| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 96361 |
Intravenous infusion, hydration; each additional hour |
19,334 |
17,200 |
$5.39M |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
37,187 |
35,084 |
$3.86M |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
34,987 |
32,356 |
$2.68M |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
37,465 |
34,545 |
$2.42M |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
10,682 |
10,223 |
$1.73M |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
9,754 |
9,427 |
$979K |
| 70450 |
Computed tomography, head or brain; without contrast material |
6,744 |
6,376 |
$773K |
| 43239 |
Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple |
2,163 |
2,092 |
$607K |
| 96360 |
Intravenous infusion, hydration; initial, 31 minutes to 1 hour |
5,241 |
5,027 |
$540K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
3,038 |
2,918 |
$479K |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
4,873 |
4,668 |
$388K |
| 71275 |
Computed tomographic angiography, chest, with contrast material |
2,487 |
2,391 |
$354K |
| 64721 |
|
499 |
459 |
$278K |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
3,508 |
3,337 |
$273K |
| 96366 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour |
1,422 |
1,285 |
$270K |
| 45385 |
Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) |
695 |
675 |
$247K |
| 12001 |
|
1,219 |
1,203 |
$229K |
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
2,656 |
2,138 |
$205K |
| 80053 |
Comprehensive metabolic panel |
49,162 |
43,545 |
$186K |
| 45380 |
Colonoscopy, flexible; with biopsy, single or multiple |
622 |
614 |
$186K |
| 93971 |
|
2,335 |
2,258 |
$185K |
| 47562 |
|
75 |
75 |
$160K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
4,399 |
4,239 |
$148K |
| 70553 |
Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences |
696 |
679 |
$139K |
| 70496 |
|
952 |
922 |
$139K |
| 76830 |
Ultrasound, transvaginal |
1,739 |
1,684 |
$125K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
2,261 |
2,182 |
$119K |
| 93976 |
|
2,142 |
2,063 |
$100K |
| 10060 |
|
458 |
442 |
$81K |
| 59025 |
Fetal non-stress test |
689 |
571 |
$77K |
| 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 |
884 |
858 |
$68K |
| 84484 |
|
16,018 |
12,374 |
$64K |
| 99281 |
Emergency department visit for the evaluation and management, self-limited or minor |
645 |
610 |
$63K |
| 12002 |
|
316 |
314 |
$54K |
| 76801 |
|
1,244 |
1,159 |
$50K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
12,002 |
10,568 |
$48K |
| 93306 |
Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete |
199 |
191 |
$47K |
| 12011 |
|
219 |
217 |
$46K |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
1,779 |
1,642 |
$42K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
28,419 |
25,041 |
$42K |
| 70491 |
|
253 |
241 |
$41K |
| G0378 |
Hospital observation service, per hour |
5,167 |
2,788 |
$38K |
| 83605 |
|
7,317 |
6,493 |
$37K |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
5,070 |
4,198 |
$36K |
| 71260 |
Computed tomography, thorax, diagnostic; with contrast material |
682 |
669 |
$35K |
| 72125 |
Computed tomography, cervical spine; without contrast material |
3,116 |
2,973 |
$28K |
| 78452 |
Myocardial perfusion imaging, tomographic (SPECT); multiple studies at rest and/or stress |
114 |
106 |
$28K |
| 84145 |
|
3,064 |
2,770 |
$27K |
| 90715 |
|
1,571 |
1,543 |
$25K |
| 99291 |
Critical care, evaluation and management of the critically ill patient, first 30-74 minutes |
527 |
495 |
$23K |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
32,027 |
28,935 |
$21K |
| 43248 |
|
44 |
42 |
$21K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
2,007 |
1,956 |
$21K |
| 70498 |
|
950 |
920 |
$20K |
| 87040 |
|
3,807 |
2,182 |
$20K |
| 83880 |
|
4,439 |
4,047 |
$20K |
| 85379 |
|
4,212 |
4,058 |
$18K |
| 70486 |
|
947 |
922 |
$18K |
| 87254 |
|
1,122 |
1,096 |
$17K |
| 93017 |
|
249 |
240 |
$17K |
| 71046 |
Radiologic examination, chest; 2 views |
11,071 |
10,529 |
$17K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
770 |
726 |
$17K |
| 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 |
1,771 |
1,601 |
$16K |
| 71250 |
|
413 |
400 |
$16K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
55,860 |
48,366 |
$14K |
| 36415 |
Collection of venous blood by venipuncture |
12,721 |
9,979 |
$12K |
| 76770 |
|
147 |
138 |
$12K |
| 45378 |
Colonoscopy, flexible; diagnostic, including collection of specimen(s) |
25 |
24 |
$10K |
| 96375 |
Therapeutic injection; each additional sequential IV push |
23,451 |
20,192 |
$10K |
| 80047 |
|
1,841 |
1,731 |
$9K |
| 87637 |
Infectious agent detection by nucleic acid; SARS-CoV-2, influenza, and RSV |
4,089 |
3,970 |
$9K |
| 80050 |
General health panel |
1,769 |
1,719 |
$9K |
| 87400 |
|
634 |
605 |
$8K |
| 76870 |
|
113 |
111 |
$8K |
| A4649 |
Surgical supply; miscellaneous |
4,275 |
3,819 |
$8K |
| 71045 |
Radiologic examination, chest; single view |
10,092 |
9,400 |
$8K |
| 74174 |
|
93 |
89 |
$7K |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
25,924 |
22,580 |
$6K |
| 87420 |
|
472 |
464 |
$6K |
| 97161 |
|
226 |
218 |
$6K |
| 80179 |
|
1,492 |
1,406 |
$6K |
| 29125 |
|
28 |
26 |
$6K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
10,313 |
8,777 |
$6K |
| C1713 |
Anchor/screw for opposing bone-to-bone or soft tissue-to-bone (implantable) |
2,288 |
2,005 |
$6K |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
10,776 |
10,087 |
$4K |
| 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 |
116 |
108 |
$4K |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
17,266 |
15,810 |
$4K |
| 73630 |
|
1,981 |
1,902 |
$4K |
| 36592 |
|
18,189 |
16,838 |
$3K |
| 73721 |
Magnetic resonance imaging, any joint of lower extremity; without contrast material |
24 |
24 |
$3K |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
17,394 |
16,394 |
$3K |
| 73564 |
|
841 |
801 |
$3K |
| 80143 |
|
1,575 |
1,485 |
$3K |
| 74450 |
|
13 |
12 |
$3K |
| 83735 |
|
10,868 |
9,574 |
$3K |
| 80305 |
|
8,191 |
7,747 |
$3K |
| 73130 |
|
1,766 |
1,666 |
$3K |
| 73030 |
|
1,782 |
1,656 |
$3K |
| J1170 |
Injection, hydromorphone, up to 4 mg |
13,091 |
9,433 |
$3K |
| 73610 |
|
2,114 |
2,001 |
$3K |
| 81025 |
|
16,273 |
15,300 |
$3K |
| 84443 |
Thyroid stimulating hormone (TSH) |
3,154 |
2,987 |
$2K |
| J2270 |
Injection, morphine sulfate, up to 10 mg |
7,689 |
6,434 |
$2K |
| 81003 |
|
24,725 |
22,830 |
$2K |
| 85027 |
|
5,436 |
4,839 |
$2K |
| 72100 |
|
647 |
641 |
$2K |
| 83690 |
|
16,259 |
14,774 |
$2K |
| J2704 |
Injection, propofol, 10 mg |
15,790 |
13,001 |
$2K |
| J7120 |
Ringers lactate infusion, up to 1000 cc |
15,172 |
14,066 |
$2K |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
4,569 |
4,065 |
$2K |
| 51610 |
|
14 |
12 |
$2K |
| 81001 |
|
15,857 |
14,761 |
$2K |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
3,618 |
3,444 |
$2K |
| J1200 |
Injection, diphenhydramine hcl, up to 50 mg |
4,987 |
4,611 |
$2K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
1,997 |
1,947 |
$2K |
| 85610 |
|
5,681 |
5,106 |
$2K |
| 73502 |
|
922 |
865 |
$1K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
1,788 |
1,739 |
$1K |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
10,788 |
10,184 |
$1K |
| 73140 |
|
608 |
577 |
$1K |
| 73110 |
|
1,365 |
1,280 |
$1K |
| 86140 |
|
3,404 |
3,141 |
$1K |
| 96376 |
|
7,636 |
5,853 |
$1K |
| J2060 |
Injection, lorazepam, 2 mg |
3,436 |
3,072 |
$1K |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
6,466 |
6,174 |
$1K |
| 84702 |
|
2,221 |
1,990 |
$1K |
| 73560 |
|
731 |
679 |
$1K |
| 74018 |
|
968 |
915 |
$1K |
| 87077 |
|
1,729 |
1,640 |
$1K |
| 85730 |
|
3,629 |
3,324 |
$1K |
| 87088 |
|
3,564 |
3,410 |
$1K |
| 93970 |
|
14 |
14 |
$1K |
| 72131 |
|
60 |
55 |
$1K |
| 73590 |
|
285 |
273 |
$1K |
| 87252 |
|
65 |
64 |
$1K |
| 87186 |
|
1,040 |
988 |
$1K |
| A9577 |
Injection, gadobenate dimeglumine (multihance), per ml |
826 |
787 |
$1K |
| 73080 |
|
177 |
172 |
$1K |
| J0690 |
Injection, cefazolin sodium, 500 mg |
6,275 |
5,511 |
$1K |
| 99152 |
|
782 |
710 |
$1K |
| 86900 |
|
1,639 |
1,518 |
$974.14 |
| 82947 |
|
4,051 |
2,834 |
$833.84 |
| J2360 |
Injection, orphenadrine citrate, up to 60 mg |
1,230 |
1,184 |
$813.55 |
| J3475 |
Injection, magnesium sulfate, per 500 mg |
975 |
877 |
$744.18 |
| 87070 |
|
3,429 |
3,269 |
$738.04 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
10,063 |
9,449 |
$730.12 |
| 88307 |
|
53 |
51 |
$723.39 |
| J1644 |
Injection, heparin sodium, per 1000 units |
721 |
407 |
$700.67 |
| 84703 |
|
6,069 |
5,799 |
$678.31 |
| 87430 |
|
2,119 |
2,070 |
$665.59 |
| 85014 |
|
3,069 |
2,726 |
$642.03 |
| 76937 |
|
13 |
12 |
$640.50 |
| 87631 |
|
12 |
12 |
$606.40 |
| 85007 |
|
3,440 |
3,113 |
$572.49 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
1,761 |
1,102 |
$545.94 |
| 82077 |
|
4,807 |
4,407 |
$541.05 |
| 87633 |
Infectious agent detection by nucleic acid, respiratory virus, 12-25 targets |
13 |
12 |
$536.04 |
| J0295 |
Injection, ampicillin sodium/sulbactam sodium, per 1.5 gm |
423 |
334 |
$530.90 |
| J0780 |
Injection, prochlorperazine, up to 10 mg |
2,054 |
1,925 |
$494.65 |
| 86901 |
|
2,051 |
1,875 |
$482.22 |
| J2930 |
Injection, methylprednisolone sodium succinate, up to 125 mg |
2,054 |
1,880 |
$435.82 |
| J2765 |
Injection, metoclopramide hcl, up to 10 mg |
3,086 |
2,907 |
$432.96 |
| 86850 |
|
903 |
848 |
$411.65 |
| J1630 |
Injection, haloperidol, up to 5 mg |
744 |
683 |
$376.39 |
| 85652 |
|
1,388 |
1,322 |
$336.65 |
| 71101 |
|
229 |
225 |
$318.34 |
| 87300 |
|
797 |
781 |
$299.04 |
| 87253 |
|
15 |
14 |
$291.89 |
| 82803 |
|
1,608 |
1,335 |
$291.37 |
| 84439 |
|
447 |
419 |
$290.42 |
| 87280 |
|
555 |
544 |
$284.03 |
| J1790 |
Injection, droperidol, up to 5 mg |
932 |
865 |
$282.12 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
116 |
110 |
$277.28 |
| 87205 |
|
2,436 |
2,284 |
$240.55 |
| 87279 |
|
890 |
781 |
$238.32 |
| 87184 |
|
2,887 |
2,773 |
$233.35 |
| 72040 |
|
26 |
26 |
$223.79 |
| 87486 |
|
13 |
12 |
$223.12 |
| 87636 |
Infectious agent detection by nucleic acid; SARS-CoV-2 and influenza virus types A and B |
414 |
405 |
$185.43 |
| J3480 |
Injection, potassium chloride, per 2 meq |
714 |
564 |
$172.85 |
| 87210 |
|
554 |
544 |
$171.09 |
| J3370 |
Injection, vancomycin hcl, 500 mg |
667 |
511 |
$152.50 |
| 84100 |
|
244 |
199 |
$152.09 |
| 84112 |
|
14 |
12 |
$144.04 |
| C1769 |
Guide wire |
1,020 |
965 |
$142.36 |
| 82565 |
|
227 |
218 |
$142.01 |
| 88342 |
|
410 |
393 |
$141.60 |
| 82553 |
|
36 |
31 |
$134.34 |
| 85018 |
|
446 |
335 |
$133.20 |
| 87581 |
|
13 |
12 |
$131.07 |
| 87798 |
Infectious agent detection by nucleic acid; not otherwise specified, amplified probe, each organism |
13 |
12 |
$131.07 |
| J8540 |
Dexamethasone, oral, 0.25 mg |
999 |
769 |
$129.54 |
| 87147 |
|
458 |
440 |
$118.19 |
| 82800 |
|
585 |
495 |
$117.89 |
| 80061 |
Lipid panel |
26 |
25 |
$112.52 |
| 87260 |
|
203 |
200 |
$111.56 |
| 87634 |
|
13 |
13 |
$108.25 |
| 82962 |
|
411 |
306 |
$107.35 |
| 82550 |
|
784 |
708 |
$97.28 |
| 88304 |
|
904 |
886 |
$93.70 |
| 87807 |
|
247 |
244 |
$84.32 |
| J0330 |
Injection, succinylcholine chloride, up to 20 mg |
2,907 |
2,824 |
$83.29 |
| J2550 |
Injection, promethazine hcl, up to 50 mg |
1,034 |
901 |
$80.85 |
| 36416 |
|
3,210 |
2,899 |
$70.66 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
165 |
165 |
$59.82 |
| 73090 |
|
143 |
133 |
$58.56 |
| J2710 |
Injection, neostigmine methylsulfate, up to 0.5 mg |
1,673 |
1,566 |
$52.10 |
| J2543 |
Injection, piperacillin sodium/tazobactam sodium, 1 gram/0.125 grams (1.125 grams) |
340 |
227 |
$50.44 |
| Q9963 |
High osmolar contrast material, 350-399 mg/ml iodine concentration, per ml |
289 |
282 |
$49.01 |
| G0379 |
Direct admission of patient for hospital observation care |
35 |
29 |
$47.10 |
| A9500 |
Technetium tc-99m sestamibi, diagnostic, per study dose |
67 |
64 |
$41.08 |
| 72020 |
|
30 |
30 |
$39.76 |
| 76000 |
|
12 |
12 |
$39.71 |
| 85651 |
|
389 |
375 |
$39.49 |
| A9585 |
Injection, gadobutrol, 0.1 ml |
305 |
293 |
$35.00 |
| 87220 |
|
205 |
199 |
$34.18 |
| J1815 |
Injection, insulin, per 5 units |
1,841 |
1,023 |
$30.00 |
| J1650 |
Injection, enoxaparin sodium, 10 mg |
1,207 |
716 |
$29.33 |
| 73562 |
|
15 |
15 |
$29.23 |
| 82272 |
|
179 |
172 |
$24.33 |
| 82330 |
|
67 |
58 |
$18.62 |
| J7512 |
Prednisone, immediate release or delayed release, oral, 1 mg |
1,908 |
1,604 |
$17.13 |
| 82009 |
|
332 |
311 |
$15.47 |
| J2919 |
Injection, methylprednisolone sodium succinate, 5 mg |
237 |
220 |
$11.21 |
| J2370 |
Injection, phenylephrine hcl, up to 1 ml |
1,363 |
1,263 |
$9.56 |
| 87081 |
|
12 |
12 |
$6.17 |
| 84295 |
|
58 |
55 |
$5.35 |
| 84132 |
|
60 |
56 |
$5.11 |
| 81000 |
|
16 |
12 |
$2.89 |
| J7040 |
Infusion, normal saline solution, sterile (500 ml = 1 unit) |
953 |
828 |
$2.20 |
| A9579 |
Injection, gadolinium-based magnetic resonance contrast agent, not otherwise specified (nos), per ml |
200 |
198 |
$0.00 |
| 87808 |
|
109 |
106 |
$0.00 |
| J7060 |
5% dextrose/water (500 ml = 1 unit) |
13 |
12 |
$0.00 |
| J1940 |
Injection, furosemide, up to 20 mg |
36 |
36 |
$0.00 |
| J1642 |
Injection, heparin sodium, (heparin lock flush), per 10 units |
428 |
357 |
$0.00 |
| J2371 |
Injection, phenylephrine hydrochloride, 20 micrograms |
265 |
254 |
$0.00 |
| Q9969 |
Tc-99m from non-highly enriched uranium source, full cost recovery add-on, per study dose |
20 |
17 |
$0.00 |
| J3411 |
Injection, thiamine hcl, 100 mg |
14 |
12 |
$0.00 |
| 99153 |
Mod sedat endo service >5yrs |
62 |
51 |
$0.00 |
| 96368 |
|
55 |
51 |
$0.00 |
| J2003 |
Injection, lidocaine hydrochloride, 1 mg |
356 |
290 |
$0.00 |
| J0571 |
Buprenorphine, oral, 1 mg |
29 |
17 |
$0.00 |
| J2795 |
Injection, ropivacaine hydrochloride, 1 mg |
85 |
84 |
$0.00 |
| J3360 |
Injection, diazepam, up to 5 mg |
15 |
13 |
$0.00 |
| J2470 |
Injection, pantoprazole sodium, 40 mg |
32 |
25 |
$0.00 |
| J7620 |
Albuterol, up to 2.5 mg and ipratropium bromide, up to 0.5 mg, fda-approved final product, non-compounded, administered through dme |
56 |
48 |
$0.00 |
| C9290 |
Injection, bupivacaine liposome, 1 mg |
27 |
26 |
$0.00 |
| J1836 |
Injection, metronidazole, 10 mg |
15 |
12 |
$0.00 |
| J7050 |
Infusion, normal saline solution, 250 cc |
15 |
12 |
$0.00 |
| J0131 |
Injection, acetaminophen, not otherwise specified,10 mg |
16 |
16 |
$0.00 |
| J0360 |
Injection, hydralazine hcl, up to 20 mg |
13 |
12 |
$0.00 |
| U0002 |
2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc |
24 |
24 |
$0.00 |
| G1004 |
Clinical decision support mechanism national decision support company, as defined by the medicare appropriate use criteria program |
8,414 |
6,933 |
$0.00 |
| Q9966 |
Low osmolar contrast material, 200-299 mg/ml iodine concentration, per ml |
34 |
34 |
$0.00 |
| 51702 |
|
27 |
24 |
$0.00 |
| C9113 |
Injection, pantoprazole sodium, per vial |
264 |
189 |
$0.00 |
| J2272 |
Injection, morphine sulfate (fresenius kabi), not therapeutically equivalent to j2270, up to 10 mg |
747 |
688 |
$0.00 |
| J0665 |
Injection, bupivicaine, not otherwise specified, 0.5 mg |
1,015 |
924 |
$0.00 |
| 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 |
151 |
145 |
$0.00 |
| A4314 |
Insertion tray with drainage bag with indwelling catheter, foley type, two-way latex with coating (teflon, silicone, silicone elastomer or hydrophilic, etc.) |
54 |
53 |
$0.00 |
| 82010 |
|
125 |
112 |
$0.00 |
| 0225U |
|
57 |
56 |
$0.00 |
| J1596 |
Injection, glycopyrrolate, 0.1 mg |
226 |
222 |
$0.00 |
| C1894 |
Introducer/sheath, other than guiding, other than intracardiac electrophysiological, non-laser |
28 |
24 |
$0.00 |
| J2004 |
Injection, lidocaine hcl with epinephrine, 1 mg |
44 |
43 |
$0.00 |
| G8978 |
Mobility: walking & moving around functional limitation, current status, at therapy episode outset and at reporting intervals |
12 |
12 |
$0.00 |
| J1171 |
Injection, hydromorphone, 0.1 mg |
148 |
116 |
$0.00 |
| 0042T |
|
28 |
28 |
$0.00 |
| A9502 |
Technetium tc-99m tetrofosmin, diagnostic, per study dose |
54 |
43 |
$0.00 |
| J0694 |
Injection, cefoxitin sodium, 1 gm |
14 |
12 |
$0.00 |
| 87075 |
|
16 |
15 |
$0.00 |
| 0232T |
|
12 |
12 |
$0.00 |
| J0737 |
Injection, clindamycin phosphate (baxter), not therapeutically equivalent to j0736, 300 mg |
15 |
12 |
$0.00 |
| 72070 |
|
12 |
12 |
$0.00 |
| 51701 |
|
14 |
12 |
$0.00 |
| 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 |
13 |
13 |
$0.00 |