| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
20,494 |
19,400 |
$2.81M |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
16,381 |
15,430 |
$2.24M |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
3,882 |
3,800 |
$1.55M |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
9,869 |
9,363 |
$1.37M |
| 87637 |
Infectious agent detection by nucleic acid; SARS-CoV-2, influenza, and RSV |
15,552 |
12,784 |
$1.32M |
| 96361 |
Intravenous infusion, hydration; each additional hour |
6,209 |
5,548 |
$1.14M |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
11,669 |
8,806 |
$1.13M |
| 80053 |
Comprehensive metabolic panel |
47,328 |
32,406 |
$902K |
| 70450 |
Computed tomography, head or brain; without contrast material |
2,799 |
2,746 |
$823K |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
10,712 |
3,524 |
$705K |
| 11042 |
Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm |
2,596 |
1,207 |
$661K |
| H0005 |
Alcohol and/or drug services; group counseling by a clinician |
11,113 |
2,320 |
$657K |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
1,554 |
1,532 |
$584K |
| G0397 |
Alcohol and/or substance (other than tobacco) misuse structured assessment (e.g., audit, dast), and intervention, greater than 30 minutes |
4,159 |
2,470 |
$562K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
1,610 |
1,588 |
$370K |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
2,690 |
2,630 |
$341K |
| G0396 |
Alcohol and/or substance (other than tobacco) misuse structured assessment (e.g., audit, dast), and brief intervention 15 to 30 minutes |
3,238 |
2,222 |
$332K |
| 99281 |
Emergency department visit for the evaluation and management, self-limited or minor |
2,526 |
2,464 |
$326K |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
6,830 |
6,131 |
$288K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
2,806 |
2,689 |
$256K |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
2,280 |
2,188 |
$256K |
| 96360 |
Intravenous infusion, hydration; initial, 31 minutes to 1 hour |
1,747 |
1,696 |
$231K |
| 36415 |
Collection of venous blood by venipuncture |
34,703 |
19,399 |
$226K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
1,871 |
1,390 |
$191K |
| 70553 |
Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences |
410 |
410 |
$187K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
2,468 |
2,468 |
$179K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
5,712 |
5,605 |
$158K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
2,657 |
2,492 |
$152K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
7,115 |
6,393 |
$149K |
| 59025 |
Fetal non-stress test |
3,647 |
1,795 |
$148K |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
4,034 |
4,019 |
$142K |
| 76830 |
Ultrasound, transvaginal |
1,955 |
1,915 |
$140K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
36,188 |
32,164 |
$138K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
5,697 |
5,588 |
$130K |
| 71275 |
Computed tomographic angiography, chest, with contrast material |
380 |
376 |
$130K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
2,760 |
1,950 |
$130K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
11,178 |
10,356 |
$128K |
| 86850 |
|
4,631 |
4,380 |
$125K |
| 76801 |
|
1,284 |
1,188 |
$114K |
| 97161 |
|
1,482 |
1,464 |
$114K |
| 76770 |
|
740 |
723 |
$108K |
| 96366 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour |
877 |
712 |
$108K |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
2,185 |
2,128 |
$107K |
| 84443 |
Thyroid stimulating hormone (TSH) |
10,318 |
10,061 |
$107K |
| 71046 |
Radiologic examination, chest; 2 views |
6,939 |
6,747 |
$104K |
| 72125 |
Computed tomography, cervical spine; without contrast material |
892 |
880 |
$100K |
| 76641 |
|
1,706 |
1,660 |
$96K |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
1,371 |
1,354 |
$94K |
| 93306 |
Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete |
408 |
406 |
$90K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
2,163 |
2,099 |
$89K |
| 71250 |
|
572 |
571 |
$86K |
| 86901 |
|
4,646 |
4,397 |
$83K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
1,206 |
1,206 |
$81K |
| 76700 |
Ultrasound, abdominal, real time with image documentation; complete |
699 |
697 |
$80K |
| 80061 |
Lipid panel |
8,083 |
8,027 |
$69K |
| 86900 |
|
4,641 |
4,393 |
$67K |
| 84484 |
|
6,275 |
5,663 |
$66K |
| U0002 |
2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc |
1,359 |
1,303 |
$66K |
| S9480 |
Intensive outpatient psychiatric services, per diem |
625 |
135 |
$66K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
748 |
627 |
$65K |
| 92507 |
Treatment of speech, language, voice, communication, and/or auditory processing disorder |
648 |
192 |
$61K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
5,712 |
5,667 |
$61K |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
2,935 |
2,877 |
$60K |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
6,332 |
5,955 |
$60K |
| 43239 |
Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple |
108 |
108 |
$57K |
| 97140 |
Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) |
1,895 |
751 |
$57K |
| 88175 |
Cytopathology, cervical or vaginal, any reporting system; collected in preservative fluid, automated thin layer |
1,844 |
1,844 |
$57K |
| 96375 |
Therapeutic injection; each additional sequential IV push |
4,959 |
4,479 |
$54K |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
9,001 |
8,306 |
$54K |
| 12001 |
|
148 |
148 |
$53K |
| 93971 |
|
607 |
589 |
$49K |
| 87660 |
|
3,689 |
3,619 |
$48K |
| 77065 |
Tomosynthesis, mammo |
447 |
447 |
$44K |
| 71045 |
Radiologic examination, chest; single view |
4,997 |
4,779 |
$43K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
3,400 |
3,185 |
$42K |
| 87480 |
|
3,351 |
3,286 |
$41K |
| 84439 |
|
4,050 |
4,026 |
$41K |
| 87510 |
|
3,250 |
3,186 |
$40K |
| 87624 |
Infectious agent detection by nucleic acid; human papillomavirus (HPV), high-risk types |
1,164 |
1,164 |
$37K |
| 70486 |
|
286 |
285 |
$36K |
| 81001 |
|
13,135 |
12,118 |
$36K |
| G0378 |
Hospital observation service, per hour |
518 |
506 |
$35K |
| 84702 |
|
3,749 |
3,158 |
$35K |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
2,399 |
2,388 |
$34K |
| 87502 |
Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets |
704 |
697 |
$34K |
| 81025 |
|
5,151 |
4,955 |
$33K |
| 82607 |
|
2,342 |
2,326 |
$33K |
| H0002 |
Behavioral health screening to determine eligibility for admission to treatment program |
193 |
193 |
$32K |
| 97162 |
|
325 |
324 |
$32K |
| 77066 |
Tomosynthesis, mammo |
380 |
380 |
$31K |
| 90715 |
|
1,098 |
1,090 |
$30K |
| 83880 |
|
931 |
857 |
$30K |
| 73564 |
|
1,011 |
993 |
$29K |
| 76536 |
|
579 |
574 |
$28K |
| 83655 |
|
1,858 |
1,843 |
$28K |
| 83735 |
|
7,151 |
6,433 |
$27K |
| 82746 |
|
1,922 |
1,912 |
$27K |
| 87077 |
|
3,210 |
3,073 |
$27K |
| 73630 |
|
1,521 |
1,422 |
$26K |
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
843 |
658 |
$24K |
| 73130 |
|
1,596 |
1,436 |
$24K |
| 83690 |
|
8,107 |
7,621 |
$24K |
| 82728 |
|
1,530 |
1,520 |
$24K |
| 11045 |
|
19 |
13 |
$23K |
| 72110 |
|
608 |
606 |
$23K |
| 85610 |
|
4,621 |
4,194 |
$23K |
| 73030 |
|
1,126 |
1,067 |
$23K |
| 97112 |
Therapeutic procedure, each 15 minutes; neuromuscular reeducation of movement, balance, coordination |
814 |
385 |
$23K |
| 73110 |
|
1,177 |
1,031 |
$22K |
| 73610 |
|
1,438 |
1,317 |
$21K |
| 74018 |
|
1,558 |
1,477 |
$21K |
| 94060 |
|
500 |
497 |
$21K |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
2,470 |
2,470 |
$20K |
| 84403 |
|
627 |
620 |
$19K |
| 85730 |
|
3,701 |
3,526 |
$18K |
| 82248 |
|
3,386 |
3,292 |
$17K |
| 87040 |
|
1,668 |
1,595 |
$17K |
| 86803 |
|
1,961 |
1,954 |
$17K |
| 97165 |
|
290 |
287 |
$17K |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
1,948 |
1,271 |
$16K |
| 87430 |
|
4,222 |
4,143 |
$15K |
| G0279 |
Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066) |
400 |
400 |
$15K |
| 81420 |
Fetal chromosomal aneuploidy genomic sequence analysis panel |
28 |
28 |
$15K |
| 87081 |
|
5,261 |
5,165 |
$14K |
| 90834 |
Psychotherapy, 45 minutes with patient |
102 |
98 |
$14K |
| 84100 |
|
4,845 |
4,498 |
$13K |
| 85027 |
|
3,187 |
3,016 |
$13K |
| 86762 |
|
1,244 |
1,241 |
$13K |
| 76376 |
|
301 |
300 |
$12K |
| 96376 |
|
1,077 |
753 |
$12K |
| 83540 |
|
2,032 |
2,018 |
$12K |
| 87340 |
|
1,538 |
1,533 |
$12K |
| 84703 |
|
2,754 |
2,691 |
$12K |
| A9575 |
Injection, gadoterate meglumine, 0.1 ml |
491 |
485 |
$12K |
| 84480 |
|
1,534 |
1,527 |
$11K |
| 94726 |
|
359 |
359 |
$11K |
| 87150 |
|
288 |
285 |
$11K |
| 86592 |
|
4,439 |
4,287 |
$10K |
| 93017 |
|
78 |
78 |
$10K |
| 94729 |
|
352 |
352 |
$10K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
93 |
93 |
$9K |
| 84153 |
|
408 |
407 |
$9K |
| 83550 |
|
1,381 |
1,371 |
$8K |
| 82570 |
|
1,637 |
1,562 |
$8K |
| 81220 |
CFTR (cystic fibrosis transmembrane conductance regulator) gene analysis; common variants |
29 |
29 |
$8K |
| 81329 |
|
63 |
63 |
$8K |
| 86140 |
|
1,698 |
1,411 |
$8K |
| 80076 |
|
932 |
913 |
$7K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
66 |
64 |
$7K |
| 82043 |
|
1,218 |
1,213 |
$7K |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
714 |
708 |
$7K |
| 87075 |
|
794 |
761 |
$7K |
| 92526 |
|
72 |
29 |
$7K |
| 62323 |
|
12 |
12 |
$7K |
| 85379 |
|
1,233 |
1,202 |
$5K |
| 83605 |
|
1,723 |
1,590 |
$5K |
| 84146 |
|
234 |
231 |
$5K |
| 83001 |
|
225 |
224 |
$5K |
| 12011 |
|
13 |
13 |
$5K |
| 85651 |
|
1,641 |
1,534 |
$5K |
| 87801 |
Infectious agent detection by nucleic acid; amplified probe, multiple organisms |
93 |
93 |
$5K |
| 12002 |
|
12 |
12 |
$5K |
| 84402 |
|
155 |
154 |
$5K |
| 81003 |
|
7,051 |
6,540 |
$5K |
| 82950 |
|
1,314 |
1,312 |
$5K |
| 80299 |
|
1,357 |
1,270 |
$4K |
| 99215 |
Prolong outpt/office vis |
38 |
38 |
$4K |
| 73502 |
|
175 |
171 |
$4K |
| 87070 |
|
575 |
569 |
$4K |
| 73721 |
Magnetic resonance imaging, any joint of lower extremity; without contrast material |
13 |
13 |
$4K |
| 83002 |
|
176 |
175 |
$4K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
1,606 |
1,573 |
$4K |
| 73080 |
|
159 |
144 |
$4K |
| 87186 |
|
687 |
667 |
$4K |
| 97116 |
|
105 |
69 |
$4K |
| 86618 |
|
174 |
174 |
$3K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
31 |
31 |
$3K |
| 90674 |
|
147 |
147 |
$3K |
| 86703 |
|
200 |
198 |
$3K |
| 29125 |
|
13 |
13 |
$3K |
| 70496 |
|
13 |
12 |
$3K |
| 76870 |
|
61 |
61 |
$3K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
25 |
25 |
$3K |
| 88142 |
|
93 |
93 |
$3K |
| 90756 |
|
107 |
107 |
$3K |
| 71260 |
Computed tomography, thorax, diagnostic; with contrast material |
13 |
13 |
$3K |
| J0131 |
Injection, acetaminophen, not otherwise specified,10 mg |
341 |
312 |
$3K |
| 82105 |
|
365 |
364 |
$2K |
| 88304 |
|
61 |
60 |
$2K |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
6,796 |
6,227 |
$2K |
| 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 |
48 |
37 |
$2K |
| 83021 |
|
95 |
95 |
$2K |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
3,770 |
3,695 |
$2K |
| 82550 |
|
767 |
717 |
$2K |
| 97530 |
Therapeutic activities, direct patient contact, each 15 minutes |
89 |
39 |
$2K |
| 72052 |
|
67 |
67 |
$2K |
| 83020 |
|
225 |
225 |
$2K |
| 59430 |
|
65 |
65 |
$2K |
| 71271 |
|
54 |
54 |
$2K |
| G0108 |
Diabetes outpatient self-management training services, individual, per 30 minutes |
48 |
48 |
$2K |
| 87153 |
|
27 |
27 |
$2K |
| 80143 |
|
957 |
884 |
$2K |
| 76642 |
|
55 |
54 |
$2K |
| 88342 |
|
26 |
26 |
$2K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
16 |
16 |
$2K |
| 80179 |
|
942 |
875 |
$2K |
| 94760 |
|
273 |
221 |
$2K |
| J0330 |
Injection, succinylcholine chloride, up to 20 mg |
856 |
850 |
$2K |
| 87800 |
|
59 |
59 |
$2K |
| 97010 |
|
101 |
64 |
$2K |
| 84550 |
|
413 |
381 |
$2K |
| 84436 |
|
581 |
581 |
$1K |
| A9573 |
Injection, gadopiclenol, 1 ml |
74 |
72 |
$1K |
| 82670 |
|
44 |
43 |
$1K |
| 86787 |
|
301 |
301 |
$1K |
| J2704 |
Injection, propofol, 10 mg |
1,331 |
1,305 |
$1K |
| 87653 |
|
52 |
52 |
$1K |
| 96367 |
|
28 |
25 |
$1K |
| 0011A |
|
84 |
84 |
$1K |
| H0038 |
Self-help/peer services, per 15 minutes |
23 |
13 |
$1K |
| 82150 |
|
161 |
160 |
$1K |
| 86038 |
|
159 |
159 |
$1K |
| 86308 |
|
303 |
296 |
$1K |
| 84481 |
|
97 |
96 |
$1K |
| 0012A |
|
66 |
66 |
$1K |
| 84630 |
|
101 |
101 |
$940.57 |
| J2930 |
Injection, methylprednisolone sodium succinate, up to 125 mg |
264 |
244 |
$855.35 |
| J1097 |
Phenylephrine 10.16 mg/ml and ketorolac 2.88 mg/ml ophthalmic irrigation solution, 1 ml |
12 |
12 |
$639.75 |
| J2270 |
Injection, morphine sulfate, up to 10 mg |
1,940 |
1,717 |
$603.16 |
| 87420 |
|
114 |
112 |
$571.81 |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
12 |
12 |
$562.94 |
| 90661 |
|
25 |
25 |
$558.80 |
| 90656 |
|
42 |
42 |
$546.39 |
| 73090 |
|
41 |
39 |
$537.92 |
| 82803 |
|
28 |
25 |
$536.73 |
| 87210 |
|
87 |
87 |
$532.92 |
| 83615 |
|
123 |
110 |
$526.29 |
| 73565 |
|
15 |
15 |
$519.12 |
| J1200 |
Injection, diphenhydramine hcl, up to 50 mg |
1,297 |
1,197 |
$515.38 |
| J2360 |
Injection, orphenadrine citrate, up to 60 mg |
277 |
272 |
$486.38 |
| 73562 |
|
12 |
12 |
$481.44 |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
2,273 |
2,205 |
$477.06 |
| G0103 |
Prostate cancer screening; prostate specific antigen test (psa) |
41 |
41 |
$475.12 |
| J0690 |
Injection, cefazolin sodium, 500 mg |
1,317 |
1,164 |
$470.77 |
| 90686 |
|
16 |
16 |
$441.18 |
| 99401 |
|
14 |
14 |
$426.24 |
| 84145 |
|
15 |
13 |
$424.64 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
551 |
515 |
$403.38 |
| 80349 |
|
203 |
202 |
$398.00 |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
5,240 |
4,833 |
$354.14 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
19 |
15 |
$336.02 |
| 82627 |
|
12 |
12 |
$313.28 |
| J1650 |
Injection, enoxaparin sodium, 10 mg |
446 |
312 |
$310.16 |
| 84156 |
|
103 |
89 |
$281.23 |
| 82784 |
|
12 |
12 |
$262.07 |
| 73560 |
|
15 |
13 |
$257.63 |
| 72100 |
|
13 |
13 |
$256.66 |
| 80074 |
|
14 |
13 |
$256.39 |
| 84425 |
|
14 |
14 |
$256.09 |
| J2765 |
Injection, metoclopramide hcl, up to 10 mg |
1,884 |
1,785 |
$244.90 |
| 82375 |
|
15 |
13 |
$182.50 |
| G8431 |
Screening for depression is documented as being positive and a follow-up plan is documented |
29 |
27 |
$181.50 |
| 99406 |
|
17 |
17 |
$173.90 |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
1,518 |
1,502 |
$171.12 |
| 87205 |
|
65 |
63 |
$170.49 |
| 86141 |
|
13 |
13 |
$164.71 |
| 86706 |
|
14 |
14 |
$161.64 |
| 74021 |
|
13 |
13 |
$154.78 |
| 90671 |
|
12 |
12 |
$150.60 |
| 73590 |
|
15 |
14 |
$123.78 |
| 82677 |
|
12 |
12 |
$109.86 |
| 84479 |
|
241 |
241 |
$97.34 |
| 82247 |
|
15 |
12 |
$86.80 |
| 86709 |
|
25 |
25 |
$78.87 |
| 86431 |
|
12 |
12 |
$76.64 |
| J2543 |
Injection, piperacillin sodium/tazobactam sodium, 1 gram/0.125 grams (1.125 grams) |
15 |
12 |
$75.50 |
| C9113 |
Injection, pantoprazole sodium, per vial |
169 |
135 |
$71.49 |
| 82565 |
|
12 |
12 |
$70.44 |
| 86336 |
|
14 |
14 |
$69.17 |
| J2001 |
Injection, lidocaine hcl for intravenous infusion, 10 mg |
1,539 |
1,523 |
$62.67 |
| G1013 |
Clinical decision support mechanism evidencecare imagingcare, as defined by the medicare appropriate use criteria program |
3,043 |
2,950 |
$59.88 |
| 93356 |
|
25 |
25 |
$57.77 |
| J2060 |
Injection, lorazepam, 2 mg |
466 |
401 |
$51.50 |
| J8540 |
Dexamethasone, oral, 0.25 mg |
162 |
150 |
$46.79 |
| 86705 |
|
22 |
22 |
$45.59 |
| J1630 |
Injection, haloperidol, up to 5 mg |
56 |
51 |
$38.83 |
| J2919 |
Injection, methylprednisolone sodium succinate, 5 mg |
37 |
28 |
$34.18 |
| J1644 |
Injection, heparin sodium, per 1000 units |
53 |
41 |
$25.56 |
| J3370 |
Injection, vancomycin hcl, 500 mg |
19 |
12 |
$22.72 |
| J3301 |
Injection, triamcinolone acetonide, not otherwise specified, 10 mg |
60 |
60 |
$18.50 |
| J7512 |
Prednisone, immediate release or delayed release, oral, 1 mg |
115 |
109 |
$14.11 |
| 90658 |
|
25 |
25 |
$11.80 |
| 85660 |
|
12 |
12 |
$10.53 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
12 |
12 |
$8.71 |
| J1170 |
Injection, hydromorphone, up to 4 mg |
31 |
25 |
$4.41 |
| Q0177 |
Hydroxyzine pamoate, 25 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at the time of chemotherapy treatment, not to exceed a 48 hour dosage regimen |
31 |
27 |
$1.99 |