| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
61,085 |
53,149 |
$9.64M |
| H0020 |
Alcohol and/or drug services; methadone administration and/or service (provision of the drug by a licensed program) |
245,754 |
14,856 |
$7.58M |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
23,796 |
21,288 |
$5.87M |
| 90832 |
Psychotherapy, 30 minutes with patient |
27,037 |
14,903 |
$3.86M |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
15,936 |
14,491 |
$3.46M |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
15,236 |
14,502 |
$3.24M |
| G2067 |
Medication assisted treatment, methadone; weekly bundle including dispensing and/or administration, substance use counseling, individual and group therapy, and toxicology testing, if performed (provision of the services by a medicare-enrolled opioid treatment program) |
12,378 |
3,920 |
$2.79M |
| 41899 |
Unlisted procedure, dentoalveolar structures |
1,211 |
1,210 |
$2.45M |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
8,668 |
7,347 |
$2.17M |
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
23,760 |
18,274 |
$2.01M |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
10,242 |
9,451 |
$1.97M |
| 80053 |
Comprehensive metabolic panel |
24,674 |
23,692 |
$1.72M |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
9,544 |
9,130 |
$1.67M |
| G0396 |
Alcohol and/or substance (other than tobacco) misuse structured assessment (e.g., audit, dast), and brief intervention 15 to 30 minutes |
13,679 |
8,593 |
$1.58M |
| H2019 |
Therapeutic behavioral services, per 15 minutes |
1,436 |
1,418 |
$1.28M |
| 70450 |
Computed tomography, head or brain; without contrast material |
2,791 |
2,722 |
$920K |
| 90834 |
Psychotherapy, 45 minutes with patient |
3,365 |
2,125 |
$802K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
15,776 |
14,606 |
$757K |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
10,565 |
3,109 |
$708K |
| 80076 |
|
8,101 |
7,693 |
$671K |
| 81025 |
|
9,063 |
8,721 |
$664K |
| 99281 |
Emergency department visit for the evaluation and management, self-limited or minor |
2,249 |
2,005 |
$619K |
| 90853 |
Group psychotherapy (other than of a multiple-family group) |
7,832 |
1,318 |
$561K |
| H2036 |
Alcohol and/or other drug treatment program, per diem |
3,810 |
682 |
$517K |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
1,730 |
1,708 |
$500K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
1,619 |
1,588 |
$492K |
| 11042 |
Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm |
409 |
185 |
$461K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
2,830 |
2,823 |
$454K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
2,793 |
2,782 |
$429K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
2,715 |
2,693 |
$426K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
2,661 |
2,637 |
$426K |
| H2001 |
Rehabilitation program, per 1/2 day |
3,472 |
578 |
$359K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
5,910 |
5,850 |
$347K |
| 76700 |
Ultrasound, abdominal, real time with image documentation; complete |
1,436 |
1,431 |
$314K |
| 80061 |
Lipid panel |
17,959 |
17,718 |
$307K |
| 92557 |
|
4,514 |
4,485 |
$272K |
| 93306 |
Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete |
1,252 |
1,250 |
$257K |
| 86701 |
|
3,628 |
3,608 |
$256K |
| 90833 |
Psychotherapy, 30 minutes with patient when performed with an E&M service (add-on) |
3,874 |
3,396 |
$255K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
3,573 |
3,565 |
$252K |
| G0397 |
Alcohol and/or substance (other than tobacco) misuse structured assessment (e.g., audit, dast), and intervention, greater than 30 minutes |
1,643 |
1,368 |
$241K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
1,235 |
1,222 |
$236K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
804 |
797 |
$230K |
| 86900 |
|
1,629 |
1,589 |
$214K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
9,013 |
8,347 |
$210K |
| 87651 |
Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe |
1,301 |
1,284 |
$210K |
| 86480 |
|
2,288 |
2,258 |
$207K |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
1,758 |
1,530 |
$202K |
| 45378 |
Colonoscopy, flexible; diagnostic, including collection of specimen(s) |
138 |
138 |
$192K |
| 90686 |
|
6,853 |
6,775 |
$164K |
| H0040 |
Assertive community treatment program, per diem |
87 |
84 |
$156K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
650 |
634 |
$153K |
| 97161 |
|
1,324 |
1,290 |
$151K |
| 97140 |
Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) |
7,325 |
2,547 |
$150K |
| 0241U |
Neonatal screening for hereditary disorders, genomic sequence analysis panel |
6,979 |
6,762 |
$148K |
| 82962 |
|
16,769 |
7,886 |
$136K |
| 88342 |
|
379 |
378 |
$134K |
| 36415 |
Collection of venous blood by venipuncture |
26,049 |
24,311 |
$125K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
5,851 |
5,790 |
$122K |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
3,483 |
3,463 |
$116K |
| H0050 |
Alcohol and/or drug services, brief intervention, per 15 minutes |
2,067 |
1,518 |
$115K |
| 90791 |
Psychiatric diagnostic evaluation |
424 |
407 |
$109K |
| 97530 |
Therapeutic activities, direct patient contact, each 15 minutes |
3,483 |
1,355 |
$109K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
535 |
531 |
$107K |
| 99385 |
|
655 |
651 |
$104K |
| 83880 |
|
809 |
794 |
$87K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
3,395 |
2,513 |
$80K |
| 50590 |
|
56 |
36 |
$75K |
| 99386 |
|
492 |
491 |
$74K |
| 83655 |
|
4,414 |
4,377 |
$72K |
| H0002 |
Behavioral health screening to determine eligibility for admission to treatment program |
355 |
353 |
$72K |
| 99173 |
|
4,065 |
4,044 |
$63K |
| 87624 |
Infectious agent detection by nucleic acid; human papillomavirus (HPV), high-risk types |
1,225 |
1,188 |
$59K |
| 97802 |
|
3,924 |
3,661 |
$58K |
| H0005 |
Alcohol and/or drug services; group counseling by a clinician |
859 |
275 |
$57K |
| 90651 |
|
1,531 |
1,527 |
$53K |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
1,189 |
1,157 |
$53K |
| 43239 |
Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple |
86 |
86 |
$52K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
275 |
260 |
$51K |
| U0002 |
2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc |
1,139 |
1,106 |
$49K |
| 86702 |
|
3,343 |
3,326 |
$48K |
| 84443 |
Thyroid stimulating hormone (TSH) |
9,549 |
8,956 |
$46K |
| 90715 |
|
1,715 |
1,699 |
$43K |
| 71046 |
Radiologic examination, chest; 2 views |
4,565 |
4,528 |
$37K |
| 76830 |
Ultrasound, transvaginal |
1,028 |
1,003 |
$37K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
20,373 |
19,779 |
$35K |
| G0378 |
Hospital observation service, per hour |
432 |
200 |
$32K |
| G0108 |
Diabetes outpatient self-management training services, individual, per 30 minutes |
960 |
878 |
$32K |
| 76770 |
|
230 |
228 |
$32K |
| 76641 |
|
1,128 |
691 |
$31K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
12,865 |
12,716 |
$30K |
| 81001 |
|
20,633 |
19,847 |
$29K |
| 99401 |
|
685 |
669 |
$29K |
| 90620 |
|
1,229 |
1,226 |
$29K |
| 82465 |
|
6,416 |
6,363 |
$27K |
| 90734 |
|
1,304 |
1,300 |
$25K |
| 90792 |
Psychiatric diagnostic evaluation with medical services |
84 |
84 |
$22K |
| 88142 |
|
841 |
803 |
$22K |
| 71275 |
Computed tomographic angiography, chest, with contrast material |
67 |
67 |
$21K |
| 99215 |
Prolong outpt/office vis |
100 |
95 |
$21K |
| 93975 |
|
38 |
38 |
$21K |
| 88304 |
|
416 |
413 |
$20K |
| H1005 |
Prenatal care, at-risk enhanced service package (includes h1001-h1004) |
1,284 |
796 |
$19K |
| G0168 |
Wound closure utilizing tissue adhesive(s) only |
52 |
51 |
$19K |
| 85027 |
|
17,601 |
16,305 |
$18K |
| 85610 |
|
4,558 |
4,264 |
$16K |
| 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 |
1,896 |
1,823 |
$16K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
179 |
175 |
$15K |
| 90670 |
|
715 |
710 |
$15K |
| 73562 |
|
1,536 |
1,304 |
$15K |
| 99291 |
Critical care, evaluation and management of the critically ill patient, first 30-74 minutes |
89 |
88 |
$14K |
| 83021 |
|
925 |
900 |
$13K |
| 72100 |
|
1,259 |
1,250 |
$13K |
| 97112 |
Therapeutic procedure, each 15 minutes; neuromuscular reeducation of movement, balance, coordination |
590 |
303 |
$13K |
| 84439 |
|
3,779 |
3,716 |
$13K |
| 83525 |
|
1,209 |
1,195 |
$13K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
5,452 |
5,375 |
$12K |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
6,226 |
5,959 |
$12K |
| 87088 |
|
5,385 |
5,180 |
$11K |
| 73630 |
|
1,841 |
1,571 |
$11K |
| 90633 |
|
620 |
617 |
$10K |
| 86580 |
|
365 |
357 |
$10K |
| 70551 |
Magnetic resonance imaging, brain; without contrast material |
24 |
24 |
$10K |
| 98960 |
|
362 |
343 |
$10K |
| 29540 |
|
41 |
41 |
$9K |
| 99201 |
|
73 |
71 |
$9K |
| 90746 |
|
345 |
343 |
$9K |
| 99442 |
|
152 |
129 |
$8K |
| 93970 |
|
25 |
25 |
$8K |
| 87077 |
|
2,633 |
2,555 |
$8K |
| 86769 |
|
266 |
264 |
$8K |
| 93017 |
|
186 |
177 |
$8K |
| G0008 |
Administration of influenza virus vaccine |
631 |
630 |
$7K |
| 87661 |
Infectious agent detection by nucleic acid; Trichomonas vaginalis, amplified probe |
230 |
229 |
$7K |
| J7613 |
Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg |
1,509 |
1,404 |
$7K |
| 86803 |
|
3,466 |
3,437 |
$7K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
26 |
26 |
$7K |
| 87400 |
|
909 |
895 |
$7K |
| 73030 |
|
860 |
816 |
$7K |
| 82728 |
|
1,308 |
1,301 |
$6K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
7,174 |
6,817 |
$6K |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
2,382 |
2,367 |
$6K |
| 77065 |
Tomosynthesis, mammo |
80 |
77 |
$6K |
| H0038 |
Self-help/peer services, per 15 minutes |
249 |
175 |
$6K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
6,441 |
6,273 |
$6K |
| 70486 |
|
37 |
37 |
$6K |
| 76642 |
|
203 |
170 |
$6K |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
672 |
672 |
$6K |
| 90698 |
|
285 |
284 |
$6K |
| 71045 |
Radiologic examination, chest; single view |
3,445 |
3,361 |
$6K |
| 90744 |
|
328 |
328 |
$6K |
| 93971 |
|
52 |
50 |
$6K |
| 99383 |
|
27 |
27 |
$5K |
| J2704 |
Injection, propofol, 10 mg |
902 |
890 |
$5K |
| 0012A |
|
224 |
220 |
$5K |
| 73610 |
|
991 |
904 |
$5K |
| 82607 |
|
1,816 |
1,798 |
$5K |
| 90461 |
|
1,119 |
1,109 |
$4K |
| 80305 |
|
5,556 |
5,066 |
$4K |
| 76536 |
|
84 |
84 |
$4K |
| 90716 |
|
168 |
167 |
$4K |
| 0011A |
|
234 |
233 |
$4K |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
2,069 |
1,957 |
$4K |
| 73130 |
|
619 |
584 |
$4K |
| 97162 |
|
29 |
29 |
$4K |
| 90707 |
|
166 |
164 |
$4K |
| 87340 |
|
1,432 |
1,417 |
$3K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
561 |
553 |
$3K |
| 86706 |
|
1,826 |
1,809 |
$3K |
| 72125 |
Computed tomography, cervical spine; without contrast material |
111 |
109 |
$3K |
| 90680 |
|
154 |
154 |
$3K |
| 86762 |
|
929 |
926 |
$3K |
| 84702 |
|
1,410 |
1,300 |
$3K |
| 86765 |
|
944 |
940 |
$3K |
| 85730 |
|
2,789 |
2,715 |
$3K |
| 81005 |
|
1,486 |
1,429 |
$3K |
| 77080 |
|
51 |
51 |
$3K |
| 96375 |
Therapeutic injection; each additional sequential IV push |
2,890 |
2,811 |
$3K |
| 99406 |
|
52 |
50 |
$3K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
25 |
25 |
$3K |
| H0004 |
Behavioral health counseling and therapy, per 15 minutes |
44 |
24 |
$2K |
| G0283 |
Electrical stimulation (unattended), to one or more areas for indication(s) other than wound care, as part of a therapy plan of care |
99 |
37 |
$2K |
| 90662 |
|
83 |
83 |
$2K |
| 0031A |
|
63 |
62 |
$2K |
| 71250 |
|
13 |
13 |
$2K |
| 82550 |
|
600 |
575 |
$2K |
| 86592 |
|
2,718 |
2,695 |
$2K |
| 86704 |
|
797 |
790 |
$2K |
| 84480 |
|
388 |
381 |
$2K |
| 83550 |
|
1,215 |
1,207 |
$2K |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
2,178 |
1,816 |
$2K |
| 77066 |
Tomosynthesis, mammo |
24 |
24 |
$2K |
| 90685 |
|
105 |
104 |
$2K |
| 81000 |
|
4,501 |
4,182 |
$2K |
| 83690 |
|
3,009 |
2,908 |
$2K |
| 80320 |
|
2,838 |
2,693 |
$2K |
| 87070 |
|
1,313 |
1,291 |
$2K |
| 82043 |
|
2,033 |
2,014 |
$2K |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
771 |
754 |
$2K |
| 76801 |
|
13 |
12 |
$2K |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
741 |
727 |
$2K |
| 90732 |
|
38 |
37 |
$2K |
| 88300 |
|
35 |
24 |
$2K |
| 97164 |
|
26 |
25 |
$1K |
| 86787 |
|
643 |
639 |
$1K |
| 99441 |
|
41 |
41 |
$1K |
| 83735 |
|
1,645 |
1,420 |
$1K |
| 73502 |
|
131 |
114 |
$1K |
| 84484 |
|
3,253 |
2,986 |
$1K |
| 86708 |
|
504 |
500 |
$1K |
| 86140 |
|
479 |
470 |
$1K |
| 86735 |
|
590 |
588 |
$1K |
| 82150 |
|
1,710 |
1,679 |
$1K |
| J2765 |
Injection, metoclopramide hcl, up to 10 mg |
85 |
80 |
$1K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
828 |
817 |
$952.60 |
| 99402 |
|
16 |
16 |
$926.98 |
| 80178 |
|
153 |
147 |
$906.89 |
| 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 |
12 |
12 |
$869.95 |
| Q0091 |
Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory |
997 |
987 |
$820.91 |
| H0049 |
Alcohol and/or drug screening |
12 |
12 |
$815.88 |
| 80329 |
|
1,878 |
1,808 |
$807.68 |
| 85651 |
|
1,307 |
1,289 |
$787.22 |
| 87186 |
|
753 |
738 |
$766.61 |
| J7510 |
Prednisolone oral, per 5 mg |
533 |
509 |
$754.79 |
| 73110 |
|
162 |
156 |
$714.94 |
| 80050 |
General health panel |
24 |
24 |
$681.64 |
| 90710 |
|
37 |
37 |
$667.48 |
| 82746 |
|
115 |
114 |
$596.48 |
| 86038 |
|
191 |
187 |
$545.29 |
| 86709 |
|
172 |
172 |
$541.20 |
| 90713 |
|
36 |
36 |
$515.31 |
| J7620 |
Albuterol, up to 2.5 mg and ipratropium bromide, up to 0.5 mg, fda-approved final product, non-compounded, administered through dme |
1,041 |
961 |
$505.14 |
| 90632 |
|
13 |
13 |
$482.29 |
| 80164 |
|
57 |
55 |
$468.27 |
| 97116 |
|
18 |
14 |
$427.35 |
| 84703 |
|
657 |
630 |
$422.44 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
987 |
979 |
$405.29 |
| 84153 |
|
166 |
165 |
$403.15 |
| 87522 |
Neg quan hep c or qual rna |
12 |
12 |
$402.03 |
| 72052 |
|
12 |
12 |
$390.40 |
| 82075 |
|
16 |
14 |
$387.22 |
| 90688 |
|
15 |
15 |
$363.45 |
| 85378 |
|
586 |
575 |
$358.46 |
| 84436 |
|
211 |
203 |
$338.55 |
| 83605 |
|
1,017 |
972 |
$328.42 |
| T1013 |
Sign language or oral interpretive services, per 15 minutes |
26 |
21 |
$307.78 |
| 96127 |
|
1,954 |
1,889 |
$304.28 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
117 |
116 |
$250.37 |
| 84100 |
|
339 |
290 |
$243.60 |
| 83002 |
|
12 |
12 |
$149.09 |
| 83001 |
|
12 |
12 |
$130.99 |
| 82977 |
|
28 |
24 |
$125.75 |
| 73590 |
|
12 |
12 |
$83.50 |
| 85660 |
|
14 |
14 |
$54.26 |
| 87040 |
|
129 |
127 |
$40.83 |
| 91301 |
|
61 |
61 |
$26.00 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
4,425 |
4,255 |
$19.92 |
| 87338 |
|
13 |
13 |
$16.06 |
| J2001 |
Injection, lidocaine hcl for intravenous infusion, 10 mg |
270 |
198 |
$13.62 |
| J1200 |
Injection, diphenhydramine hcl, up to 50 mg |
625 |
542 |
$13.48 |
| 84479 |
|
52 |
49 |
$13.20 |
| 84550 |
|
12 |
12 |
$10.06 |
| J2060 |
Injection, lorazepam, 2 mg |
349 |
269 |
$7.05 |
| 83615 |
|
17 |
16 |
$6.67 |
| J1630 |
Injection, haloperidol, up to 5 mg |
115 |
103 |
$1.98 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
263 |
214 |
$1.70 |
| J2919 |
Injection, methylprednisolone sodium succinate, 5 mg |
20 |
16 |
$0.32 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
27 |
26 |
$0.00 |
| 87420 |
|
140 |
137 |
$0.00 |
| 87275 |
|
18 |
18 |
$0.00 |
| 99080 |
|
1,243 |
377 |
$0.00 |
| 82009 |
|
14 |
14 |
$0.00 |
| J2930 |
Injection, methylprednisolone sodium succinate, up to 125 mg |
17 |
12 |
$0.00 |