| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
25,678 |
24,323 |
$3.07M |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
10,599 |
9,629 |
$2.72M |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
14,695 |
13,652 |
$2.52M |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
19,983 |
17,833 |
$887K |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
8,094 |
7,325 |
$738K |
| 87633 |
Infectious agent detection by nucleic acid, respiratory virus, 12-25 targets |
5,811 |
5,729 |
$449K |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
3,164 |
3,065 |
$445K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
6,124 |
5,782 |
$407K |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
4,352 |
3,236 |
$397K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
6,643 |
6,566 |
$390K |
| G0378 |
Hospital observation service, per hour |
600 |
572 |
$380K |
| 81514 |
|
2,047 |
2,020 |
$303K |
| 71046 |
Radiologic examination, chest; 2 views |
7,366 |
7,099 |
$273K |
| 70450 |
Computed tomography, head or brain; without contrast material |
3,122 |
3,037 |
$268K |
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
4,064 |
3,052 |
$261K |
| 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 |
5,058 |
4,849 |
$218K |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
9,611 |
2,387 |
$202K |
| 71045 |
Radiologic examination, chest; single view |
5,303 |
5,067 |
$200K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
1,879 |
1,830 |
$194K |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
2,549 |
2,511 |
$179K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
1,809 |
1,793 |
$159K |
| 59426 |
|
173 |
173 |
$148K |
| 96361 |
Intravenous infusion, hydration; each additional hour |
6,041 |
4,589 |
$136K |
| 96375 |
Therapeutic injection; each additional sequential IV push |
7,100 |
5,455 |
$135K |
| 59025 |
Fetal non-stress test |
1,794 |
778 |
$134K |
| 80061 |
Lipid panel |
10,401 |
10,304 |
$123K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
6,357 |
6,244 |
$122K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
2,132 |
2,116 |
$118K |
| 87636 |
Infectious agent detection by nucleic acid; SARS-CoV-2 and influenza virus types A and B |
2,090 |
2,016 |
$113K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
5,776 |
5,678 |
$110K |
| 84443 |
Thyroid stimulating hormone (TSH) |
13,264 |
12,977 |
$109K |
| 93306 |
Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete |
632 |
589 |
$105K |
| 80053 |
Comprehensive metabolic panel |
34,307 |
30,786 |
$103K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
4,007 |
3,737 |
$102K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
2,133 |
2,130 |
$97K |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
1,671 |
1,645 |
$96K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
38,782 |
34,099 |
$91K |
| 96360 |
Intravenous infusion, hydration; initial, 31 minutes to 1 hour |
940 |
892 |
$91K |
| 99281 |
Emergency department visit for the evaluation and management, self-limited or minor |
2,267 |
2,227 |
$91K |
| 87637 |
Infectious agent detection by nucleic acid; SARS-CoV-2, influenza, and RSV |
1,262 |
1,236 |
$90K |
| 11042 |
Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm |
887 |
220 |
$88K |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
5,198 |
5,158 |
$87K |
| 87651 |
Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe |
3,138 |
3,095 |
$65K |
| 59430 |
|
279 |
279 |
$64K |
| 71275 |
Computed tomographic angiography, chest, with contrast material |
737 |
721 |
$63K |
| 76801 |
|
1,153 |
1,026 |
$57K |
| 20610 |
|
1,764 |
1,385 |
$56K |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
6,410 |
5,793 |
$53K |
| 43239 |
Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple |
180 |
143 |
$53K |
| 87798 |
Infectious agent detection by nucleic acid; not otherwise specified, amplified probe, each organism |
2,665 |
2,640 |
$49K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
1,508 |
1,419 |
$49K |
| 76830 |
Ultrasound, transvaginal |
816 |
812 |
$48K |
| 97140 |
Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) |
4,093 |
1,258 |
$45K |
| 87428 |
|
1,063 |
1,039 |
$44K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
6,172 |
5,939 |
$41K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
719 |
708 |
$41K |
| 73721 |
Magnetic resonance imaging, any joint of lower extremity; without contrast material |
343 |
340 |
$39K |
| 94060 |
|
303 |
303 |
$39K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
7,159 |
7,051 |
$38K |
| 73630 |
|
2,949 |
2,792 |
$35K |
| 72100 |
|
1,037 |
1,035 |
$32K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
8,896 |
7,610 |
$32K |
| 99460 |
|
608 |
608 |
$32K |
| 73610 |
|
2,684 |
2,483 |
$31K |
| 82607 |
|
3,489 |
3,453 |
$30K |
| 73030 |
|
2,136 |
2,059 |
$29K |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
10,509 |
9,704 |
$28K |
| 84439 |
|
5,293 |
5,228 |
$26K |
| 73110 |
|
1,930 |
1,730 |
$25K |
| 86900 |
|
2,694 |
2,611 |
$25K |
| 73130 |
|
2,408 |
2,202 |
$24K |
| 99238 |
Hospital discharge day management, 30 minutes or less |
592 |
583 |
$24K |
| 87481 |
|
380 |
378 |
$24K |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
2,167 |
2,161 |
$23K |
| 81025 |
|
11,314 |
10,291 |
$23K |
| 73560 |
|
1,201 |
1,158 |
$23K |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
1,853 |
1,852 |
$22K |
| 97161 |
|
525 |
521 |
$22K |
| 72148 |
Magnetic resonance imaging, lumbar spine; without contrast material |
206 |
203 |
$20K |
| G0260 |
Injection procedure for sacroiliac joint; provision of anesthetic, steroid and/or other therapeutic agent, with or without arthrography |
64 |
63 |
$19K |
| 83880 |
|
2,665 |
2,445 |
$19K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
437 |
434 |
$18K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
1,864 |
1,779 |
$18K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
967 |
695 |
$17K |
| 87801 |
Infectious agent detection by nucleic acid; amplified probe, multiple organisms |
408 |
405 |
$17K |
| 87502 |
Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets |
2,111 |
2,051 |
$15K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
8,452 |
7,621 |
$15K |
| 74018 |
|
778 |
751 |
$15K |
| 64635 |
|
29 |
12 |
$15K |
| 36415 |
Collection of venous blood by venipuncture |
51,738 |
42,651 |
$15K |
| 86780 |
|
1,857 |
1,846 |
$14K |
| 71250 |
|
288 |
284 |
$14K |
| 97530 |
Therapeutic activities, direct patient contact, each 15 minutes |
620 |
449 |
$14K |
| 90715 |
|
1,322 |
1,313 |
$14K |
| 71260 |
Computed tomography, thorax, diagnostic; with contrast material |
125 |
121 |
$13K |
| 76642 |
|
338 |
336 |
$13K |
| 64493 |
|
50 |
25 |
$13K |
| 96366 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour |
447 |
306 |
$13K |
| 87631 |
|
1,133 |
1,094 |
$12K |
| 80074 |
|
450 |
443 |
$12K |
| 76775 |
|
278 |
276 |
$11K |
| 99215 |
Prolong outpt/office vis |
113 |
90 |
$11K |
| 73562 |
|
1,066 |
1,032 |
$11K |
| 84702 |
|
1,925 |
1,452 |
$11K |
| 74022 |
|
810 |
786 |
$11K |
| 83550 |
|
2,111 |
2,084 |
$11K |
| 93010 |
Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only |
2,271 |
1,824 |
$10K |
| 86850 |
|
2,754 |
2,658 |
$10K |
| 87186 |
|
3,447 |
3,304 |
$10K |
| 59425 |
|
19 |
19 |
$9K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
116 |
116 |
$9K |
| 87088 |
|
3,092 |
2,962 |
$9K |
| G0103 |
Prostate cancer screening; prostate specific antigen test (psa) |
821 |
818 |
$9K |
| 59409 |
Vaginal delivery only (with or without episiotomy and/or forceps) |
12 |
12 |
$9K |
| 97014 |
|
1,104 |
321 |
$9K |
| 93971 |
|
156 |
151 |
$9K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
2,873 |
2,499 |
$8K |
| 73502 |
|
622 |
614 |
$8K |
| 72050 |
|
186 |
186 |
$8K |
| 81003 |
|
15,251 |
13,842 |
$8K |
| 86762 |
|
1,160 |
1,155 |
$8K |
| 87480 |
|
647 |
642 |
$7K |
| 87510 |
|
646 |
641 |
$7K |
| 72125 |
Computed tomography, cervical spine; without contrast material |
592 |
588 |
$7K |
| 81001 |
|
11,640 |
10,863 |
$7K |
| 76536 |
|
144 |
144 |
$7K |
| 87660 |
|
616 |
611 |
$7K |
| 87486 |
|
350 |
345 |
$7K |
| 87581 |
|
350 |
345 |
$7K |
| 83735 |
|
7,632 |
6,643 |
$7K |
| 82043 |
|
1,942 |
1,925 |
$7K |
| 73564 |
|
185 |
174 |
$6K |
| 82728 |
|
752 |
739 |
$6K |
| 97162 |
|
128 |
125 |
$6K |
| 93225 |
|
107 |
106 |
$5K |
| 83540 |
|
1,410 |
1,395 |
$5K |
| 85610 |
|
7,599 |
6,756 |
$5K |
| 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 |
2,834 |
2,451 |
$5K |
| 76641 |
|
92 |
92 |
$5K |
| J0702 |
Injection, betamethasone acetate 3 mg and betamethasone sodium phosphate 3 mg |
924 |
861 |
$5K |
| 86803 |
|
1,106 |
1,101 |
$5K |
| 84403 |
|
285 |
285 |
$5K |
| 86140 |
|
2,249 |
2,006 |
$4K |
| 82540 |
|
1,732 |
1,680 |
$4K |
| 85651 |
|
2,469 |
2,214 |
$4K |
| J1040 |
Injection, methylprednisolone acetate, 80 mg |
876 |
853 |
$4K |
| 86706 |
|
854 |
851 |
$4K |
| 85027 |
|
1,797 |
1,667 |
$3K |
| 85730 |
|
6,164 |
5,778 |
$3K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
36 |
36 |
$3K |
| 82950 |
|
1,112 |
1,112 |
$3K |
| 86901 |
|
2,974 |
2,842 |
$3K |
| 77066 |
Tomosynthesis, mammo |
53 |
53 |
$3K |
| 86038 |
|
406 |
403 |
$3K |
| 87070 |
|
1,002 |
958 |
$3K |
| 87077 |
|
743 |
712 |
$3K |
| 86703 |
|
431 |
428 |
$3K |
| 73590 |
|
229 |
211 |
$2K |
| 87340 |
|
457 |
455 |
$2K |
| 54160 |
|
27 |
27 |
$2K |
| 97035 |
|
417 |
180 |
$2K |
| 90686 |
|
193 |
191 |
$2K |
| 80076 |
|
425 |
404 |
$2K |
| 85007 |
|
1,788 |
1,659 |
$2K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
62 |
56 |
$2K |
| 58300 |
|
42 |
37 |
$2K |
| 84484 |
|
5,297 |
4,698 |
$2K |
| 77065 |
Tomosynthesis, mammo |
57 |
53 |
$2K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
26 |
26 |
$2K |
| 83690 |
|
6,117 |
5,643 |
$2K |
| 27096 |
|
49 |
48 |
$2K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
38 |
35 |
$2K |
| G0483 |
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; 22 or more drug class(es), including metabolite(s) if performed |
17 |
17 |
$2K |
| 71271 |
|
29 |
29 |
$2K |
| 97602 |
|
27 |
12 |
$2K |
| 73221 |
|
16 |
15 |
$2K |
| 82150 |
|
1,888 |
1,804 |
$1K |
| 70486 |
|
40 |
39 |
$1K |
| 87400 |
|
139 |
69 |
$1K |
| 84146 |
|
104 |
103 |
$1K |
| 73140 |
|
79 |
73 |
$1K |
| 84550 |
|
477 |
461 |
$1K |
| 87081 |
|
266 |
264 |
$956.61 |
| 83655 |
|
331 |
330 |
$956.06 |
| 73090 |
|
127 |
115 |
$940.16 |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
15 |
14 |
$926.89 |
| 84480 |
|
103 |
101 |
$917.46 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
12 |
12 |
$800.69 |
| 86665 |
|
69 |
69 |
$684.87 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
44 |
43 |
$654.83 |
| J1030 |
Injection, methylprednisolone acetate, 40 mg |
158 |
152 |
$632.85 |
| 82550 |
|
998 |
899 |
$622.34 |
| 84153 |
|
64 |
64 |
$615.09 |
| G0279 |
Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066) |
55 |
55 |
$606.62 |
| 87661 |
Infectious agent detection by nucleic acid; Trichomonas vaginalis, amplified probe |
30 |
30 |
$605.52 |
| 64494 |
|
49 |
25 |
$597.54 |
| 73080 |
|
82 |
74 |
$591.24 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
34 |
34 |
$542.64 |
| 72131 |
|
12 |
12 |
$514.58 |
| 84156 |
|
314 |
272 |
$506.44 |
| 85379 |
|
1,407 |
1,367 |
$501.32 |
| 64495 |
|
14 |
12 |
$500.28 |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
1,564 |
1,338 |
$494.16 |
| 64636 |
|
35 |
12 |
$476.22 |
| 86663 |
|
70 |
70 |
$394.55 |
| 86664 |
|
70 |
70 |
$394.55 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
25 |
25 |
$392.70 |
| 94726 |
|
133 |
133 |
$381.22 |
| 86580 |
|
68 |
64 |
$353.49 |
| 83001 |
|
27 |
27 |
$350.09 |
| 84100 |
|
481 |
387 |
$292.14 |
| 83615 |
|
91 |
90 |
$283.26 |
| 86376 |
|
32 |
32 |
$267.62 |
| 82746 |
|
33 |
32 |
$260.19 |
| 84481 |
|
26 |
26 |
$244.33 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
2,620 |
2,097 |
$233.20 |
| 72070 |
|
13 |
13 |
$229.20 |
| 86430 |
|
80 |
79 |
$217.80 |
| 84703 |
|
299 |
289 |
$209.41 |
| 97012 |
|
34 |
12 |
$203.00 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
8,123 |
7,349 |
$202.40 |
| 81002 |
|
77 |
70 |
$197.74 |
| 86308 |
|
86 |
86 |
$184.11 |
| 84460 |
|
52 |
50 |
$135.89 |
| 87040 |
|
672 |
643 |
$134.48 |
| 82962 |
|
1,132 |
860 |
$133.98 |
| 93226 |
|
120 |
119 |
$132.16 |
| 82565 |
|
40 |
39 |
$113.78 |
| G2211 |
Visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and/or with medical care services that are part of ongoing care related to a patient's single, serious condition or a complex condition. (add-on code, list separately in addition to office/outpatient evaluation and management visit, new or established) |
68 |
68 |
$108.24 |
| 84450 |
|
37 |
36 |
$101.19 |
| 82570 |
|
40 |
38 |
$99.19 |
| 86255 |
|
12 |
12 |
$86.76 |
| 83516 |
|
12 |
12 |
$85.11 |
| 82784 |
|
12 |
12 |
$80.88 |
| 80164 |
|
13 |
12 |
$70.20 |
| 12001 |
|
231 |
231 |
$56.06 |
| J2274 |
Injection, morphine sulfate, preservative-free for epidural or intrathecal use, 10 mg |
1,139 |
991 |
$47.10 |
| 87420 |
|
93 |
89 |
$37.65 |
| 83605 |
|
1,852 |
1,682 |
$36.24 |
| 99051 |
|
145 |
141 |
$36.00 |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
53 |
53 |
$23.85 |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
7,744 |
6,832 |
$16.24 |
| J0665 |
Injection, bupivicaine, not otherwise specified, 0.5 mg |
488 |
443 |
$11.29 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
5,033 |
4,913 |
$11.16 |
| J2930 |
Injection, methylprednisolone sodium succinate, up to 125 mg |
596 |
537 |
$10.39 |
| J1010 |
Injection, methylprednisolone acetate, 1 mg |
142 |
140 |
$4.03 |
| J2550 |
Injection, promethazine hcl, up to 50 mg |
491 |
404 |
$2.31 |
| 3074F |
|
2,713 |
2,504 |
$1.55 |
| 3078F |
|
2,304 |
2,147 |
$1.31 |
| 3079F |
|
1,303 |
1,231 |
$1.16 |
| J7512 |
Prednisone, immediate release or delayed release, oral, 1 mg |
94 |
88 |
$0.80 |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
2,809 |
2,687 |
$0.77 |
| 3075F |
|
696 |
666 |
$0.68 |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
2,985 |
2,880 |
$0.52 |
| J1200 |
Injection, diphenhydramine hcl, up to 50 mg |
1,782 |
1,614 |
$0.48 |
| 0503F |
|
208 |
207 |
$0.14 |
| 0502F |
|
3,746 |
2,254 |
$0.07 |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
7,411 |
7,040 |
$0.00 |
| A9577 |
Injection, gadobenate dimeglumine (multihance), per ml |
635 |
625 |
$0.00 |
| J2919 |
Injection, methylprednisolone sodium succinate, 5 mg |
25 |
24 |
$0.00 |
| 29125 |
|
91 |
91 |
$0.00 |
| J1171 |
Injection, hydromorphone, 0.1 mg |
22 |
18 |
$0.00 |
| 94729 |
|
145 |
145 |
$0.00 |
| J2270 |
Injection, morphine sulfate, up to 10 mg |
373 |
328 |
$0.00 |
| J0780 |
Injection, prochlorperazine, up to 10 mg |
14 |
14 |
$0.00 |
| J3475 |
Injection, magnesium sulfate, per 500 mg |
73 |
65 |
$0.00 |
| 82805 |
|
16 |
14 |
$0.00 |
| J0690 |
Injection, cefazolin sodium, 500 mg |
1,172 |
1,127 |
$0.00 |
| J1170 |
Injection, hydromorphone, up to 4 mg |
1,490 |
1,335 |
$0.00 |
| J1630 |
Injection, haloperidol, up to 5 mg |
27 |
24 |
$0.00 |
| J2765 |
Injection, metoclopramide hcl, up to 10 mg |
624 |
566 |
$0.00 |
| 96376 |
|
422 |
369 |
$0.00 |
| J0330 |
Injection, succinylcholine chloride, up to 20 mg |
382 |
378 |
$0.00 |
| J3490 |
Unclassified drugs |
574 |
529 |
$0.00 |
| J2060 |
Injection, lorazepam, 2 mg |
639 |
547 |
$0.00 |
| J2704 |
Injection, propofol, 10 mg |
2,134 |
2,095 |
$0.00 |
| A9270 |
Non-covered item or service |
159 |
152 |
$0.00 |
| J1642 |
Injection, heparin sodium, (heparin lock flush), per 10 units |
127 |
51 |
$0.00 |
| C9290 |
Injection, bupivacaine liposome, 1 mg |
30 |
28 |
$0.00 |
| 94660 |
|
26 |
26 |
$0.00 |
| 0500F |
|
41 |
41 |
$0.00 |
| 83874 |
|
27 |
25 |
$0.00 |
| 84436 |
|
16 |
15 |
$0.00 |