| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
28,536 |
24,869 |
$9.56M |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
29,855 |
26,922 |
$6.17M |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
7,907 |
7,273 |
$4.51M |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
17,908 |
16,734 |
$3.31M |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
4,334 |
3,966 |
$1.50M |
| 70450 |
Computed tomography, head or brain; without contrast material |
9,674 |
8,740 |
$799K |
| 72125 |
Computed tomography, cervical spine; without contrast material |
3,444 |
3,148 |
$539K |
| C1713 |
Anchor/screw for opposing bone-to-bone or soft tissue-to-bone (implantable) |
559 |
483 |
$491K |
| G0378 |
Hospital observation service, per hour |
19,603 |
9,705 |
$473K |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
5,170 |
4,780 |
$452K |
| 43239 |
Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple |
1,655 |
1,508 |
$447K |
| C1776 |
Joint device (implantable) |
296 |
250 |
$259K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,668 |
1,303 |
$234K |
| 71275 |
Computed tomographic angiography, chest, with contrast material |
2,629 |
2,444 |
$230K |
| 45380 |
Colonoscopy, flexible; with biopsy, single or multiple |
692 |
627 |
$221K |
| 99291 |
Critical care, evaluation and management of the critically ill patient, first 30-74 minutes |
265 |
240 |
$199K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,733 |
1,512 |
$167K |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
6,608 |
4,255 |
$129K |
| 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 |
3,554 |
3,366 |
$117K |
| 93306 |
Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete |
899 |
829 |
$104K |
| 47562 |
|
30 |
28 |
$91K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
1,272 |
986 |
$91K |
| 80053 |
Comprehensive metabolic panel |
53,927 |
44,423 |
$78K |
| 74174 |
|
99 |
90 |
$66K |
| 93971 |
|
1,620 |
1,485 |
$65K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
500 |
491 |
$50K |
| 70496 |
|
86 |
78 |
$49K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
25,689 |
20,405 |
$43K |
| C1769 |
Guide wire |
1,849 |
1,623 |
$32K |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
405 |
131 |
$28K |
| 45378 |
Colonoscopy, flexible; diagnostic, including collection of specimen(s) |
73 |
66 |
$24K |
| 76819 |
Fetal biophysical profile; without non-stress testing |
883 |
681 |
$23K |
| 80320 |
|
5,808 |
5,259 |
$20K |
| 96361 |
Intravenous infusion, hydration; each additional hour |
6,025 |
5,228 |
$19K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
418 |
408 |
$17K |
| 45385 |
Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) |
84 |
77 |
$15K |
| J3490 |
Unclassified drugs |
37,940 |
13,710 |
$15K |
| 93970 |
|
92 |
87 |
$14K |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
13,611 |
12,260 |
$13K |
| 96376 |
|
11,728 |
7,117 |
$13K |
| 70551 |
Magnetic resonance imaging, brain; without contrast material |
451 |
400 |
$10K |
| 71045 |
Radiologic examination, chest; single view |
20,265 |
17,956 |
$10K |
| 93976 |
|
2,575 |
2,318 |
$10K |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
25,675 |
22,275 |
$10K |
| 96366 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour |
1,506 |
1,190 |
$9K |
| 88307 |
|
469 |
321 |
$9K |
| 96375 |
Therapeutic injection; each additional sequential IV push |
21,442 |
16,511 |
$8K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
8,428 |
6,546 |
$7K |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
5,882 |
5,299 |
$7K |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
2,656 |
2,433 |
$7K |
| 49083 |
|
22 |
12 |
$6K |
| 71046 |
Radiologic examination, chest; 2 views |
5,994 |
5,520 |
$6K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
1,934 |
1,773 |
$6K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
54,513 |
45,001 |
$5K |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
6,095 |
5,545 |
$5K |
| 70491 |
|
13 |
12 |
$5K |
| 70486 |
|
169 |
161 |
$5K |
| 76830 |
Ultrasound, transvaginal |
1,706 |
1,571 |
$4K |
| 86850 |
|
3,765 |
3,424 |
$4K |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
25,806 |
20,488 |
$4K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
645 |
593 |
$3K |
| 76642 |
|
53 |
52 |
$3K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
2,099 |
1,866 |
$3K |
| 71250 |
|
102 |
91 |
$3K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
10,108 |
6,680 |
$3K |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
4,217 |
2,961 |
$3K |
| 97530 |
Therapeutic activities, direct patient contact, each 15 minutes |
2,921 |
1,654 |
$2K |
| 87636 |
Infectious agent detection by nucleic acid; SARS-CoV-2 and influenza virus types A and B |
5,277 |
4,963 |
$2K |
| 59025 |
Fetal non-stress test |
44 |
26 |
$2K |
| A9585 |
Injection, gadobutrol, 0.1 ml |
63 |
60 |
$2K |
| 72100 |
|
2,330 |
2,136 |
$2K |
| 84484 |
|
20,771 |
11,234 |
$2K |
| 88341 |
|
57 |
36 |
$2K |
| 87631 |
|
996 |
970 |
$2K |
| 12001 |
|
81 |
75 |
$2K |
| 96360 |
Intravenous infusion, hydration; initial, 31 minutes to 1 hour |
2,194 |
2,031 |
$2K |
| 76801 |
|
1,750 |
1,542 |
$2K |
| 81025 |
|
7,253 |
6,537 |
$2K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
13 |
12 |
$1K |
| 83690 |
|
17,022 |
14,765 |
$1K |
| 70498 |
|
82 |
78 |
$1K |
| 71260 |
Computed tomography, thorax, diagnostic; with contrast material |
139 |
120 |
$1K |
| 74018 |
|
884 |
816 |
$1K |
| 73030 |
|
1,708 |
1,517 |
$1K |
| J8540 |
Dexamethasone, oral, 0.25 mg |
237 |
188 |
$1K |
| 73562 |
|
2,147 |
1,812 |
$1K |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
8,454 |
7,662 |
$1K |
| 97535 |
Self-care/home management training, each 15 minutes |
2,881 |
1,809 |
$1K |
| 73630 |
|
1,561 |
1,395 |
$983.18 |
| 87040 |
|
5,407 |
2,710 |
$864.12 |
| J2704 |
Injection, propofol, 10 mg |
12,631 |
10,756 |
$821.21 |
| 82947 |
|
25,729 |
12,305 |
$757.88 |
| 84702 |
|
4,874 |
4,387 |
$702.76 |
| 73130 |
|
1,159 |
1,042 |
$669.06 |
| 83605 |
|
10,508 |
8,222 |
$658.52 |
| 83735 |
|
11,816 |
9,722 |
$642.03 |
| 72141 |
|
14 |
12 |
$624.87 |
| 81001 |
|
15,926 |
14,181 |
$616.32 |
| J2270 |
Injection, morphine sulfate, up to 10 mg |
13,799 |
9,789 |
$551.91 |
| 85027 |
|
8,495 |
6,507 |
$478.92 |
| 84703 |
|
9,923 |
9,122 |
$459.28 |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
1,517 |
1,475 |
$401.67 |
| J7030 |
Infusion, normal saline solution , 1000 cc |
13,492 |
10,967 |
$391.62 |
| 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 |
607 |
544 |
$389.61 |
| 80329 |
|
843 |
707 |
$379.06 |
| 73610 |
|
1,128 |
1,012 |
$376.71 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
12,686 |
10,689 |
$364.83 |
| 73502 |
|
813 |
718 |
$361.66 |
| 84443 |
Thyroid stimulating hormone (TSH) |
3,061 |
2,813 |
$360.90 |
| 85610 |
|
10,045 |
8,509 |
$320.03 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
2,686 |
1,286 |
$276.11 |
| J8597 |
Antiemetic drug, oral, not otherwise specified |
3,662 |
3,126 |
$269.88 |
| 85379 |
|
2,668 |
2,501 |
$244.33 |
| 87088 |
|
5,865 |
5,154 |
$231.34 |
| J8499 |
Prescription drug, oral, non chemotherapeutic, nos |
47,165 |
12,255 |
$219.60 |
| 83880 |
|
3,287 |
2,912 |
$215.33 |
| 73110 |
|
481 |
429 |
$211.11 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
3,991 |
3,187 |
$199.35 |
| 81003 |
|
7,866 |
7,185 |
$168.00 |
| 87186 |
|
2,269 |
1,996 |
$164.26 |
| 85055 |
|
778 |
542 |
$154.49 |
| 74022 |
|
136 |
129 |
$151.63 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
8,174 |
7,374 |
$135.56 |
| 74021 |
|
211 |
188 |
$131.84 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
1,565 |
1,494 |
$131.44 |
| 86769 |
|
569 |
551 |
$129.53 |
| 87077 |
|
2,717 |
2,295 |
$129.09 |
| 82550 |
|
2,688 |
2,329 |
$127.67 |
| J0690 |
Injection, cefazolin sodium, 500 mg |
5,912 |
4,041 |
$121.78 |
| 85730 |
|
3,186 |
2,844 |
$112.76 |
| 87651 |
Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe |
297 |
291 |
$107.12 |
| 80061 |
Lipid panel |
549 |
497 |
$105.35 |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
15,528 |
12,286 |
$103.48 |
| 90715 |
|
803 |
767 |
$99.66 |
| U0005 |
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, cdc or non-cdc, making use of high throughput technologies, completed within 2 calendar days from date of specimen collection (list separately in addition to either hcpcs code u0003 or u0004) as described by cms-2020-01-r2 |
1,993 |
1,869 |
$97.92 |
| 86140 |
|
1,763 |
1,556 |
$95.94 |
| C2617 |
Stent, non-coronary, temporary, without delivery system |
66 |
60 |
$94.76 |
| 97161 |
|
2,159 |
1,907 |
$94.51 |
| 82728 |
|
56 |
53 |
$87.87 |
| J2060 |
Injection, lorazepam, 2 mg |
3,413 |
2,576 |
$84.64 |
| 97140 |
Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) |
78 |
29 |
$80.75 |
| 86901 |
|
4,469 |
4,030 |
$79.02 |
| 73080 |
|
123 |
119 |
$78.15 |
| J2765 |
Injection, metoclopramide hcl, up to 10 mg |
3,022 |
2,560 |
$66.38 |
| 85652 |
|
858 |
764 |
$65.06 |
| A9270 |
Non-covered item or service |
66,988 |
7,454 |
$64.34 |
| J0360 |
Injection, hydralazine hcl, up to 20 mg |
1,161 |
838 |
$63.45 |
| J1200 |
Injection, diphenhydramine hcl, up to 50 mg |
4,040 |
3,371 |
$62.04 |
| 86900 |
|
3,981 |
3,629 |
$60.01 |
| 84100 |
|
766 |
601 |
$56.00 |
| 84156 |
|
454 |
332 |
$54.04 |
| J7120 |
Ringers lactate infusion, up to 1000 cc |
6,459 |
5,679 |
$50.42 |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
351 |
328 |
$46.99 |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
349 |
327 |
$46.91 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
823 |
784 |
$41.80 |
| J3475 |
Injection, magnesium sulfate, per 500 mg |
1,714 |
1,449 |
$39.72 |
| J1815 |
Injection, insulin, per 5 units |
5,629 |
2,252 |
$39.19 |
| 87807 |
|
360 |
349 |
$37.10 |
| G0008 |
Administration of influenza virus vaccine |
178 |
152 |
$36.00 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
606 |
572 |
$32.36 |
| 88342 |
|
1,130 |
970 |
$27.12 |
| 84132 |
|
981 |
800 |
$25.30 |
| J2550 |
Injection, promethazine hcl, up to 50 mg |
2,481 |
1,922 |
$24.95 |
| 87081 |
|
783 |
745 |
$24.56 |
| 90686 |
|
205 |
178 |
$23.49 |
| 76775 |
|
28 |
26 |
$22.98 |
| J7512 |
Prednisone, immediate release or delayed release, oral, 1 mg |
1,508 |
1,242 |
$20.58 |
| J1956 |
Injection, levofloxacin, 250 mg |
386 |
287 |
$20.53 |
| 84112 |
|
239 |
219 |
$20.29 |
| J1170 |
Injection, hydromorphone, up to 4 mg |
3,304 |
2,774 |
$19.94 |
| J7040 |
Infusion, normal saline solution, sterile (500 ml = 1 unit) |
1,752 |
1,513 |
$19.67 |
| 84550 |
|
523 |
401 |
$17.62 |
| J7999 |
Compounded drug, not otherwise classified |
938 |
828 |
$17.34 |
| 73560 |
|
112 |
97 |
$16.62 |
| 97116 |
|
1,109 |
680 |
$16.42 |
| J2710 |
Injection, neostigmine methylsulfate, up to 0.5 mg |
1,402 |
1,246 |
$12.74 |
| 82140 |
|
59 |
54 |
$11.65 |
| 88304 |
|
732 |
659 |
$10.90 |
| J0330 |
Injection, succinylcholine chloride, up to 20 mg |
3,238 |
2,756 |
$10.10 |
| 82010 |
|
40 |
30 |
$9.90 |
| 82565 |
|
510 |
402 |
$8.65 |
| J2470 |
Injection, pantoprazole sodium, 40 mg |
121 |
68 |
$8.33 |
| J1650 |
Injection, enoxaparin sodium, 10 mg |
2,625 |
1,278 |
$7.78 |
| J0171 |
Injection, adrenalin, epinephrine, 0.1 mg |
34 |
32 |
$7.30 |
| J1940 |
Injection, furosemide, up to 20 mg |
168 |
109 |
$5.61 |
| J2930 |
Injection, methylprednisolone sodium succinate, up to 125 mg |
1,129 |
971 |
$5.49 |
| J2543 |
Injection, piperacillin sodium/tazobactam sodium, 1 gram/0.125 grams (1.125 grams) |
1,039 |
536 |
$4.72 |
| J2370 |
Injection, phenylephrine hcl, up to 1 ml |
618 |
554 |
$3.85 |
| J0665 |
Injection, bupivicaine, not otherwise specified, 0.5 mg |
324 |
247 |
$3.77 |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
7,116 |
6,455 |
$3.14 |
| 87210 |
|
404 |
374 |
$2.85 |
| C9113 |
Injection, pantoprazole sodium, per vial |
1,856 |
1,059 |
$1.76 |
| 99152 |
|
98 |
80 |
$0.00 |
| J2919 |
Injection, methylprednisolone sodium succinate, 5 mg |
123 |
88 |
$0.00 |
| J0780 |
Injection, prochlorperazine, up to 10 mg |
290 |
229 |
$0.00 |
| J1644 |
Injection, heparin sodium, per 1000 units |
831 |
411 |
$0.00 |
| J1596 |
Injection, glycopyrrolate, 0.1 mg |
194 |
188 |
$0.00 |
| 84450 |
|
106 |
77 |
$0.00 |
| 82570 |
|
92 |
76 |
$0.00 |
| Q0114 |
Fern test |
86 |
81 |
$0.00 |
| 29125 |
|
38 |
37 |
$0.00 |
| J0744 |
Injection, ciprofloxacin for intravenous infusion, 200 mg |
36 |
25 |
$0.00 |
| 84460 |
|
119 |
90 |
$0.00 |
| 96367 |
|
150 |
139 |
$0.00 |
| C1729 |
Catheter, drainage |
294 |
188 |
$0.00 |
| 84520 |
|
139 |
101 |
$0.00 |
| J3370 |
Injection, vancomycin hcl, 500 mg |
277 |
173 |
$0.00 |
| 12011 |
|
14 |
12 |
$0.00 |
| S0028 |
Injection, famotidine, 20 mg |
845 |
794 |
$0.00 |
| 84466 |
|
56 |
52 |
$0.00 |
| 73590 |
|
49 |
45 |
$0.00 |
| J0735 |
Injection, clonidine hydrochloride, 1 mg |
12 |
12 |
$0.00 |
| Q0245 |
Injection, bamlanivimab and etesevimab, 2100 mg |
24 |
23 |
$0.00 |
| 83540 |
|
56 |
52 |
$0.00 |
| Q0244 |
Injection, casirivimab and imdevimab, 1200 mg |
101 |
96 |
$0.00 |
| 85007 |
|
13 |
12 |
$0.00 |
| J1171 |
Injection, hydromorphone, 0.1 mg |
43 |
34 |
$0.00 |
| 84439 |
|
27 |
26 |
$0.00 |
| G0279 |
Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066) |
27 |
27 |
$0.00 |
| C1894 |
Introducer/sheath, other than guiding, other than intracardiac electrophysiological, non-laser |
80 |
76 |
$0.00 |
| M0239 |
Intravenous infusion, bamlanivimab-xxxx, includes infusion and post administration monitoring |
19 |
17 |
$0.00 |
| 76937 |
|
16 |
13 |
$0.00 |
| 82805 |
|
29 |
25 |
$0.00 |
| G8978 |
Mobility: walking & moving around functional limitation, current status, at therapy episode outset and at reporting intervals |
19 |
12 |
$0.00 |
| Q0239 |
Injection, bamlanivimab-xxxx, 700 mg |
19 |
17 |
$0.00 |
| C1758 |
Catheter, ureteral |
15 |
13 |
$0.00 |
| 84145 |
|
13 |
12 |
$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 |
17 |
13 |
$0.00 |
| M0245 |
Intravenous infusion, bamlanivimab and etesevimab, includes infusion and post administration monitoring |
24 |
23 |
$0.00 |
| 94760 |
|
511 |
273 |
$0.00 |
| 97162 |
|
43 |
29 |
$0.00 |
| 97165 |
|
258 |
234 |
$0.00 |
| 82553 |
|
14 |
14 |
$0.00 |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
397 |
388 |
$0.00 |
| J3480 |
Injection, potassium chloride, per 2 meq |
279 |
217 |
$0.00 |
| 87205 |
|
378 |
280 |
$0.00 |
| J2371 |
Injection, phenylephrine hydrochloride, 20 micrograms |
100 |
97 |
$0.00 |
| 71101 |
|
31 |
25 |
$0.00 |
| 43264 |
|
30 |
25 |
$0.00 |
| J2001 |
Injection, lidocaine hcl for intravenous infusion, 10 mg |
1,981 |
1,689 |
$0.00 |
| 72072 |
|
12 |
12 |
$0.00 |
| J1630 |
Injection, haloperidol, up to 5 mg |
16 |
12 |
$0.00 |
| 72170 |
|
15 |
15 |
$0.00 |
| 87070 |
|
101 |
78 |
$0.00 |
| J2175 |
Injection, meperidine hydrochloride, per 100 mg |
91 |
80 |
$0.00 |
| J1920 |
Injection, labetalol hydrochloride, 5 mg |
66 |
40 |
$0.00 |
| J2795 |
Injection, ropivacaine hydrochloride, 1 mg |
124 |
109 |
$0.00 |
| 85018 |
|
44 |
26 |
$0.00 |
| M0243 |
Intravenous infusion or subcutaneous injection, casirivimab and imdevimab includes infusion or injection, and post administration monitoring |
105 |
99 |
$0.00 |
| 73552 |
|
13 |
13 |
$0.00 |
| L8699 |
Prosthetic implant, not otherwise specified |
17 |
13 |
$0.00 |
| 72040 |
|
45 |
42 |
$0.00 |
| 87147 |
|
35 |
32 |
$0.00 |
| 87184 |
|
13 |
12 |
$0.00 |
| J2003 |
Injection, lidocaine hydrochloride, 1 mg |
176 |
159 |
$0.00 |
| J3360 |
Injection, diazepam, up to 5 mg |
22 |
16 |
$0.00 |
| J1836 |
Injection, metronidazole, 10 mg |
74 |
41 |
$0.00 |
| C1726 |
Catheter, balloon dilatation, non-vascular |
15 |
15 |
$0.00 |
| 82607 |
|
18 |
12 |
$0.00 |