |
$1K |
| 82805 |
|
195 |
118 |
$979.32 |
| P9016 |
Red blood cells, leukocytes reduced, each unit |
27 |
12 |
$934.25 |
| 87340 |
|
2,514 |
2,355 |
$893.85 |
| 86038 |
|
291 |
240 |
$874.16 |
| 97535 |
Self-care/home management training, each 15 minutes |
33 |
25 |
$839.04 |
| 73660 |
|
12 |
12 |
$814.94 |
| 83021 |
|
227 |
215 |
$802.22 |
| 82570 |
|
2,061 |
1,703 |
$792.63 |
| 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 |
4,250 |
3,664 |
$718.04 |
| 82248 |
|
1,516 |
1,118 |
$716.33 |
| 0352U |
|
96 |
93 |
$701.63 |
| 84403 |
|
134 |
112 |
$695.75 |
| 84550 |
|
1,433 |
1,119 |
$693.65 |
| 10061 |
|
25 |
24 |
$641.52 |
| 87798 |
Infectious agent detection by nucleic acid; not otherwise specified, amplified probe, each organism |
199 |
172 |
$634.82 |
| P9047 |
Infusion, albumin (human), 25%, 50 ml |
18 |
12 |
$614.48 |
| 87015 |
|
198 |
152 |
$605.27 |
| J0780 |
Injection, prochlorperazine, up to 10 mg |
1,593 |
1,200 |
$556.85 |
| J3490 |
Unclassified drugs |
1,026 |
851 |
$544.11 |
| 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 |
19 |
15 |
$528.63 |
| 94060 |
|
20 |
16 |
$510.14 |
| 84146 |
|
40 |
39 |
$507.23 |
| 86787 |
|
953 |
902 |
$492.97 |
| J3475 |
Injection, magnesium sulfate, per 500 mg |
287 |
191 |
$412.28 |
| 84480 |
|
181 |
157 |
$410.32 |
| 82550 |
|
1,785 |
1,318 |
$359.18 |
| 97167 |
|
26 |
26 |
$357.87 |
| 82140 |
|
717 |
492 |
$332.84 |
| 85014 |
|
702 |
421 |
$318.38 |
| J0360 |
Injection, hydralazine hcl, up to 20 mg |
58 |
44 |
$316.15 |
| 36416 |
|
111 |
89 |
$305.49 |
| 88304 |
|
46 |
41 |
$290.58 |
| 85018 |
|
1,346 |
862 |
$261.15 |
| J2930 |
Injection, methylprednisolone sodium succinate, up to 125 mg |
1,542 |
1,197 |
$238.18 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
96 |
85 |
$238.05 |
| 86364 |
|
16 |
15 |
$231.62 |
| 12002 |
|
16 |
13 |
$176.93 |
| 83993 |
|
12 |
12 |
$154.32 |
| 86359 |
|
81 |
61 |
$145.69 |
| 82378 |
|
13 |
12 |
$132.55 |
| 87427 |
|
69 |
55 |
$131.52 |
| 87653 |
|
14 |
14 |
$125.49 |
| 83655 |
|
45 |
45 |
$116.57 |
| 84153 |
|
147 |
108 |
$115.08 |
| 80069 |
|
178 |
155 |
$114.98 |
| 73552 |
|
37 |
25 |
$114.71 |
| 86376 |
|
361 |
309 |
$111.43 |
| 87102 |
|
17 |
12 |
$98.68 |
| 87430 |
|
175 |
157 |
$98.55 |
| 87581 |
|
140 |
120 |
$95.78 |
| 87486 |
|
140 |
120 |
$95.78 |
| 82951 |
|
12 |
12 |
$87.62 |
| 83020 |
|
227 |
215 |
$72.47 |
| 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 |
263 |
199 |
$71.75 |
| 82785 |
|
48 |
40 |
$59.93 |
| 51798 |
|
78 |
39 |
$47.61 |
| 83615 |
|
546 |
346 |
$43.55 |
| 87536 |
|
78 |
58 |
$42.04 |
| G0103 |
Prostate cancer screening; prostate specific antigen test (psa) |
37 |
24 |
$38.10 |
| 86709 |
|
488 |
394 |
$37.12 |
| 87529 |
|
12 |
12 |
$35.32 |
| 84436 |
|
102 |
87 |
$31.75 |
| 82784 |
|
14 |
13 |
$29.27 |
| 84132 |
|
38 |
24 |
$27.95 |
| 86431 |
|
64 |
56 |
$19.69 |
| 86356 |
|
81 |
61 |
$19.38 |
| 86360 |
|
81 |
61 |
$19.38 |
| 85045 |
|
177 |
120 |
$18.97 |
| 86769 |
|
17 |
14 |
$17.67 |
| 80202 |
|
25 |
12 |
$17.10 |
| 83001 |
|
39 |
37 |
$16.44 |
| 83721 |
|
16 |
15 |
$15.54 |
| 80178 |
|
19 |
13 |
$7.95 |
| 83516 |
|
23 |
14 |
$6.61 |
| 87493 |
|
19 |
14 |
$6.42 |
| 81050 |
|
12 |
12 |
$5.32 |
| 87449 |
|
126 |
98 |
$4.23 |
| 82010 |
|
122 |
94 |
$3.31 |
| 86255 |
|
18 |
12 |
$3.30 |
| 85379 |
|
98 |
51 |
$2.63 |
| 86880 |
|
32 |
24 |
$1.27 |
| J1940 |
Injection, furosemide, up to 20 mg |
14 |
12 |
$0.00 |
| G0008 |
Administration of influenza virus vaccine |
74 |
58 |
$0.00 |
| 90686 |
|
147 |
117 |
$0.00 |
| J1790 |
Injection, droperidol, up to 5 mg |
195 |
174 |
$0.00 |
| 0240U |
|
44 |
30 |
$0.00 |
| J7060 |
5% dextrose/water (500 ml = 1 unit) |
45 |
24 |
$0.00 |
| 87046 |
|
67 |
56 |
$0.00 |
| 94761 |
|
112 |
95 |
$0.00 |
| 82952 |
|
12 |
12 |
$0.00 |
| 72170 |
|
197 |
136 |
$0.00 |
| J3360 |
Injection, diazepam, up to 5 mg |
17 |
15 |
$0.00 |
| J0561 |
Injection, penicillin g benzathine, 100,000 units |
26 |
25 |
$0.00 |
| J2920 |
Injection, methylprednisolone sodium succinate, up to 40 mg |
59 |
13 |
$0.00 |
| 87481 |
|
576 |
389 |
$0.00 |
| C9113 |
Injection, pantoprazole sodium, per vial |
124 |
77 |
$0.00 |
| J3370 |
Injection, vancomycin hcl, 500 mg |
94 |
53 |
$0.00 |
| J0692 |
Injection, cefepime hydrochloride, 500 mg |
144 |
88 |
$0.00 |
| J7510 |
Prednisolone oral, per 5 mg |
220 |
208 |
$0.00 |
| 87328 |
|
13 |
12 |
$0.00 |
| J1580 |
Injection, garamycin, gentamicin, up to 80 mg |
15 |
12 |
$0.00 |
| 0353U |
|
121 |
116 |
$0.00 |
| Q0244 |
Injection, casirivimab and imdevimab, 1200 mg |
27 |
23 |
$0.00 |
| 29515 |
|
42 |
37 |
$0.00 |
| 85384 |
|
22 |
13 |
$0.00 |
| 87400 |
|
15 |
13 |
$0.00 |
| 87045 |
|
67 |
56 |
$0.00 |
| 87329 |
|
13 |
12 |
$0.00 |