| Code | Description | Claims | Beneficiaries | Total Paid |
| 99283 |
|
46,224 |
41,568 |
$6.95M |
| 99284 |
|
39,358 |
34,915 |
$6.63M |
| 74177 |
|
5,800 |
5,318 |
$2.65M |
| 99285 |
|
12,474 |
11,344 |
$1.63M |
| 74176 |
|
4,351 |
4,002 |
$1.59M |
| 70450 |
|
8,564 |
7,762 |
$1.51M |
| 72125 |
|
2,536 |
2,349 |
$799K |
| 11042 |
|
4,953 |
1,970 |
$691K |
| 78452 |
|
816 |
695 |
$680K |
| G0378 |
Hospital observation service, per hour |
9,800 |
5,237 |
$625K |
| 99282 |
|
6,569 |
6,061 |
$564K |
| 71275 |
|
1,581 |
1,429 |
$538K |
| 43239 |
|
941 |
879 |
$484K |
| 96361 |
|
16,749 |
13,068 |
$438K |
| 47563 |
|
110 |
105 |
$367K |
| 97110 |
|
6,478 |
1,702 |
$320K |
| 99281 |
|
3,420 |
3,218 |
$175K |
| 93458 |
|
111 |
91 |
$172K |
| 97602 |
|
2,217 |
494 |
$170K |
| 88305 |
|
3,712 |
3,365 |
$157K |
| 49083 |
|
443 |
192 |
$151K |
| C1713 |
Anchor/screw for opposing bone-to-bone or soft tissue-to-bone (implantable) |
148 |
123 |
$149K |
| 72131 |
|
983 |
916 |
$146K |
| 10060 |
|
815 |
761 |
$140K |
| 70486 |
|
587 |
547 |
$133K |
| 97140 |
|
2,619 |
921 |
$129K |
| 92507 |
|
1,601 |
594 |
$114K |
| 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 |
9,338 |
7,883 |
$102K |
| 73564 |
|
2,716 |
2,363 |
$96K |
| 70553 |
|
199 |
169 |
$92K |
| 97113 |
|
1,441 |
432 |
$88K |
| C1781 |
Mesh (implantable) |
352 |
323 |
$88K |
| 12001 |
|
507 |
493 |
$86K |
| 97112 |
|
1,680 |
492 |
$81K |
| 77067 |
|
956 |
860 |
$77K |
| 97530 |
|
1,559 |
689 |
$70K |
| 93306 |
|
467 |
394 |
$64K |
| 73030 |
|
1,995 |
1,801 |
$63K |
| 87070 |
|
4,914 |
4,519 |
$46K |
| 29581 |
|
4,086 |
737 |
$46K |
| 29125 |
|
301 |
284 |
$45K |
| 97162 |
|
1,044 |
893 |
$45K |
| 71046 |
|
9,787 |
8,807 |
$41K |
| 70498 |
|
100 |
98 |
$33K |
| 88304 |
|
2,723 |
2,550 |
$30K |
| 93798 |
|
532 |
92 |
$25K |
| 93971 |
|
1,702 |
1,560 |
$25K |
| 71250 |
|
268 |
239 |
$24K |
| 12002 |
|
134 |
128 |
$24K |
| 96366 |
|
2,056 |
1,311 |
$22K |
| 93005 |
|
26,002 |
22,469 |
$22K |
| 97163 |
|
292 |
246 |
$21K |
| 76700 |
|
446 |
418 |
$16K |
| 76856 |
|
660 |
618 |
$16K |
| 71045 |
|
15,486 |
13,858 |
$16K |
| 76705 |
|
1,721 |
1,605 |
$15K |
| 80053 |
|
54,249 |
46,195 |
$14K |
| 97750 |
|
595 |
492 |
$14K |
| 88341 |
|
36 |
28 |
$13K |
| 84484 |
|
20,317 |
13,812 |
$12K |
| 96375 |
|
16,426 |
14,053 |
$12K |
| 29515 |
|
104 |
100 |
$11K |
| 73130 |
|
2,078 |
1,873 |
$11K |
| 73630 |
|
2,180 |
1,931 |
$9K |
| 80307 |
|
10,345 |
9,094 |
$9K |
| 97116 |
|
1,232 |
481 |
$9K |
| 97535 |
|
952 |
633 |
$9K |
| 90935 |
|
84 |
42 |
$8K |
| 73110 |
|
924 |
838 |
$8K |
| 99291 |
|
27 |
27 |
$8K |
| 72110 |
|
187 |
177 |
$7K |
| 70551 |
|
31 |
27 |
$7K |
| 45380 |
|
38 |
38 |
$7K |
| 96365 |
|
7,481 |
6,536 |
$7K |
| 97597 |
|
488 |
294 |
$6K |
| 87635 |
|
3,555 |
3,275 |
$5K |
| 76770 |
|
214 |
196 |
$5K |
| 73610 |
|
1,766 |
1,618 |
$5K |
| 97161 |
|
201 |
178 |
$4K |
| 88307 |
|
191 |
172 |
$4K |
| 96374 |
|
19,746 |
17,641 |
$4K |
| M0243 |
Intravenous infusion or subcutaneous injection, casirivimab and imdevimab includes infusion or injection, and post administration monitoring |
19 |
19 |
$4K |
| 77080 |
|
174 |
145 |
$4K |
| 10061 |
|
14 |
14 |
$3K |
| 80320 |
|
2,651 |
2,443 |
$3K |
| 73502 |
|
876 |
785 |
$3K |
| 72100 |
|
825 |
757 |
$3K |
| 85025 |
|
57,880 |
48,718 |
$3K |
| 93970 |
|
138 |
121 |
$3K |
| 87502 |
|
1,430 |
1,374 |
$3K |
| 11045 |
|
57 |
13 |
$3K |
| 72128 |
|
40 |
39 |
$3K |
| 74018 |
|
332 |
302 |
$2K |
| 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 |
781 |
707 |
$2K |
| 12011 |
|
12 |
12 |
$2K |
| 29130 |
|
12 |
12 |
$2K |
| 76830 |
|
461 |
434 |
$2K |
| 97166 |
|
206 |
171 |
$2K |
| 36415 |
|
11,891 |
7,120 |
$2K |
| 80048 |
|
11,073 |
8,626 |
$2K |
| 82803 |
|
307 |
271 |
$2K |
| 77065 |
Tomosynthesis, mammo |
31 |
26 |
$2K |
| 72070 |
|
207 |
190 |
$2K |
| 96360 |
|
5,536 |
4,915 |
$2K |
| 45385 |
|
17 |
17 |
$2K |
| 99212 |
|
248 |
172 |
$2K |
| 72050 |
|
41 |
40 |
$2K |
| 81001 |
|
24,736 |
22,394 |
$1K |
| 83880 |
|
4,595 |
3,982 |
$1K |
| A9500 |
Technetium tc-99m sestamibi, diagnostic, per study dose |
837 |
713 |
$1K |
| 73080 |
|
232 |
215 |
$1K |
| 36410 |
|
32 |
28 |
$1K |
| 96372 |
|
10,641 |
8,040 |
$1K |
| 80143 |
|
780 |
717 |
$1K |
| 71101 |
|
232 |
219 |
$1K |
| 94640 |
|
5,037 |
2,914 |
$952.67 |
| 72040 |
|
189 |
173 |
$888.46 |
| 87040 |
|
3,485 |
1,922 |
$883.17 |
| 73560 |
|
29 |
24 |
$849.71 |
| 73140 |
|
178 |
176 |
$780.31 |
| 83735 |
|
25,574 |
21,239 |
$766.61 |
| 83690 |
|
15,607 |
14,069 |
$731.54 |
| 81025 |
|
11,647 |
10,937 |
$704.83 |
| 73590 |
|
409 |
376 |
$685.91 |
| 80061 |
|
946 |
769 |
$656.57 |
| 71260 |
|
12 |
12 |
$643.58 |
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
207 |
120 |
$577.46 |
| 87804 |
|
4,049 |
3,806 |
$563.05 |
| 87801 |
|
162 |
154 |
$559.69 |
| U0002 |
2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc |
3,277 |
3,134 |
$557.05 |
| 85027 |
|
6,111 |
4,942 |
$524.61 |
| 85610 |
|
8,842 |
7,580 |
$512.01 |
| 85730 |
|
4,441 |
3,853 |
$506.72 |
| 96367 |
|
744 |
639 |
$495.80 |
| 87186 |
|
3,699 |
3,265 |
$474.62 |
| 93017 |
|
819 |
698 |
$438.19 |
| 97014 |
|
668 |
276 |
$429.09 |
| 84702 |
|
2,212 |
2,078 |
$420.42 |
| 84443 |
|
2,741 |
2,492 |
$399.90 |
| 76642 |
|
55 |
50 |
$373.69 |
| 82948 |
|
18,850 |
7,650 |
$369.43 |
| 99211 |
|
22 |
13 |
$360.49 |
| 87073 |
|
2,194 |
1,974 |
$351.13 |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
19,086 |
16,149 |
$318.47 |
| 96376 |
|
6,142 |
4,146 |
$289.05 |
| 36592 |
|
374 |
313 |
$280.78 |
| 87491 |
|
1,035 |
999 |
$269.61 |
| C1751 |
Catheter, infusion, inserted peripherally, centrally or midline (other than hemodialysis) |
270 |
227 |
$249.00 |
| 87088 |
|
5,574 |
5,116 |
$247.86 |
| 83036 |
|
1,369 |
1,185 |
$234.85 |
| 90715 |
|
2,442 |
2,337 |
$233.17 |
| J2270 |
Injection, morphine sulfate, up to 10 mg |
10,572 |
7,443 |
$184.15 |
| 80047 |
|
1,771 |
1,572 |
$179.33 |
| A9270 |
Non-covered item or service |
41,361 |
9,414 |
$177.35 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
11,680 |
10,529 |
$176.90 |
| 87430 |
|
2,268 |
2,177 |
$171.02 |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
10,515 |
9,496 |
$156.26 |
| J1200 |
Injection, diphenhydramine hcl, up to 50 mg |
3,516 |
3,132 |
$153.51 |
| 87634 |
|
758 |
741 |
$150.85 |
| 83605 |
|
4,488 |
3,667 |
$148.88 |
| 84703 |
|
1,965 |
1,892 |
$135.61 |
| 85379 |
|
2,574 |
2,353 |
$123.38 |
| 87651 |
|
319 |
315 |
$116.97 |
| 74019 |
|
127 |
114 |
$116.61 |
| J2060 |
Injection, lorazepam, 2 mg |
3,533 |
2,992 |
$101.50 |
| 87147 |
|
1,464 |
1,241 |
$96.84 |
| 74022 |
|
25 |
24 |
$96.25 |
| 76857 |
|
27 |
26 |
$92.98 |
| 76815 |
|
91 |
84 |
$90.30 |
| G0379 |
Direct admission of patient for hospital observation care |
13 |
13 |
$84.54 |
| 86850 |
|
1,364 |
1,166 |
$67.55 |
| J1170 |
Injection, hydromorphone, up to 4 mg |
3,876 |
2,957 |
$64.25 |
| J0690 |
Injection, cefazolin sodium, 500 mg |
5,750 |
4,659 |
$63.07 |
| 84132 |
|
1,381 |
1,134 |
$60.76 |
| 87077 |
|
3,017 |
2,578 |
$58.76 |
| 87591 |
|
1,171 |
1,123 |
$56.39 |
| 81003 |
|
3,038 |
2,826 |
$55.85 |
| 82550 |
|
1,874 |
1,563 |
$53.82 |
| 73090 |
|
169 |
155 |
$50.85 |
| J3370 |
Injection, vancomycin hcl, 500 mg |
1,213 |
867 |
$48.59 |
| 99152 |
|
1,007 |
870 |
$47.50 |
| 82565 |
|
1,765 |
1,552 |
$46.70 |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
6,877 |
5,985 |
$43.35 |
| 82947 |
|
900 |
748 |
$43.15 |
| J7120 |
Ringers lactate infusion, up to 1000 cc |
5,655 |
4,684 |
$38.48 |
| 86901 |
|
1,874 |
1,658 |
$38.15 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
4,213 |
3,577 |
$30.49 |
| 86900 |
|
1,878 |
1,658 |
$25.58 |
| J1790 |
Injection, droperidol, up to 5 mg |
892 |
832 |
$24.22 |
| J1644 |
Injection, heparin sodium, per 1000 units |
4,092 |
2,034 |
$23.94 |
| 80076 |
|
153 |
134 |
$22.39 |
| 85651 |
|
1,258 |
1,141 |
$21.95 |
| 85014 |
|
2,785 |
2,357 |
$21.61 |
| J3480 |
Injection, potassium chloride, per 2 meq |
659 |
400 |
$21.60 |
| J2930 |
Injection, methylprednisolone sodium succinate, up to 125 mg |
1,681 |
1,277 |
$20.56 |
| J3475 |
Injection, magnesium sulfate, per 500 mg |
1,178 |
976 |
$19.18 |
| 87205 |
|
3,024 |
2,735 |
$19.11 |
| J2550 |
Injection, promethazine hcl, up to 50 mg |
1,019 |
857 |
$16.16 |
| 94664 |
|
419 |
392 |
$15.32 |
| J1650 |
Injection, enoxaparin sodium, 10 mg |
1,782 |
803 |
$14.40 |
| 90471 |
|
2,495 |
2,307 |
$13.38 |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
7,628 |
6,666 |
$12.99 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
5,317 |
4,728 |
$11.19 |
| J0780 |
Injection, prochlorperazine, up to 10 mg |
770 |
676 |
$9.90 |
| 87807 |
|
285 |
275 |
$8.57 |
| 82272 |
|
551 |
488 |
$6.59 |
| J3490 |
Unclassified drugs |
158 |
117 |
$5.99 |
| G0283 |
Electrical stimulation (unattended), to one or more areas for indication(s) other than wound care, as part of a therapy plan of care |
34 |
13 |
$4.32 |
| J1815 |
Injection, insulin, per 5 units |
506 |
317 |
$2.76 |
| J0330 |
Injection, succinylcholine chloride, up to 20 mg |
1,277 |
1,142 |
$1.16 |
| J2710 |
Injection, neostigmine methylsulfate, up to 0.5 mg |
1,472 |
1,310 |
$0.00 |
| C1760 |
Closure device, vascular (implantable/insertable) |
144 |
133 |
$0.00 |
| A9576 |
Injection, gadoteridol, (prohance multipack), per ml |
183 |
156 |
$0.00 |
| 87210 |
|
607 |
585 |
$0.00 |
| 82010 |
|
434 |
386 |
$0.00 |
| C9113 |
Injection, pantoprazole sodium, per vial |
1,509 |
1,069 |
$0.00 |
| J2919 |
Injection, methylprednisolone sodium succinate, 5 mg |
35 |
30 |
$0.00 |
| 84100 |
|
1,194 |
944 |
$0.00 |
| J1245 |
Injection, dipyridamole, per 10 mg |
263 |
219 |
$0.00 |
| C1894 |
Introducer/sheath, other than guiding, other than intracardiac electrophysiological, non-laser |
1,437 |
1,231 |
$0.00 |
| J7030 |
Infusion, normal saline solution , 1000 cc |
606 |
462 |
$0.00 |
| J0665 |
Injection, bupivicaine, not otherwise specified, 0.5 mg |
583 |
496 |
$0.00 |
| 82248 |
|
186 |
177 |
$0.00 |
| A6196 |
Alginate or other fiber gelling dressing, wound cover, sterile, pad size 16 sq. in. or less, each dressing |
164 |
52 |
$0.00 |
| 96413 |
|
203 |
166 |
$0.00 |
| G8989 |
Self care functional limitation, discharge status, at discharge from therapy or to end reporting |
152 |
118 |
$0.00 |
| G8979 |
Mobility: walking & moving around functional limitation, projected goal status, at therapy episode outset, at reporting intervals, and at discharge or to end reporting |
644 |
485 |
$0.00 |
| C1729 |
Catheter, drainage |
537 |
242 |
$0.00 |
| 82140 |
|
208 |
180 |
$0.00 |
| A6021 |
Collagen dressing, sterile, size 16 sq. in. or less, each |
132 |
52 |
$0.00 |
| 84520 |
|
73 |
53 |
$0.00 |
| J1596 |
Injection, glycopyrrolate, 0.1 mg |
235 |
224 |
$0.00 |
| G8978 |
Mobility: walking & moving around functional limitation, current status, at therapy episode outset and at reporting intervals |
564 |
439 |
$0.00 |
| J1953 |
Injection, levetiracetam, 10 mg |
33 |
28 |
$0.00 |
| J2272 |
Injection, morphine sulfate (fresenius kabi), not therapeutically equivalent to j2270, up to 10 mg |
132 |
104 |
$0.00 |
| 74300 |
|
110 |
104 |
$0.00 |
| 87045 |
|
14 |
14 |
$0.00 |
| 84295 |
|
50 |
36 |
$0.00 |
| J7040 |
Infusion, normal saline solution, sterile (500 ml = 1 unit) |
55 |
53 |
$0.00 |
| J0744 |
Injection, ciprofloxacin for intravenous infusion, 200 mg |
40 |
32 |
$0.00 |
| 85347 |
|
20 |
13 |
$0.00 |
| J0171 |
Injection, adrenalin, epinephrine, 0.1 mg |
78 |
72 |
$0.00 |
| J2004 |
Injection, lidocaine hcl with epinephrine, 1 mg |
17 |
17 |
$0.00 |
| Q2038 |
Influenza virus vaccine, split virus, when administered to individuals 3 years of age and older, for intramuscular use (fluzone) |
79 |
65 |
$0.00 |
| 36600 |
|
23 |
21 |
$0.00 |
| J1171 |
Injection, hydromorphone, 0.1 mg |
25 |
20 |
$0.00 |
| C1758 |
Catheter, ureteral |
45 |
44 |
$0.00 |
| 89051 |
|
31 |
26 |
$0.00 |
| A9537 |
Technetium tc-99m mebrofenin, diagnostic, per study dose, up to 15 millicuries |
15 |
13 |
$0.00 |
| 97167 |
|
15 |
12 |
$0.00 |
| 87899 |
|
18 |
14 |
$0.00 |
| 87324 |
|
14 |
14 |
$0.00 |
| J0153 |
Injection, adenosine, 1 mg (not to be used to report any adenosine phosphate compounds) |
37 |
30 |
$0.00 |
| C8929 |
Transthoracic echocardiography with contrast, or without contrast followed by with contrast, real-time with image documentation (2d), includes m-mode recording, when performed, complete, with spectral doppler echocardiography, and with color flow doppler echocardiography |
14 |
12 |
$0.00 |
| 82374 |
|
13 |
12 |
$0.00 |
| C1769 |
Guide wire |
1,810 |
1,568 |
$0.00 |
| J7512 |
Prednisone, immediate release or delayed release, oral, 1 mg |
273 |
260 |
$0.00 |
| J2795 |
Injection, ropivacaine hydrochloride, 1 mg |
192 |
174 |
$0.00 |
| 99153 |
Mod sedat endo service >5yrs |
131 |
107 |
$0.00 |
| J2370 |
Injection, phenylephrine hcl, up to 1 ml |
1,072 |
654 |
$0.00 |
| G8988 |
Self care functional limitation, projected goal status, at therapy episode outset, at reporting intervals, and at discharge or to end reporting |
241 |
191 |
$0.00 |
| J2765 |
Injection, metoclopramide hcl, up to 10 mg |
1,795 |
1,539 |
$0.00 |
| 82330 |
|
16 |
15 |
$0.00 |
| J2543 |
Injection, piperacillin sodium/tazobactam sodium, 1 gram/0.125 grams (1.125 grams) |
329 |
163 |
$0.00 |
| 77063 |
|
61 |
58 |
$0.00 |
| J2371 |
Injection, phenylephrine hydrochloride, 20 micrograms |
42 |
38 |
$0.00 |
| A9585 |
Injection, gadobutrol, 0.1 ml |
374 |
321 |
$0.00 |
| 88342 |
|
1,653 |
1,501 |
$0.00 |
| J7999 |
Compounded drug, not otherwise classified |
645 |
598 |
$0.00 |
| G8987 |
Self care functional limitation, current status, at therapy episode outset and at reporting intervals |
196 |
157 |
$0.00 |
| J2704 |
Injection, propofol, 10 mg |
2,357 |
2,131 |
$0.00 |
| 94760 |
|
1,718 |
1,080 |
$0.00 |
| G8980 |
Mobility: walking & moving around functional limitation, discharge status, at discharge from therapy or to end reporting |
334 |
266 |
$0.00 |
| 77001 |
|
13 |
12 |
$0.00 |
| A6207 |
Contact layer, sterile, more than 16 sq. in. but less than or equal to 48 sq. in., each dressing |
503 |
102 |
$0.00 |
| J2175 |
Injection, meperidine hydrochloride, per 100 mg |
1,633 |
1,458 |
$0.00 |
| J1805 |
Injection, esmolol hydrochloride, 10 mg |
26 |
25 |
$0.00 |
| J2001 |
Injection, lidocaine hcl for intravenous infusion, 10 mg |
725 |
599 |
$0.00 |
| J0360 |
Injection, hydralazine hcl, up to 20 mg |
228 |
178 |
$0.00 |
| 80051 |
|
72 |
58 |
$0.00 |
| 87490 |
|
131 |
126 |
$0.00 |
| 76801 |
|
304 |
275 |
$0.00 |
| 36416 |
|
3,084 |
1,510 |
$0.00 |
| J2785 |
Injection, regadenoson, 0.1 mg |
205 |
179 |
$0.00 |
| 88311 |
|
454 |
389 |
$0.00 |
| C1725 |
Catheter, transluminal angioplasty, non-laser (may include guidance, infusion/perfusion capability) |
56 |
49 |
$0.00 |
| J1940 |
Injection, furosemide, up to 20 mg |
176 |
104 |
$0.00 |
| J0456 |
Injection, azithromycin, 500 mg |
82 |
59 |
$0.00 |
| J1630 |
Injection, haloperidol, up to 5 mg |
120 |
110 |
$0.00 |
| 87015 |
|
236 |
196 |
$0.00 |
| J1642 |
Injection, heparin sodium, (heparin lock flush), per 10 units |
62 |
41 |
$0.00 |
| 95886 |
|
12 |
12 |
$0.00 |
| G0008 |
Administration of influenza virus vaccine |
36 |
31 |
$0.00 |
| 70496 |
|
80 |
80 |
$0.00 |
| 82435 |
|
50 |
36 |
$0.00 |
| 85018 |
|
17 |
12 |
$0.00 |
| J2003 |
Injection, lidocaine hydrochloride, 1 mg |
176 |
137 |
$0.00 |
| J0280 |
Injection, aminophyllin, up to 250 mg |
74 |
53 |
$0.00 |
| 90732 |
|
13 |
12 |
$0.00 |
| 86140 |
|
82 |
76 |
$0.00 |
| 99406 |
|
51 |
48 |
$0.00 |
| C1889 |
Implantable/insertable device, not otherwise classified |
23 |
23 |
$0.00 |
| J7050 |
Infusion, normal saline solution, 250 cc |
97 |
66 |
$0.00 |
| 76817 |
|
27 |
25 |
$0.00 |
| 87426 |
|
23 |
21 |
$0.00 |
| 73060 |
|
15 |
13 |
$0.00 |
| 76870 |
|
12 |
12 |
$0.00 |
| J2470 |
Injection, pantoprazole sodium, 40 mg |
20 |
13 |
$0.00 |
| 88300 |
|
15 |
12 |
$0.00 |
| 82150 |
|
13 |
13 |
$0.00 |