| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99284 |
Emergency department visit for the evaluation and management, high severity |
17,460 |
15,998 |
$3.17M |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
22,284 |
20,933 |
$2.60M |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
7,057 |
6,547 |
$2.17M |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
10,675 |
9,703 |
$1.03M |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
3,178 |
3,032 |
$477K |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
5,088 |
4,881 |
$349K |
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
8,242 |
6,080 |
$341K |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
3,751 |
3,130 |
$326K |
| 96361 |
Intravenous infusion, hydration; each additional hour |
10,829 |
9,273 |
$303K |
| 96375 |
Therapeutic injection; each additional sequential IV push |
9,506 |
8,143 |
$301K |
| 87637 |
Infectious agent detection by nucleic acid; SARS-CoV-2, influenza, and RSV |
4,003 |
3,932 |
$275K |
| 70450 |
Computed tomography, head or brain; without contrast material |
3,322 |
3,152 |
$272K |
| 96360 |
Intravenous infusion, hydration; initial, 31 minutes to 1 hour |
2,532 |
2,403 |
$241K |
| 59025 |
Fetal non-stress test |
2,806 |
1,577 |
$235K |
| 93306 |
Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete |
1,004 |
987 |
$215K |
| 71046 |
Radiologic examination, chest; 2 views |
5,872 |
5,591 |
$205K |
| 71045 |
Radiologic examination, chest; single view |
5,185 |
4,919 |
$200K |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
7,185 |
1,849 |
$178K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
1,472 |
1,400 |
$162K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
4,386 |
4,274 |
$106K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
10,202 |
9,388 |
$99K |
| 76830 |
Ultrasound, transvaginal |
1,744 |
1,705 |
$99K |
| 92507 |
Treatment of speech, language, voice, communication, and/or auditory processing disorder |
2,468 |
860 |
$99K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
1,926 |
1,921 |
$92K |
| 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 |
1,912 |
1,877 |
$67K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
1,177 |
1,167 |
$66K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
1,149 |
1,099 |
$60K |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
998 |
968 |
$55K |
| 73630 |
|
2,651 |
2,240 |
$51K |
| 80061 |
Lipid panel |
8,542 |
8,452 |
$46K |
| 72148 |
Magnetic resonance imaging, lumbar spine; without contrast material |
383 |
373 |
$44K |
| 82947 |
|
2,062 |
1,636 |
$42K |
| 71275 |
Computed tomographic angiography, chest, with contrast material |
407 |
395 |
$37K |
| 84443 |
Thyroid stimulating hormone (TSH) |
12,229 |
11,950 |
$36K |
| 80053 |
Comprehensive metabolic panel |
30,440 |
27,456 |
$36K |
| G0378 |
Hospital observation service, per hour |
635 |
528 |
$35K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
37,512 |
32,951 |
$32K |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
4,548 |
4,502 |
$27K |
| 73610 |
|
1,700 |
1,472 |
$27K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
431 |
427 |
$25K |
| 73721 |
Magnetic resonance imaging, any joint of lower extremity; without contrast material |
189 |
184 |
$23K |
| 73030 |
|
1,407 |
1,277 |
$21K |
| 73564 |
|
745 |
663 |
$20K |
| 86900 |
|
1,761 |
1,663 |
$20K |
| 97112 |
Therapeutic procedure, each 15 minutes; neuromuscular reeducation of movement, balance, coordination |
955 |
357 |
$20K |
| 97140 |
Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) |
1,519 |
532 |
$19K |
| 93971 |
|
341 |
318 |
$18K |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
1,400 |
1,400 |
$17K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
2,086 |
2,048 |
$17K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
8,187 |
8,088 |
$17K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
2,078 |
2,038 |
$17K |
| 36415 |
Collection of venous blood by venipuncture |
25,475 |
22,526 |
$16K |
| 73130 |
|
1,269 |
1,140 |
$15K |
| 97161 |
|
286 |
278 |
$14K |
| 87502 |
Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets |
3,207 |
3,096 |
$12K |
| 73110 |
|
732 |
611 |
$11K |
| 87390 |
|
1,750 |
1,746 |
$11K |
| 96366 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour |
431 |
303 |
$11K |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
3,896 |
3,580 |
$11K |
| 72100 |
|
296 |
291 |
$11K |
| 72125 |
Computed tomography, cervical spine; without contrast material |
874 |
841 |
$10K |
| 84439 |
|
5,068 |
4,970 |
$10K |
| 80055 |
|
587 |
586 |
$10K |
| 73502 |
|
412 |
368 |
$9K |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
9,388 |
8,759 |
$8K |
| 97530 |
Therapeutic activities, direct patient contact, each 15 minutes |
406 |
162 |
$8K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
8,054 |
7,339 |
$8K |
| 82607 |
|
2,685 |
2,656 |
$8K |
| 94060 |
|
65 |
63 |
$8K |
| 93017 |
|
238 |
230 |
$8K |
| 73562 |
|
431 |
352 |
$7K |
| 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 |
645 |
640 |
$7K |
| 74018 |
|
392 |
389 |
$7K |
| 82728 |
|
2,111 |
2,071 |
$7K |
| 86702 |
|
1,758 |
1,750 |
$6K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
704 |
686 |
$6K |
| 45380 |
Colonoscopy, flexible; with biopsy, single or multiple |
14 |
13 |
$6K |
| 71271 |
|
101 |
101 |
$6K |
| 78452 |
Myocardial perfusion imaging, tomographic (SPECT); multiple studies at rest and/or stress |
12 |
12 |
$6K |
| 87636 |
Infectious agent detection by nucleic acid; SARS-CoV-2 and influenza virus types A and B |
326 |
322 |
$6K |
| 87634 |
|
887 |
845 |
$5K |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
1,796 |
1,712 |
$5K |
| 84702 |
|
1,856 |
1,366 |
$5K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
5,986 |
5,554 |
$4K |
| 88175 |
Cytopathology, cervical or vaginal, any reporting system; collected in preservative fluid, automated thin layer |
587 |
587 |
$4K |
| 87070 |
|
2,581 |
2,478 |
$4K |
| 86701 |
|
1,752 |
1,747 |
$4K |
| 86803 |
|
955 |
954 |
$4K |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
3,057 |
2,486 |
$4K |
| 83550 |
|
1,564 |
1,534 |
$4K |
| 83540 |
|
2,236 |
2,185 |
$3K |
| 74022 |
|
2,158 |
2,039 |
$3K |
| 87186 |
|
2,702 |
2,598 |
$3K |
| 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 |
2,220 |
1,841 |
$3K |
| 81001 |
|
12,461 |
11,422 |
$3K |
| 74019 |
|
109 |
108 |
$3K |
| 72110 |
|
186 |
180 |
$3K |
| 87077 |
|
2,763 |
2,650 |
$3K |
| J3490 |
Unclassified drugs |
13,733 |
6,962 |
$3K |
| 83735 |
|
7,547 |
6,767 |
$3K |
| 71260 |
Computed tomography, thorax, diagnostic; with contrast material |
13 |
13 |
$3K |
| 82746 |
|
952 |
942 |
$3K |
| 85027 |
|
2,024 |
1,931 |
$3K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
2,819 |
2,757 |
$3K |
| 87480 |
|
945 |
928 |
$2K |
| 87660 |
|
945 |
928 |
$2K |
| G0103 |
Prostate cancer screening; prostate specific antigen test (psa) |
634 |
634 |
$2K |
| 87624 |
Infectious agent detection by nucleic acid; human papillomavirus (HPV), high-risk types |
319 |
319 |
$2K |
| 87510 |
|
942 |
925 |
$2K |
| 81003 |
|
10,041 |
9,576 |
$2K |
| 76700 |
Ultrasound, abdominal, real time with image documentation; complete |
40 |
40 |
$2K |
| 86140 |
|
4,187 |
3,883 |
$2K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
132 |
120 |
$2K |
| 87081 |
|
2,581 |
2,517 |
$2K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
409 |
351 |
$2K |
| 80074 |
|
195 |
195 |
$2K |
| 86850 |
|
1,561 |
1,475 |
$2K |
| 83880 |
|
2,264 |
2,110 |
$2K |
| 76801 |
|
29 |
29 |
$2K |
| 82570 |
|
1,684 |
1,591 |
$2K |
| 73221 |
|
12 |
12 |
$2K |
| 81025 |
|
7,548 |
7,052 |
$1K |
| 82043 |
|
1,374 |
1,367 |
$1K |
| 85610 |
|
6,315 |
5,491 |
$1K |
| 82950 |
|
730 |
726 |
$1K |
| 76770 |
|
24 |
24 |
$1K |
| 73100 |
|
31 |
26 |
$1K |
| 73560 |
|
47 |
39 |
$1K |
| 76642 |
|
29 |
28 |
$1K |
| 99281 |
Emergency department visit for the evaluation and management, self-limited or minor |
31 |
30 |
$1K |
| 86038 |
|
393 |
389 |
$999.91 |
| 83690 |
|
6,859 |
6,194 |
$992.07 |
| 85652 |
|
2,370 |
2,239 |
$973.48 |
| G0145 |
Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, with screening by automated system and manual rescreening under physician supervision |
69 |
68 |
$971.92 |
| 72131 |
|
28 |
24 |
$941.43 |
| 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 |
95 |
91 |
$787.76 |
| 83516 |
|
154 |
137 |
$760.88 |
| 87651 |
Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe |
1,491 |
1,473 |
$729.39 |
| 73140 |
|
29 |
26 |
$727.20 |
| 76536 |
|
13 |
13 |
$715.55 |
| 82248 |
|
328 |
223 |
$689.03 |
| 76775 |
|
13 |
13 |
$668.00 |
| 85730 |
|
3,888 |
3,531 |
$658.53 |
| G0482 |
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; 15-21 drug class(es), including metabolite(s) if performed |
73 |
73 |
$641.34 |
| 80076 |
|
560 |
536 |
$613.39 |
| 84703 |
|
978 |
934 |
$607.63 |
| 86787 |
|
121 |
121 |
$564.04 |
| 84403 |
|
104 |
102 |
$539.08 |
| 72050 |
|
28 |
28 |
$525.72 |
| 83655 |
|
137 |
135 |
$492.82 |
| 72040 |
|
24 |
24 |
$476.52 |
| 94726 |
|
13 |
13 |
$474.36 |
| 86901 |
|
1,885 |
1,768 |
$471.02 |
| 82247 |
|
214 |
129 |
$458.19 |
| 84146 |
|
86 |
84 |
$424.25 |
| 82150 |
|
727 |
698 |
$388.51 |
| 87340 |
|
222 |
222 |
$374.82 |
| 83001 |
|
81 |
81 |
$374.08 |
| C9803 |
Hospital outpatient clinic visit specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source |
41 |
41 |
$362.53 |
| 87205 |
|
619 |
584 |
$335.96 |
| 86780 |
|
77 |
77 |
$320.06 |
| 87147 |
|
356 |
338 |
$304.49 |
| 84550 |
|
573 |
531 |
$300.56 |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
4,746 |
4,477 |
$300.00 |
| 73590 |
|
12 |
12 |
$290.88 |
| 93296 |
|
12 |
12 |
$247.55 |
| 83020 |
|
69 |
69 |
$243.82 |
| 96367 |
|
13 |
13 |
$225.90 |
| J7030 |
Infusion, normal saline solution , 1000 cc |
6,956 |
6,062 |
$213.20 |
| 85007 |
|
205 |
190 |
$209.17 |
| 84484 |
|
5,964 |
4,060 |
$176.49 |
| 83721 |
|
57 |
57 |
$169.84 |
| 86308 |
|
866 |
835 |
$169.27 |
| 85379 |
|
1,990 |
1,927 |
$165.82 |
| 87522 |
Neg quan hep c or qual rna |
13 |
12 |
$164.71 |
| 85018 |
|
196 |
176 |
$162.34 |
| Q3014 |
Telehealth originating site facility fee |
27 |
26 |
$146.94 |
| 82565 |
|
114 |
92 |
$136.76 |
| 93225 |
|
13 |
13 |
$133.22 |
| 87801 |
Infectious agent detection by nucleic acid; amplified probe, multiple organisms |
166 |
159 |
$132.33 |
| 84481 |
|
58 |
58 |
$130.06 |
| Q9969 |
Tc-99m from non-highly enriched uranium source, full cost recovery add-on, per study dose |
16 |
15 |
$128.34 |
| 84156 |
|
182 |
164 |
$125.49 |
| 82951 |
|
29 |
27 |
$116.37 |
| 85014 |
|
150 |
140 |
$116.26 |
| 86431 |
|
89 |
89 |
$112.40 |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
10,195 |
8,849 |
$106.87 |
| 84460 |
|
129 |
115 |
$102.94 |
| 87046 |
|
29 |
26 |
$98.80 |
| 86677 |
|
165 |
151 |
$95.84 |
| 87040 |
|
1,372 |
818 |
$86.91 |
| 82550 |
|
211 |
187 |
$82.91 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
66 |
53 |
$81.43 |
| A9270 |
Non-covered item or service |
22,550 |
12,309 |
$81.41 |
| 86364 |
|
15 |
15 |
$80.98 |
| 86592 |
|
41 |
41 |
$77.55 |
| 82077 |
|
1,784 |
1,606 |
$71.56 |
| 87807 |
|
62 |
58 |
$67.10 |
| 83605 |
|
2,265 |
1,903 |
$65.50 |
| 82977 |
|
58 |
56 |
$59.54 |
| 72072 |
|
15 |
14 |
$57.04 |
| 87045 |
|
29 |
26 |
$49.40 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
3,292 |
3,037 |
$46.71 |
| G0008 |
Administration of influenza virus vaccine |
45 |
28 |
$46.33 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
1,666 |
1,497 |
$40.58 |
| 84450 |
|
42 |
37 |
$40.19 |
| 84480 |
|
15 |
13 |
$36.74 |
| 84520 |
|
35 |
26 |
$33.10 |
| 85651 |
|
14 |
14 |
$29.96 |
| J7040 |
Infusion, normal saline solution, sterile (500 ml = 1 unit) |
966 |
896 |
$27.45 |
| J0665 |
Injection, bupivicaine, not otherwise specified, 0.5 mg |
161 |
144 |
$26.19 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
11,042 |
9,876 |
$23.03 |
| 87427 |
|
12 |
12 |
$20.25 |
| 86762 |
|
30 |
30 |
$18.94 |
| 87075 |
|
42 |
42 |
$18.92 |
| 80179 |
|
732 |
701 |
$14.91 |
| 80143 |
|
772 |
733 |
$14.91 |
| 84100 |
|
63 |
56 |
$8.94 |
| 36416 |
|
254 |
210 |
$0.01 |
| J2765 |
Injection, metoclopramide hcl, up to 10 mg |
870 |
802 |
$0.00 |
| J2704 |
Injection, propofol, 10 mg |
3,493 |
3,380 |
$0.00 |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
3,385 |
2,989 |
$0.00 |
| J0690 |
Injection, cefazolin sodium, 500 mg |
1,656 |
1,356 |
$0.00 |
| A9585 |
Injection, gadobutrol, 0.1 ml |
290 |
285 |
$0.00 |
| J2360 |
Injection, orphenadrine citrate, up to 60 mg |
1,265 |
1,210 |
$0.00 |
| J0500 |
Injection, dicyclomine hcl, up to 20 mg |
674 |
628 |
$0.00 |
| J2060 |
Injection, lorazepam, 2 mg |
798 |
707 |
$0.00 |
| 96376 |
|
1,905 |
1,473 |
$0.00 |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
2,256 |
1,953 |
$0.00 |
| J2001 |
Injection, lidocaine hcl for intravenous infusion, 10 mg |
1,282 |
1,174 |
$0.00 |
| J1170 |
Injection, hydromorphone, up to 4 mg |
1,882 |
1,565 |
$0.00 |
| J0330 |
Injection, succinylcholine chloride, up to 20 mg |
214 |
211 |
$0.00 |
| J7050 |
Infusion, normal saline solution, 250 cc |
568 |
371 |
$0.00 |
| J8540 |
Dexamethasone, oral, 0.25 mg |
108 |
105 |
$0.00 |
| J0131 |
Injection, acetaminophen, not otherwise specified,10 mg |
26 |
26 |
$0.00 |
| J3360 |
Injection, diazepam, up to 5 mg |
40 |
34 |
$0.00 |
| J1630 |
Injection, haloperidol, up to 5 mg |
55 |
50 |
$0.00 |
| J1040 |
Injection, methylprednisolone acetate, 80 mg |
41 |
39 |
$0.00 |
| J8597 |
Antiemetic drug, oral, not otherwise specified |
26 |
25 |
$0.00 |
| J2371 |
Injection, phenylephrine hydrochloride, 20 micrograms |
12 |
12 |
$0.00 |
| J2370 |
Injection, phenylephrine hcl, up to 1 ml |
27 |
27 |
$0.00 |
| J3480 |
Injection, potassium chloride, per 2 meq |
18 |
13 |
$0.00 |
| J2930 |
Injection, methylprednisolone sodium succinate, up to 125 mg |
2,902 |
2,694 |
$0.00 |
| C1713 |
Anchor/screw for opposing bone-to-bone or soft tissue-to-bone (implantable) |
41 |
41 |
$0.00 |
| J1200 |
Injection, diphenhydramine hcl, up to 50 mg |
2,709 |
2,395 |
$0.00 |
| 90715 |
|
661 |
657 |
$0.00 |
| J7120 |
Ringers lactate infusion, up to 1000 cc |
2,828 |
2,447 |
$0.00 |
| J2270 |
Injection, morphine sulfate, up to 10 mg |
2,021 |
1,769 |
$0.00 |
| J0780 |
Injection, prochlorperazine, up to 10 mg |
27 |
25 |
$0.00 |
| J2919 |
Injection, methylprednisolone sodium succinate, 5 mg |
288 |
279 |
$0.00 |
| J2710 |
Injection, neostigmine methylsulfate, up to 0.5 mg |
266 |
262 |
$0.00 |
| S5000 |
Prescription drug, generic |
1,464 |
849 |
$0.00 |
| Q0144 |
Azithromycin dihydrate, oral, capsules/powder, 1 gram |
541 |
533 |
$0.00 |
| J3475 |
Injection, magnesium sulfate, per 500 mg |
226 |
206 |
$0.00 |
| 94729 |
|
68 |
68 |
$0.00 |
| J7510 |
Prednisolone oral, per 5 mg |
48 |
47 |
$0.00 |
| J1171 |
Injection, hydromorphone, 0.1 mg |
27 |
25 |
$0.00 |
| J1644 |
Injection, heparin sodium, per 1000 units |
52 |
27 |
$0.00 |
| 82010 |
|
12 |
12 |
$0.00 |
| C9113 |
Injection, pantoprazole sodium, per vial |
27 |
25 |
$0.00 |
| J1596 |
Injection, glycopyrrolate, 0.1 mg |
33 |
33 |
$0.00 |
| G1004 |
Clinical decision support mechanism national decision support company, as defined by the medicare appropriate use criteria program |
78 |
75 |
$0.00 |
| J0171 |
Injection, adrenalin, epinephrine, 0.1 mg |
12 |
12 |
$0.00 |
| 82800 |
|
23 |
13 |
$0.00 |