| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
22,495 |
20,856 |
$5.67M |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
16,261 |
14,491 |
$5.08M |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
11,614 |
10,391 |
$3.81M |
| G0378 |
Hospital observation service, per hour |
10,454 |
4,104 |
$2.34M |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
7,680 |
7,334 |
$1.40M |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
4,346 |
4,053 |
$1.38M |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
40,562 |
9,760 |
$1.11M |
| 11042 |
Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm |
4,246 |
1,705 |
$1.02M |
| 93306 |
Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete |
2,117 |
1,932 |
$772K |
| OP710 |
|
5,224 |
4,211 |
$714K |
| 96361 |
Intravenous infusion, hydration; each additional hour |
8,608 |
7,651 |
$622K |
| 97140 |
Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) |
22,137 |
6,217 |
$607K |
| 70450 |
Computed tomography, head or brain; without contrast material |
5,802 |
5,027 |
$585K |
| OP270 |
|
11,423 |
7,126 |
$565K |
| 0202U |
Oncology (prostate), multianalyte, gene expression profiling |
6,656 |
6,084 |
$552K |
| OP250 |
|
77,293 |
26,034 |
$497K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
2,015 |
1,853 |
$493K |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
7,308 |
4,530 |
$481K |
| 96375 |
Therapeutic injection; each additional sequential IV push |
9,860 |
7,731 |
$432K |
| C1713 |
Anchor/screw for opposing bone-to-bone or soft tissue-to-bone (implantable) |
374 |
323 |
$397K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
17,194 |
14,706 |
$340K |
| OP272 |
|
9,415 |
5,880 |
$303K |
| 76830 |
Ultrasound, transvaginal |
1,755 |
1,693 |
$250K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
31,157 |
23,963 |
$236K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
2,470 |
2,410 |
$216K |
| 96366 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour |
2,103 |
1,127 |
$214K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
8,032 |
7,764 |
$207K |
| 80053 |
Comprehensive metabolic panel |
25,713 |
20,510 |
$206K |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
10,918 |
9,627 |
$202K |
| 96360 |
Intravenous infusion, hydration; initial, 31 minutes to 1 hour |
3,624 |
3,336 |
$202K |
| 96376 |
|
5,304 |
2,747 |
$198K |
| 93017 |
|
662 |
603 |
$197K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
7,829 |
6,401 |
$195K |
| 71045 |
Radiologic examination, chest; single view |
9,426 |
8,229 |
$184K |
| 87633 |
Infectious agent detection by nucleic acid, respiratory virus, 12-25 targets |
1,608 |
1,576 |
$175K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
6,907 |
4,195 |
$159K |
| 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 |
3,406 |
3,091 |
$149K |
| 71046 |
Radiologic examination, chest; 2 views |
5,239 |
4,993 |
$145K |
| 76700 |
Ultrasound, abdominal, real time with image documentation; complete |
1,473 |
1,430 |
$140K |
| 72125 |
Computed tomography, cervical spine; without contrast material |
1,506 |
1,262 |
$132K |
| 71275 |
Computed tomographic angiography, chest, with contrast material |
1,259 |
1,161 |
$118K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
4,830 |
4,059 |
$109K |
| 97161 |
|
2,590 |
2,468 |
$93K |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
1,646 |
1,466 |
$93K |
| 72148 |
Magnetic resonance imaging, lumbar spine; without contrast material |
178 |
158 |
$92K |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
3,708 |
3,327 |
$90K |
| 76641 |
|
704 |
573 |
$89K |
| 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 |
3,058 |
2,651 |
$84K |
| 92507 |
Treatment of speech, language, voice, communication, and/or auditory processing disorder |
1,447 |
486 |
$80K |
| 84484 |
|
10,371 |
8,433 |
$77K |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
2,429 |
2,368 |
$75K |
| 93970 |
|
441 |
395 |
$73K |
| 93971 |
|
668 |
604 |
$70K |
| 96413 |
Chemotherapy administration, intravenous infusion; up to 1 hour, single or initial substance |
385 |
197 |
$64K |
| 97162 |
|
2,256 |
1,963 |
$62K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
8,644 |
6,678 |
$59K |
| 36415 |
Collection of venous blood by venipuncture |
28,821 |
24,441 |
$58K |
| 72100 |
|
1,214 |
1,161 |
$51K |
| 96367 |
|
1,055 |
744 |
$50K |
| 71250 |
|
379 |
322 |
$49K |
| 83880 |
|
3,550 |
3,099 |
$47K |
| 73630 |
|
1,359 |
1,258 |
$45K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
273 |
254 |
$44K |
| 73560 |
|
1,794 |
1,670 |
$43K |
| 43239 |
Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple |
54 |
49 |
$42K |
| 73610 |
|
1,263 |
1,191 |
$41K |
| 73721 |
Magnetic resonance imaging, any joint of lower extremity; without contrast material |
83 |
79 |
$41K |
| 97112 |
Therapeutic procedure, each 15 minutes; neuromuscular reeducation of movement, balance, coordination |
2,027 |
753 |
$40K |
| 85610 |
|
12,931 |
11,300 |
$40K |
| 85730 |
|
11,666 |
10,421 |
$40K |
| 70551 |
Magnetic resonance imaging, brain; without contrast material |
123 |
111 |
$40K |
| 0241U |
Neonatal screening for hereditary disorders, genomic sequence analysis panel |
980 |
849 |
$39K |
| 82962 |
|
10,504 |
5,769 |
$39K |
| 81001 |
|
14,051 |
12,505 |
$39K |
| 83735 |
|
8,257 |
6,365 |
$39K |
| 76642 |
|
505 |
472 |
$38K |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
1,231 |
738 |
$38K |
| 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 |
2,930 |
2,643 |
$37K |
| 73130 |
|
1,096 |
1,034 |
$37K |
| 99291 |
Critical care, evaluation and management of the critically ill patient, first 30-74 minutes |
186 |
166 |
$36K |
| 97530 |
Therapeutic activities, direct patient contact, each 15 minutes |
2,140 |
851 |
$36K |
| 73030 |
|
1,137 |
1,005 |
$36K |
| 76536 |
|
361 |
345 |
$35K |
| 83690 |
|
8,430 |
7,412 |
$35K |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
655 |
622 |
$33K |
| 77080 |
|
360 |
351 |
$32K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
354 |
335 |
$30K |
| 77065 |
Tomosynthesis, mammo |
418 |
367 |
$29K |
| 84443 |
Thyroid stimulating hormone (TSH) |
2,954 |
2,610 |
$27K |
| 86850 |
|
2,909 |
2,639 |
$27K |
| 87486 |
|
1,597 |
1,572 |
$26K |
| 83605 |
|
3,399 |
2,882 |
$26K |
| 71260 |
Computed tomography, thorax, diagnostic; with contrast material |
162 |
146 |
$26K |
| 87040 |
|
2,718 |
2,404 |
$26K |
| G0279 |
Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066) |
973 |
864 |
$26K |
| 73110 |
|
626 |
585 |
$22K |
| 64450 |
|
28 |
27 |
$22K |
| J0131 |
Injection, acetaminophen, not otherwise specified,10 mg |
2,130 |
1,951 |
$21K |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
3,602 |
3,275 |
$21K |
| 72131 |
|
219 |
187 |
$20K |
| 86900 |
|
3,257 |
2,778 |
$20K |
| 87581 |
|
1,600 |
1,575 |
$20K |
| 81025 |
|
8,326 |
7,725 |
$19K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
1,686 |
1,484 |
$19K |
| 87631 |
|
536 |
529 |
$19K |
| 74018 |
|
699 |
669 |
$19K |
| 87798 |
Infectious agent detection by nucleic acid; not otherwise specified, amplified probe, each organism |
1,629 |
1,603 |
$19K |
| 87651 |
Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe |
1,756 |
1,693 |
$17K |
| 76819 |
Fetal biophysical profile; without non-stress testing |
177 |
109 |
$17K |
| 86901 |
|
3,273 |
2,785 |
$16K |
| 82150 |
|
3,017 |
2,799 |
$16K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
202 |
175 |
$16K |
| 82550 |
|
4,061 |
3,376 |
$16K |
| C9399 |
Unclassified drugs or biologicals |
266 |
230 |
$16K |
| 70553 |
Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences |
31 |
26 |
$15K |
| 0002A |
|
491 |
489 |
$15K |
| OP258 |
|
12,834 |
6,104 |
$15K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
4,999 |
4,735 |
$13K |
| 97116 |
|
1,301 |
545 |
$13K |
| 84702 |
|
1,640 |
1,453 |
$13K |
| 85027 |
|
3,194 |
2,431 |
$12K |
| 0001A |
|
472 |
471 |
$12K |
| OP370 |
|
278 |
221 |
$12K |
| 90715 |
|
666 |
646 |
$12K |
| 84145 |
|
1,848 |
1,556 |
$12K |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
531 |
481 |
$11K |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
7,084 |
5,558 |
$11K |
| 77066 |
Tomosynthesis, mammo |
96 |
87 |
$10K |
| 99241 |
|
426 |
383 |
$10K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
592 |
569 |
$10K |
| J3490 |
Unclassified drugs |
12,167 |
5,976 |
$10K |
| 87077 |
|
1,682 |
1,527 |
$9K |
| 84100 |
|
2,652 |
2,014 |
$9K |
| 87186 |
|
1,457 |
1,315 |
$8K |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
8,318 |
6,356 |
$8K |
| J2704 |
Injection, propofol, 10 mg |
3,678 |
3,394 |
$8K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
321 |
315 |
$8K |
| 76770 |
|
74 |
71 |
$8K |
| 80061 |
Lipid panel |
1,343 |
1,193 |
$8K |
| 85378 |
|
2,032 |
1,901 |
$8K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
1,554 |
1,520 |
$8K |
| 97535 |
Self-care/home management training, each 15 minutes |
491 |
321 |
$8K |
| J0690 |
Injection, cefazolin sodium, 500 mg |
2,381 |
1,889 |
$8K |
| 73502 |
|
194 |
172 |
$7K |
| 81003 |
|
1,844 |
1,765 |
$6K |
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
860 |
612 |
$6K |
| 12001 |
|
170 |
159 |
$6K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
131 |
131 |
$6K |
| J7050 |
Infusion, normal saline solution, 250 cc |
1,111 |
780 |
$6K |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
1,802 |
1,063 |
$6K |
| 11045 |
|
20 |
12 |
$5K |
| 70486 |
|
48 |
42 |
$5K |
| 0012A |
|
172 |
172 |
$5K |
| J7030 |
Infusion, normal saline solution , 1000 cc |
9,505 |
7,403 |
$5K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
1,215 |
1,054 |
$4K |
| 0011A |
|
168 |
168 |
$4K |
| 0004A |
|
114 |
114 |
$4K |
| 87070 |
|
630 |
584 |
$4K |
| J1170 |
Injection, hydromorphone, up to 4 mg |
3,093 |
1,837 |
$4K |
| 94760 |
|
226 |
158 |
$4K |
| A9575 |
Injection, gadoterate meglumine, 0.1 ml |
850 |
764 |
$4K |
| 72040 |
|
98 |
95 |
$3K |
| 76811 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, detailed |
14 |
12 |
$3K |
| 86140 |
|
2,004 |
1,682 |
$3K |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
4,775 |
3,916 |
$3K |
| G1004 |
Clinical decision support mechanism national decision support company, as defined by the medicare appropriate use criteria program |
12,295 |
8,519 |
$3K |
| 29125 |
|
99 |
96 |
$3K |
| 93226 |
|
16 |
14 |
$3K |
| 73590 |
|
71 |
64 |
$3K |
| 85652 |
|
1,954 |
1,674 |
$3K |
| J7512 |
Prednisone, immediate release or delayed release, oral, 1 mg |
873 |
641 |
$3K |
| 93976 |
|
13 |
13 |
$3K |
| 73080 |
|
75 |
66 |
$3K |
| 82077 |
|
628 |
508 |
$3K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
128 |
118 |
$2K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
1,393 |
1,352 |
$2K |
| 93880 |
|
12 |
12 |
$2K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
128 |
118 |
$2K |
| 90686 |
|
1,039 |
1,030 |
$2K |
| 93225 |
|
16 |
14 |
$2K |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
3,466 |
2,867 |
$2K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
68 |
51 |
$2K |
| 01480 |
|
15 |
13 |
$2K |
| C1769 |
Guide wire |
110 |
89 |
$2K |
| 99215 |
Prolong outpt/office vis |
34 |
30 |
$2K |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
2,606 |
2,242 |
$2K |
| 88304 |
|
130 |
115 |
$2K |
| C9290 |
Injection, bupivacaine liposome, 1 mg |
19 |
13 |
$2K |
| J2270 |
Injection, morphine sulfate, up to 10 mg |
1,664 |
1,054 |
$2K |
| 97166 |
|
75 |
67 |
$2K |
| 84703 |
|
600 |
530 |
$1K |
| 90670 |
|
251 |
247 |
$1K |
| U0002 |
2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc |
128 |
122 |
$1K |
| 82607 |
|
249 |
201 |
$1K |
| 87205 |
|
583 |
525 |
$1K |
| 80143 |
|
295 |
243 |
$1K |
| 76813 |
|
13 |
13 |
$1K |
| 76870 |
|
13 |
13 |
$1K |
| G8979 |
Mobility: walking & moving around functional limitation, projected goal status, at therapy episode outset, at reporting intervals, and at discharge or to end reporting |
53 |
52 |
$1K |
| G8978 |
Mobility: walking & moving around functional limitation, current status, at therapy episode outset and at reporting intervals |
42 |
41 |
$1K |
| 90698 |
|
561 |
542 |
$1K |
| J1815 |
Injection, insulin, per 5 units |
1,265 |
399 |
$1K |
| 97165 |
|
27 |
26 |
$1K |
| 90674 |
|
46 |
45 |
$1K |
| 80179 |
|
246 |
203 |
$1K |
| 72070 |
|
25 |
24 |
$964.95 |
| 82746 |
|
224 |
174 |
$952.13 |
| 90651 |
|
28 |
28 |
$935.57 |
| 97750 |
|
229 |
200 |
$918.84 |
| 0064A |
|
28 |
28 |
$897.68 |
| 80320 |
|
43 |
36 |
$844.70 |
| J0136 |
Injection, acetaminophen (b braun), not therapeutically equivalent to j0131, 10 mg |
517 |
452 |
$834.91 |
| 82728 |
|
118 |
101 |
$821.87 |
| J1650 |
Injection, enoxaparin sodium, 10 mg |
861 |
353 |
$814.32 |
| C9113 |
Injection, pantoprazole sodium, per vial |
676 |
447 |
$808.47 |
| J2795 |
Injection, ropivacaine hydrochloride, 1 mg |
340 |
287 |
$781.11 |
| J0665 |
Injection, bupivicaine, not otherwise specified, 0.5 mg |
450 |
389 |
$759.52 |
| 82553 |
|
76 |
71 |
$703.89 |
| 90734 |
|
55 |
55 |
$703.74 |
| 90791 |
Psychiatric diagnostic evaluation |
12 |
12 |
$671.10 |
| 29515 |
|
29 |
29 |
$658.58 |
| 84466 |
|
173 |
138 |
$611.72 |
| 90714 |
|
93 |
84 |
$566.49 |
| J2930 |
Injection, methylprednisolone sodium succinate, up to 125 mg |
222 |
180 |
$527.57 |
| 87075 |
|
75 |
64 |
$463.59 |
| 96368 |
|
17 |
12 |
$462.65 |
| 92523 |
|
14 |
12 |
$460.00 |
| 99201 |
|
13 |
13 |
$446.32 |
| J1200 |
Injection, diphenhydramine hcl, up to 50 mg |
989 |
702 |
$430.62 |
| 0003A |
|
12 |
12 |
$408.00 |
| A9585 |
Injection, gadobutrol, 0.1 ml |
40 |
38 |
$407.41 |
| J0137 |
Injection, acetaminophen (hikma), not therapeutically equivalent to j0131, 10 mg |
276 |
241 |
$395.72 |
| 0124A |
|
14 |
13 |
$377.62 |
| 83540 |
|
174 |
139 |
$364.54 |
| OP255 |
|
102 |
54 |
$307.33 |
| J3370 |
Injection, vancomycin hcl, 500 mg |
30 |
25 |
$286.19 |
| J2765 |
Injection, metoclopramide hcl, up to 10 mg |
706 |
606 |
$283.45 |
| 84550 |
|
113 |
95 |
$272.45 |
| J2060 |
Injection, lorazepam, 2 mg |
386 |
266 |
$243.48 |
| OP279 |
|
40 |
38 |
$243.36 |
| 87076 |
|
39 |
39 |
$230.10 |
| 94664 |
|
38 |
38 |
$230.01 |
| Q0162 |
Ondansetron 1 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 |
847 |
779 |
$212.51 |
| 00731 |
|
12 |
12 |
$204.24 |
| 82803 |
|
26 |
25 |
$194.11 |
| J0134 |
Injection, acetaminophen (fresenius kabi), not therapeutically equivalent to j0131, 10 mg |
92 |
88 |
$173.19 |
| 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 |
216 |
176 |
$164.16 |
| 87430 |
|
47 |
46 |
$154.86 |
| 90682 |
|
13 |
12 |
$133.52 |
| 83615 |
|
80 |
74 |
$128.98 |
| 90681 |
|
86 |
85 |
$128.45 |
| 90744 |
|
110 |
110 |
$124.84 |
| 86308 |
|
56 |
52 |
$118.42 |
| J0295 |
Injection, ampicillin sodium/sulbactam sodium, per 1.5 gm |
57 |
25 |
$111.87 |
| J1642 |
Injection, heparin sodium, (heparin lock flush), per 10 units |
117 |
56 |
$107.45 |
| 87081 |
|
35 |
34 |
$95.34 |
| 90671 |
|
233 |
222 |
$87.35 |
| 80076 |
|
30 |
30 |
$81.82 |
| 90474 |
|
60 |
60 |
$76.34 |
| J1171 |
Injection, hydromorphone, 0.1 mg |
51 |
38 |
$64.02 |
| 85379 |
|
33 |
32 |
$54.50 |
| 90656 |
|
91 |
90 |
$47.99 |
| L4350 |
Ankle control orthosis, stirrup style, rigid, includes any type interface (e.g., pneumatic, gel), prefabricated, off-the-shelf |
29 |
25 |
$47.76 |
| 84439 |
|
14 |
13 |
$37.47 |
| J2919 |
Injection, methylprednisolone sodium succinate, 5 mg |
43 |
28 |
$33.93 |
| J2003 |
Injection, lidocaine hydrochloride, 1 mg |
39 |
31 |
$29.68 |
| J2371 |
Injection, phenylephrine hydrochloride, 20 micrograms |
52 |
39 |
$26.72 |
| J0736 |
Injection, clindamycin phosphate, 300 mg |
14 |
13 |
$18.31 |
| J3475 |
Injection, magnesium sulfate, per 500 mg |
15 |
12 |
$17.45 |
| S0164 |
Injection, pantoprazole sodium, 40 mg |
15 |
13 |
$13.53 |
| 90633 |
|
27 |
27 |
$10.00 |
| J2470 |
Injection, pantoprazole sodium, 40 mg |
21 |
13 |
$5.77 |
| J7510 |
Prednisolone oral, per 5 mg |
53 |
52 |
$5.00 |
| J1630 |
Injection, haloperidol, up to 5 mg |
16 |
12 |
$4.00 |