| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
131,988 |
122,497 |
$14.50M |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
120,136 |
108,270 |
$8.91M |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
12,893 |
12,886 |
$2.05M |
| 87637 |
Infectious agent detection by nucleic acid; SARS-CoV-2, influenza, and RSV |
9,710 |
9,469 |
$1.34M |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
10,733 |
10,729 |
$1.09M |
| 17110 |
|
4,863 |
2,311 |
$1.07M |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
17,851 |
8,338 |
$889K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
8,326 |
8,324 |
$846K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
8,636 |
8,496 |
$812K |
| Q9992 |
Injection, buprenorphine extended-release (sublocade), greater than 100 mg |
458 |
439 |
$806K |
| 20611 |
|
3,123 |
1,602 |
$740K |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
23,157 |
23,070 |
$697K |
| 80053 |
Comprehensive metabolic panel |
62,310 |
59,479 |
$649K |
| 87801 |
Infectious agent detection by nucleic acid; amplified probe, multiple organisms |
8,640 |
8,477 |
$635K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
6,043 |
6,038 |
$631K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
5,241 |
5,234 |
$603K |
| 84443 |
Thyroid stimulating hormone (TSH) |
33,065 |
32,685 |
$538K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
4,406 |
4,406 |
$531K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
4,718 |
4,717 |
$525K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
63,062 |
60,497 |
$483K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
27,659 |
27,520 |
$482K |
| 80061 |
Lipid panel |
35,312 |
35,141 |
$475K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
3,819 |
3,819 |
$438K |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
7,052 |
5,149 |
$424K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
3,283 |
3,271 |
$399K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
9,160 |
9,025 |
$358K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
9,157 |
9,022 |
$358K |
| J0585 |
Injection, onabotulinumtoxina, 1 unit |
581 |
330 |
$351K |
| 80305 |
|
27,021 |
13,006 |
$334K |
| 99215 |
Prolong outpt/office vis |
2,041 |
1,961 |
$321K |
| 62323 |
|
905 |
393 |
$299K |
| 87661 |
Infectious agent detection by nucleic acid; Trichomonas vaginalis, amplified probe |
8,239 |
8,084 |
$298K |
| 82607 |
|
18,710 |
18,605 |
$286K |
| 87481 |
|
2,105 |
2,065 |
$281K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,924 |
1,924 |
$278K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
7,607 |
7,520 |
$275K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
17,450 |
13,925 |
$266K |
| 71046 |
Radiologic examination, chest; 2 views |
8,742 |
8,692 |
$257K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
25,747 |
25,565 |
$243K |
| 80050 |
General health panel |
6,764 |
6,690 |
$237K |
| 82728 |
|
17,661 |
17,406 |
$235K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
2,257 |
2,256 |
$234K |
| 76536 |
|
2,104 |
2,101 |
$222K |
| 58558 |
|
247 |
143 |
$222K |
| 87480 |
|
9,272 |
9,022 |
$194K |
| 84439 |
|
21,288 |
21,114 |
$194K |
| 20610 |
|
891 |
459 |
$180K |
| J1439 |
Injection, ferric carboxymaltose, 1 mg |
212 |
145 |
$168K |
| 59400 |
Routine obstetric care including antepartum care, vaginal delivery, and postpartum care |
80 |
79 |
$167K |
| 93306 |
Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete |
1,008 |
1,006 |
$165K |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
19,271 |
18,483 |
$164K |
| 27096 |
|
510 |
233 |
$147K |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
1,612 |
1,311 |
$146K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
8,544 |
8,442 |
$137K |
| 90832 |
Psychotherapy, 30 minutes with patient |
2,085 |
1,553 |
$136K |
| 99205 |
Prolong outpt/office vis |
645 |
645 |
$131K |
| 43239 |
Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple |
1,258 |
1,256 |
$130K |
| 83550 |
|
14,394 |
14,235 |
$122K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
1,067 |
952 |
$114K |
| 73630 |
|
3,517 |
3,075 |
$110K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
1,366 |
1,143 |
$109K |
| 86780 |
|
7,406 |
7,382 |
$107K |
| 59025 |
Fetal non-stress test |
2,400 |
1,158 |
$106K |
| 97161 |
|
1,247 |
1,247 |
$103K |
| 86003 |
|
1,043 |
1,041 |
$102K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
4,716 |
4,562 |
$98K |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
1,314 |
1,314 |
$97K |
| 99406 |
|
7,009 |
4,988 |
$96K |
| 84702 |
|
5,845 |
5,194 |
$96K |
| 83540 |
|
15,173 |
14,999 |
$96K |
| 87660 |
|
3,927 |
3,771 |
$91K |
| 87510 |
|
3,853 |
3,701 |
$90K |
| 87081 |
|
11,882 |
11,643 |
$87K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
1,070 |
1,013 |
$87K |
| 83516 |
|
1,807 |
1,787 |
$85K |
| 81001 |
|
25,842 |
24,925 |
$85K |
| 94729 |
|
1,630 |
1,629 |
$85K |
| 82746 |
|
5,635 |
5,611 |
$82K |
| 94726 |
|
1,603 |
1,603 |
$80K |
| 86235 |
|
1,985 |
1,974 |
$79K |
| 84403 |
|
2,628 |
2,603 |
$74K |
| 72110 |
|
1,601 |
1,600 |
$74K |
| 95024 |
|
461 |
447 |
$70K |
| 76642 |
|
619 |
619 |
$68K |
| 76819 |
Fetal biophysical profile; without non-stress testing |
825 |
552 |
$67K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
1,497 |
1,462 |
$67K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
494 |
494 |
$67K |
| 76830 |
Ultrasound, transvaginal |
655 |
652 |
$66K |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
1,414 |
1,414 |
$66K |
| 45380 |
Colonoscopy, flexible; with biopsy, single or multiple |
481 |
481 |
$65K |
| 94060 |
|
1,393 |
1,392 |
$64K |
| 73030 |
|
2,054 |
1,870 |
$62K |
| 73564 |
|
1,420 |
1,162 |
$61K |
| 87502 |
Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets |
609 |
608 |
$60K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
7,724 |
7,628 |
$60K |
| 90686 |
|
9,178 |
9,170 |
$59K |
| 83735 |
|
8,717 |
8,581 |
$57K |
| 90791 |
Psychiatric diagnostic evaluation |
347 |
347 |
$52K |
| 90682 |
|
790 |
789 |
$49K |
| 86140 |
|
9,856 |
9,700 |
$49K |
| G2066 |
Interrogation device evaluation(s), (remote) up to 30 days; implantable cardiovascular physiologic monitor system, implantable loop recorder system, or subcutaneous cardiac rhythm monitor system, remote data acquisition(s), receipt of transmissions and technician review, technical support and distribution of results |
294 |
292 |
$47K |
| 95117 |
|
4,365 |
1,680 |
$47K |
| 73562 |
|
1,263 |
1,063 |
$47K |
| 86038 |
|
3,469 |
3,439 |
$46K |
| 76700 |
Ultrasound, abdominal, real time with image documentation; complete |
396 |
395 |
$45K |
| 82043 |
|
7,966 |
7,913 |
$45K |
| 85027 |
|
6,629 |
6,014 |
$45K |
| 84146 |
|
2,187 |
2,175 |
$45K |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
531 |
530 |
$45K |
| 82784 |
|
2,593 |
2,573 |
$44K |
| 84153 |
|
2,153 |
2,143 |
$44K |
| T1013 |
Sign language or oral interpretive services, per 15 minutes |
3,463 |
3,141 |
$40K |
| 73610 |
|
1,190 |
1,128 |
$40K |
| J1756 |
Injection, iron sucrose, 1 mg |
968 |
693 |
$40K |
| 84480 |
|
2,572 |
2,554 |
$39K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
4,745 |
4,564 |
$39K |
| 86225 |
|
2,590 |
2,583 |
$39K |
| 99385 |
|
296 |
296 |
$38K |
| 64615 |
|
208 |
123 |
$38K |
| 76801 |
|
322 |
320 |
$37K |
| J2315 |
Injection, naltrexone, depot form, 1 mg |
29 |
25 |
$37K |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
963 |
688 |
$36K |
| 77002 |
|
384 |
355 |
$34K |
| 87186 |
|
3,581 |
3,484 |
$34K |
| 84703 |
|
4,095 |
4,013 |
$33K |
| 86160 |
|
2,440 |
1,372 |
$32K |
| 80074 |
|
670 |
668 |
$32K |
| 82670 |
|
1,041 |
1,024 |
$31K |
| 83001 |
|
1,581 |
1,575 |
$31K |
| 86200 |
|
2,132 |
2,126 |
$30K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
1,703 |
926 |
$30K |
| 84550 |
|
6,078 |
5,919 |
$28K |
| 90715 |
|
949 |
946 |
$28K |
| J1040 |
Injection, methylprednisolone acetate, 80 mg |
2,288 |
1,963 |
$27K |
| 93000 |
|
1,869 |
1,862 |
$26K |
| J3301 |
Injection, triamcinolone acetonide, not otherwise specified, 10 mg |
3,681 |
3,543 |
$26K |
| 73130 |
|
751 |
573 |
$26K |
| 95004 |
Percutaneous tests with allergenic extracts, immediate type reaction |
394 |
387 |
$25K |
| 83002 |
|
1,269 |
1,265 |
$25K |
| 85007 |
|
6,509 |
5,885 |
$25K |
| 90674 |
|
1,018 |
1,017 |
$24K |
| 87506 |
|
91 |
90 |
$24K |
| 86334 |
|
983 |
978 |
$23K |
| 92550 |
|
1,119 |
1,115 |
$23K |
| 83615 |
|
3,665 |
3,515 |
$23K |
| 86762 |
|
1,581 |
1,579 |
$23K |
| 85652 |
|
7,973 |
7,836 |
$23K |
| 87088 |
|
2,511 |
2,453 |
$22K |
| G2211 |
Visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and/or with medical care services that are part of ongoing care related to a patient's single, serious condition or a complex condition. (add-on code, list separately in addition to office/outpatient evaluation and management visit, new or established) |
1,667 |
1,628 |
$22K |
| 86803 |
|
1,475 |
1,468 |
$22K |
| 87070 |
|
2,189 |
2,157 |
$21K |
| 92250 |
|
472 |
472 |
$20K |
| 82570 |
|
4,033 |
3,924 |
$20K |
| 85610 |
|
4,513 |
4,187 |
$20K |
| 88342 |
|
628 |
627 |
$20K |
| 87340 |
|
1,729 |
1,719 |
$19K |
| J3420 |
Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg |
10,146 |
8,626 |
$18K |
| 85730 |
|
2,654 |
2,616 |
$18K |
| 86376 |
|
1,130 |
1,125 |
$17K |
| 80076 |
|
1,909 |
1,843 |
$17K |
| 87631 |
|
115 |
115 |
$17K |
| 86431 |
|
2,714 |
2,693 |
$17K |
| 83690 |
|
2,250 |
2,217 |
$16K |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
267 |
190 |
$16K |
| G0399 |
Home sleep test (hst) with type iii portable monitor, unattended; minimum of 4 channels: 2 respiratory movement/airflow, 1 ecg/heart rate and 1 oxygen saturation |
178 |
178 |
$16K |
| 86039 |
|
1,282 |
1,268 |
$16K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
210 |
210 |
$15K |
| 76813 |
|
133 |
133 |
$15K |
| 99443 |
|
160 |
158 |
$15K |
| 84165 |
|
1,283 |
1,271 |
$14K |
| 82150 |
|
2,033 |
2,013 |
$14K |
| 99381 |
|
134 |
134 |
$14K |
| 87653 |
|
299 |
298 |
$13K |
| 99232 |
Subsequent hospital care, per day, moderate complexity |
214 |
80 |
$12K |
| 83020 |
|
897 |
897 |
$12K |
| 96127 |
|
2,435 |
2,411 |
$12K |
| 78452 |
Myocardial perfusion imaging, tomographic (SPECT); multiple studies at rest and/or stress |
27 |
27 |
$12K |
| 83970 |
|
284 |
280 |
$12K |
| 99442 |
|
181 |
181 |
$12K |
| 92557 |
|
302 |
302 |
$11K |
| 73110 |
|
279 |
262 |
$11K |
| 74018 |
|
387 |
386 |
$10K |
| 73502 |
|
252 |
249 |
$10K |
| 83721 |
|
941 |
931 |
$10K |
| 82785 |
|
541 |
540 |
$10K |
| 70551 |
Magnetic resonance imaging, brain; without contrast material |
44 |
44 |
$10K |
| 93015 |
|
152 |
151 |
$10K |
| 90732 |
|
81 |
81 |
$10K |
| 76811 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, detailed |
55 |
55 |
$9K |
| 59426 |
|
12 |
12 |
$9K |
| 82550 |
|
1,322 |
1,294 |
$9K |
| 82947 |
|
2,161 |
2,143 |
$9K |
| 11900 |
|
168 |
164 |
$9K |
| G0103 |
Prostate cancer screening; prostate specific antigen test (psa) |
518 |
518 |
$9K |
| 90661 |
|
675 |
675 |
$9K |
| 81025 |
|
995 |
984 |
$8K |
| 87493 |
|
209 |
208 |
$8K |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
26 |
26 |
$8K |
| 97112 |
Therapeutic procedure, each 15 minutes; neuromuscular reeducation of movement, balance, coordination |
214 |
107 |
$8K |
| 95819 |
|
24 |
24 |
$8K |
| 88313 |
|
729 |
718 |
$8K |
| 84100 |
|
1,503 |
1,468 |
$7K |
| 72050 |
|
157 |
157 |
$7K |
| 99454 |
|
168 |
167 |
$7K |
| 45385 |
Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) |
28 |
28 |
$7K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
1,197 |
1,197 |
$7K |
| 36415 |
Collection of venous blood by venipuncture |
96,515 |
88,043 |
$7K |
| 20553 |
|
29 |
15 |
$7K |
| 87077 |
|
733 |
713 |
$7K |
| 85044 |
|
1,290 |
1,281 |
$6K |
| 83090 |
|
353 |
352 |
$6K |
| 90670 |
|
4,788 |
4,783 |
$6K |
| A9500 |
Technetium tc-99m sestamibi, diagnostic, per study dose |
27 |
27 |
$6K |
| 99233 |
Prolong inpt eval add15 m |
57 |
57 |
$6K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
112 |
112 |
$5K |
| 84460 |
|
1,029 |
1,000 |
$5K |
| 93298 |
|
241 |
240 |
$5K |
| 84450 |
|
1,028 |
999 |
$5K |
| 90750 |
|
25 |
25 |
$5K |
| 82627 |
|
209 |
209 |
$5K |
| 87205 |
|
1,158 |
1,138 |
$5K |
| 99386 |
|
32 |
32 |
$5K |
| 84478 |
|
783 |
764 |
$5K |
| 85045 |
|
1,165 |
1,139 |
$5K |
| 81002 |
|
1,353 |
1,297 |
$5K |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
420 |
420 |
$4K |
| 82248 |
|
840 |
700 |
$4K |
| 99383 |
|
38 |
38 |
$4K |
| 86008 |
|
14 |
14 |
$4K |
| 85018 |
|
1,624 |
1,623 |
$4K |
| 93971 |
|
39 |
38 |
$4K |
| 99222 |
Initial hospital care, per day, moderate complexity |
39 |
39 |
$4K |
| 84484 |
|
327 |
322 |
$4K |
| 99441 |
|
74 |
70 |
$4K |
| 87046 |
|
109 |
109 |
$4K |
| 76641 |
|
27 |
27 |
$3K |
| 71271 |
|
25 |
25 |
$3K |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
237 |
236 |
$3K |
| J2785 |
Injection, regadenoson, 0.1 mg |
13 |
13 |
$3K |
| 71250 |
|
24 |
24 |
$3K |
| 94010 |
|
104 |
104 |
$3K |
| 92015 |
Determination of refractive state |
2,250 |
2,248 |
$3K |
| 11730 |
|
27 |
27 |
$3K |
| 85379 |
|
253 |
251 |
$3K |
| 90632 |
|
29 |
29 |
$3K |
| 86308 |
|
436 |
433 |
$2K |
| 93351 |
|
12 |
12 |
$2K |
| 95115 |
|
243 |
93 |
$2K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
390 |
390 |
$2K |
| 92582 |
|
32 |
32 |
$2K |
| 99457 |
|
172 |
171 |
$2K |
| 95816 |
|
14 |
14 |
$2K |
| 82951 |
|
144 |
144 |
$2K |
| 77066 |
Tomosynthesis, mammo |
12 |
12 |
$2K |
| J1030 |
Injection, methylprednisolone acetate, 40 mg |
176 |
172 |
$2K |
| 90746 |
|
24 |
24 |
$2K |
| 87899 |
|
95 |
56 |
$2K |
| 96413 |
Chemotherapy administration, intravenous infusion; up to 1 hour, single or initial substance |
16 |
12 |
$2K |
| 96367 |
|
38 |
25 |
$1K |
| 83525 |
|
121 |
119 |
$1K |
| 97165 |
|
16 |
16 |
$1K |
| 95886 |
|
12 |
12 |
$1K |
| 58300 |
|
14 |
14 |
$1K |
| 87328 |
|
87 |
87 |
$1K |
| 87045 |
|
109 |
109 |
$1K |
| 93224 |
|
14 |
14 |
$1K |
| 86706 |
|
109 |
109 |
$1K |
| 86141 |
|
77 |
77 |
$1K |
| 86735 |
|
84 |
84 |
$1K |
| 86765 |
|
84 |
84 |
$1K |
| 11102 |
|
12 |
12 |
$1K |
| 90620 |
|
14 |
14 |
$1K |
| 87807 |
|
71 |
70 |
$1K |
| 87329 |
|
72 |
72 |
$976.66 |
| 97010 |
|
3,399 |
1,680 |
$898.47 |
| 84144 |
|
40 |
39 |
$838.79 |
| 90688 |
|
45 |
45 |
$813.10 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
505 |
504 |
$798.63 |
| 90461 |
|
8,105 |
8,096 |
$767.51 |
| 72052 |
|
12 |
12 |
$724.33 |
| 73522 |
|
15 |
15 |
$712.30 |
| 87427 |
|
53 |
53 |
$708.39 |
| 86787 |
|
56 |
56 |
$699.04 |
| 84156 |
|
165 |
138 |
$653.38 |
| 84436 |
|
79 |
79 |
$597.36 |
| 96380 |
|
27 |
27 |
$594.54 |
| 83861 |
|
14 |
14 |
$577.20 |
| 82952 |
|
109 |
101 |
$491.04 |
| 72072 |
|
12 |
12 |
$447.24 |
| 73140 |
|
13 |
12 |
$421.72 |
| 82977 |
|
55 |
54 |
$408.12 |
| 87015 |
|
56 |
56 |
$347.40 |
| 92504 |
|
12 |
12 |
$345.21 |
| 86709 |
|
27 |
26 |
$334.98 |
| A9576 |
Injection, gadoteridol, (prohance multipack), per ml |
12 |
12 |
$291.00 |
| 83520 |
|
12 |
12 |
$290.82 |
| 82378 |
|
13 |
13 |
$263.94 |
| 99000 |
|
46,692 |
43,041 |
$262.83 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
243 |
214 |
$248.72 |
| 90694 |
|
13 |
13 |
$244.29 |
| 81003 |
|
109 |
107 |
$210.86 |
| 82247 |
|
35 |
26 |
$191.00 |
| J7613 |
Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg |
1,262 |
1,262 |
$142.84 |
| 82270 |
|
27 |
27 |
$118.02 |
| 86580 |
|
12 |
12 |
$92.88 |
| 82565 |
|
14 |
14 |
$84.17 |
| 99497 |
|
13 |
13 |
$67.84 |
| J7512 |
Prednisone, immediate release or delayed release, oral, 1 mg |
71 |
71 |
$32.37 |
| 90647 |
|
3,523 |
3,521 |
$31.33 |
| J7620 |
Albuterol, up to 2.5 mg and ipratropium bromide, up to 0.5 mg, fda-approved final product, non-compounded, administered through dme |
128 |
127 |
$16.95 |
| J7614 |
Levalbuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 0.5 mg |
65 |
65 |
$9.38 |
| 90633 |
|
1,774 |
1,772 |
$0.00 |
| 90734 |
|
923 |
923 |
$0.00 |
| 90710 |
|
549 |
549 |
$0.00 |
| 90700 |
|
146 |
146 |
$0.00 |
| A4550 |
Surgical trays |
207 |
159 |
$0.00 |
| 90707 |
|
89 |
89 |
$0.00 |
| 90685 |
|
401 |
397 |
$0.00 |
| 90672 |
|
150 |
150 |
$0.00 |
| 90680 |
|
2,972 |
2,969 |
$0.00 |
| 90723 |
|
3,579 |
3,574 |
$0.00 |
| 90677 |
|
827 |
827 |
$0.00 |
| 99024 |
|
325 |
292 |
$0.00 |
| 90651 |
|
338 |
338 |
$0.00 |
| 90696 |
|
192 |
192 |
$0.00 |
| 90716 |
|
68 |
68 |
$0.00 |
| A9150 |
Non-prescription drugs |
25 |
24 |
$0.00 |
| G0008 |
Administration of influenza virus vaccine |
12 |
12 |
$0.00 |