| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
3,536 |
2,944 |
$3.76M |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
22,392 |
17,463 |
$3.63M |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
28,248 |
24,207 |
$3.51M |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
3,402 |
2,838 |
$3.08M |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
18,897 |
10,269 |
$2.67M |
| 0202U |
Oncology (prostate), multianalyte, gene expression profiling |
4,431 |
4,225 |
$1.77M |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
45,233 |
11,529 |
$1.66M |
| 70450 |
Computed tomography, head or brain; without contrast material |
3,942 |
2,997 |
$1.62M |
| 97140 |
Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) |
39,122 |
9,698 |
$1.24M |
| 0225U |
|
3,040 |
2,870 |
$1.20M |
| 96361 |
Intravenous infusion, hydration; each additional hour |
22,495 |
8,763 |
$937K |
| 97035 |
|
33,743 |
8,660 |
$816K |
| 87636 |
Infectious agent detection by nucleic acid; SARS-CoV-2 and influenza virus types A and B |
8,122 |
5,999 |
$746K |
| 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 |
10,350 |
8,988 |
$725K |
| G0378 |
Hospital observation service, per hour |
6,662 |
2,724 |
$665K |
| 78452 |
Myocardial perfusion imaging, tomographic (SPECT); multiple studies at rest and/or stress |
1,816 |
762 |
$573K |
| 93306 |
Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete |
1,841 |
1,467 |
$550K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
15,095 |
11,366 |
$548K |
| 96375 |
Therapeutic injection; each additional sequential IV push |
10,980 |
7,360 |
$514K |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
2,413 |
2,057 |
$511K |
| 71045 |
Radiologic examination, chest; single view |
13,572 |
8,681 |
$500K |
| 80053 |
Comprehensive metabolic panel |
57,801 |
39,648 |
$497K |
| 97010 |
|
27,379 |
7,867 |
$490K |
| 43239 |
Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple |
1,328 |
875 |
$477K |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
5,400 |
4,887 |
$436K |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
21,553 |
10,153 |
$428K |
| 71046 |
Radiologic examination, chest; 2 views |
8,120 |
6,129 |
$424K |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
10,192 |
4,485 |
$421K |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
7,936 |
6,701 |
$420K |
| 72148 |
Magnetic resonance imaging, lumbar spine; without contrast material |
889 |
778 |
$417K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
59,879 |
41,800 |
$377K |
| 80050 |
General health panel |
9,539 |
9,090 |
$375K |
| 72100 |
|
5,123 |
4,128 |
$352K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
1,935 |
1,846 |
$350K |
| 73562 |
|
3,790 |
2,707 |
$275K |
| 36415 |
Collection of venous blood by venipuncture |
110,565 |
51,271 |
$273K |
| 11042 |
Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm |
3,431 |
1,027 |
$270K |
| 96360 |
Intravenous infusion, hydration; initial, 31 minutes to 1 hour |
9,747 |
3,551 |
$268K |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
11,750 |
10,632 |
$249K |
| 97014 |
|
27,773 |
7,701 |
$242K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
14,249 |
8,824 |
$232K |
| 80061 |
Lipid panel |
20,240 |
18,051 |
$217K |
| 87637 |
Infectious agent detection by nucleic acid; SARS-CoV-2, influenza, and RSV |
1,980 |
1,741 |
$207K |
| 73630 |
|
2,583 |
2,114 |
$205K |
| 84443 |
Thyroid stimulating hormone (TSH) |
15,103 |
13,308 |
$204K |
| 96366 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour |
1,799 |
973 |
$202K |
| 73610 |
|
2,565 |
2,096 |
$196K |
| 45380 |
Colonoscopy, flexible; with biopsy, single or multiple |
540 |
382 |
$189K |
| 97535 |
Self-care/home management training, each 15 minutes |
10,016 |
5,892 |
$164K |
| 73130 |
|
2,166 |
1,733 |
$159K |
| 96376 |
|
3,012 |
1,706 |
$155K |
| 73030 |
|
2,734 |
2,100 |
$153K |
| 82607 |
|
11,657 |
10,704 |
$152K |
| 97161 |
|
4,337 |
3,292 |
$147K |
| 72040 |
|
2,191 |
1,835 |
$147K |
| 76830 |
Ultrasound, transvaginal |
794 |
728 |
$144K |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
21,083 |
16,817 |
$144K |
| 72125 |
Computed tomography, cervical spine; without contrast material |
355 |
319 |
$142K |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
9,998 |
5,266 |
$134K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,868 |
1,090 |
$134K |
| 73110 |
|
1,836 |
1,407 |
$131K |
| 80074 |
|
3,868 |
3,552 |
$130K |
| 84484 |
|
12,242 |
7,232 |
$130K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
16,563 |
15,013 |
$128K |
| 59025 |
Fetal non-stress test |
2,533 |
1,169 |
$122K |
| 93017 |
|
783 |
640 |
$121K |
| 97112 |
Therapeutic procedure, each 15 minutes; neuromuscular reeducation of movement, balance, coordination |
7,974 |
2,758 |
$113K |
| 97162 |
|
2,981 |
2,620 |
$112K |
| 71260 |
Computed tomography, thorax, diagnostic; with contrast material |
215 |
171 |
$100K |
| 71250 |
|
390 |
282 |
$98K |
| 83880 |
|
3,637 |
2,873 |
$97K |
| 73502 |
|
1,801 |
1,380 |
$91K |
| 72072 |
|
990 |
797 |
$90K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
1,555 |
815 |
$90K |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
3,165 |
2,419 |
$86K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
6,191 |
2,857 |
$84K |
| 83605 |
|
8,638 |
6,547 |
$84K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
14,773 |
8,595 |
$81K |
| 87040 |
|
9,353 |
5,100 |
$80K |
| 81001 |
|
26,475 |
22,062 |
$79K |
| 71275 |
Computed tomographic angiography, chest, with contrast material |
242 |
143 |
$75K |
| G0283 |
Electrical stimulation (unattended), to one or more areas for indication(s) other than wound care, as part of a therapy plan of care |
15,914 |
1,212 |
$74K |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
3,878 |
3,450 |
$73K |
| 76536 |
|
426 |
393 |
$71K |
| 74018 |
|
1,255 |
1,109 |
$70K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
4,822 |
4,483 |
$70K |
| 75574 |
|
153 |
129 |
$69K |
| J7030 |
Infusion, normal saline solution , 1000 cc |
14,146 |
9,215 |
$68K |
| 87522 |
Neg quan hep c or qual rna |
1,469 |
1,264 |
$68K |
| 76700 |
Ultrasound, abdominal, real time with image documentation; complete |
297 |
272 |
$63K |
| A9500 |
Technetium tc-99m sestamibi, diagnostic, per study dose |
530 |
431 |
$62K |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
9,258 |
7,785 |
$62K |
| 87186 |
|
8,316 |
6,267 |
$60K |
| 93971 |
|
340 |
300 |
$60K |
| 83735 |
|
9,266 |
7,718 |
$54K |
| J0131 |
Injection, acetaminophen, not otherwise specified,10 mg |
3,651 |
2,924 |
$54K |
| 84145 |
|
2,584 |
2,198 |
$54K |
| J2785 |
Injection, regadenoson, 0.1 mg |
478 |
394 |
$50K |
| 73080 |
|
527 |
430 |
$48K |
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
10,589 |
6,231 |
$47K |
| 82947 |
|
8,241 |
4,432 |
$45K |
| 90715 |
|
1,196 |
1,097 |
$44K |
| 83690 |
|
6,814 |
5,890 |
$43K |
| 85610 |
|
11,127 |
7,327 |
$43K |
| 72131 |
|
94 |
83 |
$41K |
| 74022 |
|
444 |
400 |
$40K |
| 84702 |
|
2,627 |
2,035 |
$39K |
| 84439 |
|
4,714 |
4,343 |
$37K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
137 |
131 |
$37K |
| 76770 |
|
358 |
267 |
$34K |
| 81025 |
|
4,207 |
3,738 |
$32K |
| 82803 |
|
1,817 |
1,246 |
$31K |
| 82728 |
|
2,962 |
2,591 |
$31K |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
7,543 |
6,069 |
$29K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
540 |
503 |
$29K |
| 85730 |
|
6,002 |
4,868 |
$29K |
| 72141 |
|
88 |
67 |
$28K |
| 84481 |
|
1,679 |
1,493 |
$27K |
| 84403 |
|
1,290 |
1,163 |
$27K |
| 87077 |
|
4,199 |
2,769 |
$27K |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
5,120 |
3,971 |
$27K |
| J7120 |
Ringers lactate infusion, up to 1000 cc |
5,619 |
4,620 |
$27K |
| 84466 |
|
2,512 |
2,235 |
$26K |
| 82570 |
|
6,182 |
5,238 |
$25K |
| 86140 |
|
5,301 |
3,867 |
$24K |
| 12001 |
|
231 |
206 |
$24K |
| 97597 |
|
402 |
153 |
$23K |
| 76775 |
|
241 |
185 |
$23K |
| 85027 |
|
4,394 |
3,180 |
$23K |
| 73090 |
|
388 |
312 |
$22K |
| 87070 |
|
2,877 |
2,336 |
$22K |
| 85379 |
|
2,435 |
2,115 |
$22K |
| 82043 |
|
4,620 |
4,153 |
$21K |
| 83540 |
|
3,633 |
3,248 |
$21K |
| 73590 |
|
303 |
243 |
$20K |
| 83655 |
|
1,694 |
1,618 |
$20K |
| 84153 |
|
1,391 |
1,188 |
$19K |
| 84703 |
|
2,828 |
2,531 |
$19K |
| 83001 |
|
1,131 |
1,051 |
$19K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
1,329 |
1,169 |
$19K |
| 86803 |
|
1,459 |
1,385 |
$19K |
| M0243 |
Intravenous infusion or subcutaneous injection, casirivimab and imdevimab includes infusion or injection, and post administration monitoring |
165 |
159 |
$18K |
| Q9991 |
Injection, buprenorphine extended-release (sublocade), less than or equal to 100 mg |
14 |
12 |
$18K |
| 70486 |
|
43 |
37 |
$18K |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
2,805 |
2,452 |
$17K |
| 97116 |
|
1,288 |
359 |
$17K |
| 10060 |
|
71 |
63 |
$17K |
| J7050 |
Infusion, normal saline solution, 250 cc |
3,687 |
2,181 |
$17K |
| 82077 |
|
918 |
768 |
$15K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
458 |
414 |
$15K |
| 86038 |
|
1,469 |
1,306 |
$15K |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
3,874 |
3,234 |
$14K |
| 84146 |
|
854 |
803 |
$14K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
441 |
411 |
$14K |
| 83002 |
|
864 |
818 |
$13K |
| J2270 |
Injection, morphine sulfate, up to 10 mg |
2,434 |
1,876 |
$13K |
| U0002 |
2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc |
269 |
240 |
$12K |
| J0690 |
Injection, cefazolin sodium, 500 mg |
2,089 |
1,445 |
$12K |
| 86850 |
|
1,704 |
1,516 |
$12K |
| 86317 |
|
841 |
802 |
$12K |
| 96367 |
|
232 |
170 |
$12K |
| 87340 |
|
1,106 |
1,048 |
$12K |
| J1170 |
Injection, hydromorphone, up to 4 mg |
1,944 |
1,533 |
$11K |
| 87081 |
|
1,932 |
1,654 |
$11K |
| 36600 |
|
1,274 |
650 |
$11K |
| J1335 |
Injection, ertapenem sodium, 500 mg |
358 |
177 |
$10K |
| 84550 |
|
2,529 |
2,075 |
$10K |
| 86592 |
|
2,601 |
2,431 |
$10K |
| 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 |
798 |
375 |
$9K |
| 82670 |
|
370 |
340 |
$9K |
| 82550 |
|
1,591 |
1,286 |
$9K |
| 86431 |
|
1,868 |
1,143 |
$9K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
55 |
53 |
$8K |
| 82150 |
|
1,276 |
1,176 |
$8K |
| J2930 |
Injection, methylprednisolone sodium succinate, up to 125 mg |
697 |
628 |
$8K |
| 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 |
110 |
85 |
$8K |
| 82746 |
|
676 |
632 |
$8K |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
3,051 |
2,593 |
$8K |
| 85652 |
|
3,066 |
2,587 |
$7K |
| 84270 |
|
448 |
418 |
$7K |
| J3370 |
Injection, vancomycin hcl, 500 mg |
882 |
502 |
$7K |
| 84156 |
|
2,533 |
1,607 |
$7K |
| J2704 |
Injection, propofol, 10 mg |
1,338 |
1,139 |
$7K |
| 74019 |
|
104 |
100 |
$7K |
| 76642 |
|
78 |
74 |
$6K |
| 45385 |
Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) |
13 |
12 |
$6K |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
600 |
539 |
$6K |
| 73721 |
Magnetic resonance imaging, any joint of lower extremity; without contrast material |
17 |
13 |
$6K |
| 99291 |
Critical care, evaluation and management of the critically ill patient, first 30-74 minutes |
15 |
13 |
$6K |
| 71101 |
|
81 |
61 |
$6K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
83 |
54 |
$6K |
| J1650 |
Injection, enoxaparin sodium, 10 mg |
556 |
336 |
$6K |
| 84402 |
|
290 |
272 |
$5K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
30 |
25 |
$5K |
| 86787 |
|
469 |
422 |
$5K |
| 86901 |
|
1,967 |
1,698 |
$5K |
| J2360 |
Injection, orphenadrine citrate, up to 60 mg |
497 |
449 |
$5K |
| 86900 |
|
1,913 |
1,693 |
$5K |
| 80348 |
|
241 |
191 |
$5K |
| J0136 |
Injection, acetaminophen (b braun), not therapeutically equivalent to j0131, 10 mg |
769 |
613 |
$5K |
| 77066 |
Tomosynthesis, mammo |
17 |
14 |
$4K |
| 87420 |
|
330 |
304 |
$4K |
| 84100 |
|
1,072 |
897 |
$4K |
| J2550 |
Injection, promethazine hcl, up to 50 mg |
673 |
561 |
$4K |
| 97530 |
Therapeutic activities, direct patient contact, each 15 minutes |
232 |
74 |
$4K |
| J0665 |
Injection, bupivicaine, not otherwise specified, 0.5 mg |
520 |
420 |
$4K |
| 73564 |
|
45 |
39 |
$4K |
| 86703 |
|
228 |
219 |
$4K |
| 84436 |
|
684 |
648 |
$4K |
| M0245 |
Intravenous infusion, bamlanivimab and etesevimab, includes infusion and post administration monitoring |
25 |
24 |
$3K |
| J0558 |
Injection, penicillin g benzathine and penicillin g procaine, 100,000 units |
32 |
29 |
$3K |
| M0239 |
Intravenous infusion, bamlanivimab-xxxx, includes infusion and post administration monitoring |
52 |
49 |
$3K |
| 94760 |
|
241 |
143 |
$3K |
| 85018 |
|
1,144 |
1,042 |
$3K |
| 76000 |
|
70 |
40 |
$3K |
| 83970 |
|
106 |
81 |
$3K |
| 36416 |
|
647 |
617 |
$3K |
| 82248 |
|
509 |
430 |
$3K |
| 99281 |
Emergency department visit for the evaluation and management, self-limited or minor |
43 |
40 |
$2K |
| 80076 |
|
351 |
318 |
$2K |
| 80179 |
|
155 |
145 |
$2K |
| J1040 |
Injection, methylprednisolone acetate, 80 mg |
128 |
114 |
$2K |
| J7040 |
Infusion, normal saline solution, sterile (500 ml = 1 unit) |
460 |
344 |
$2K |
| 82553 |
|
203 |
153 |
$2K |
| J1200 |
Injection, diphenhydramine hcl, up to 50 mg |
332 |
281 |
$2K |
| 12002 |
|
13 |
12 |
$2K |
| 86762 |
|
267 |
246 |
$2K |
| 83525 |
|
148 |
141 |
$2K |
| 73140 |
|
30 |
26 |
$1K |
| J2920 |
Injection, methylprednisolone sodium succinate, up to 40 mg |
119 |
85 |
$1K |
| 85007 |
|
499 |
432 |
$1K |
| 81003 |
|
906 |
756 |
$1K |
| 82950 |
|
276 |
271 |
$1K |
| 51702 |
|
43 |
38 |
$1K |
| 86757 |
|
81 |
53 |
$1K |
| 81511 |
|
14 |
14 |
$1K |
| 0031A |
|
64 |
64 |
$1K |
| 99490 |
Ccm add 20min |
472 |
466 |
$1K |
| 80143 |
|
61 |
56 |
$970.04 |
| 84144 |
|
25 |
25 |
$941.58 |
| A9575 |
Injection, gadoterate meglumine, 0.1 ml |
15 |
15 |
$935.94 |
| 87801 |
Infectious agent detection by nucleic acid; amplified probe, multiple organisms |
13 |
13 |
$931.88 |
| 87205 |
|
286 |
247 |
$900.60 |
| 73521 |
|
23 |
12 |
$894.95 |
| J2765 |
Injection, metoclopramide hcl, up to 10 mg |
127 |
108 |
$841.54 |
| C9113 |
Injection, pantoprazole sodium, per vial |
94 |
75 |
$837.64 |
| 29125 |
|
12 |
12 |
$832.80 |
| 86430 |
|
157 |
151 |
$808.18 |
| J2543 |
Injection, piperacillin sodium/tazobactam sodium, 1 gram/0.125 grams (1.125 grams) |
81 |
43 |
$777.60 |
| 86618 |
|
41 |
39 |
$694.42 |
| 97033 |
|
41 |
12 |
$662.56 |
| J2919 |
Injection, methylprednisolone sodium succinate, 5 mg |
81 |
60 |
$658.39 |
| 86003 |
|
56 |
28 |
$647.75 |
| 77080 |
|
14 |
13 |
$622.45 |
| 83615 |
|
62 |
51 |
$595.55 |
| 97602 |
|
19 |
13 |
$486.20 |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
24 |
14 |
$451.08 |
| 77062 |
|
14 |
14 |
$410.70 |
| 87476 |
|
12 |
12 |
$409.96 |
| 82140 |
|
25 |
24 |
$393.75 |
| 82247 |
|
53 |
40 |
$311.21 |
| J2003 |
Injection, lidocaine hydrochloride, 1 mg |
140 |
123 |
$311.08 |
| 81002 |
|
126 |
54 |
$293.23 |
| J1920 |
Injection, labetalol hydrochloride, 5 mg |
12 |
12 |
$277.98 |
| J3475 |
Injection, magnesium sulfate, per 500 mg |
23 |
18 |
$231.62 |
| 82105 |
|
12 |
12 |
$218.30 |
| 84480 |
|
15 |
15 |
$196.53 |
| J7070 |
Infusion, d5w, 1000 cc |
38 |
31 |
$194.53 |
| J0280 |
Injection, aminophyllin, up to 250 mg |
14 |
13 |
$191.40 |
| J0706 |
Injection, caffeine citrate, 5 mg |
21 |
19 |
$172.70 |
| 86308 |
|
26 |
25 |
$160.60 |
| 80177 |
|
16 |
14 |
$159.00 |
| J0780 |
Injection, prochlorperazine, up to 10 mg |
12 |
12 |
$147.32 |
| 82009 |
|
29 |
27 |
$147.18 |
| J0456 |
Injection, azithromycin, 500 mg |
19 |
13 |
$134.31 |
| J2175 |
Injection, meperidine hydrochloride, per 100 mg |
32 |
21 |
$129.19 |
| J1171 |
Injection, hydromorphone, 0.1 mg |
15 |
14 |
$128.30 |
| J3480 |
Injection, potassium chloride, per 2 meq |
16 |
12 |
$118.50 |
| J0330 |
Injection, succinylcholine chloride, up to 20 mg |
18 |
13 |
$107.08 |
| J2371 |
Injection, phenylephrine hydrochloride, 20 micrograms |
17 |
15 |
$106.22 |
| J2060 |
Injection, lorazepam, 2 mg |
32 |
28 |
$89.58 |
| 82977 |
|
14 |
13 |
$70.92 |
| 85014 |
|
31 |
29 |
$59.94 |
| 86008 |
|
19 |
17 |
$53.79 |
| 84460 |
|
14 |
13 |
$42.40 |
| 84450 |
|
14 |
13 |
$41.44 |
| 85045 |
|
31 |
12 |
$23.94 |
| J3420 |
Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg |
19 |
16 |
$18.27 |