| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
24,438 |
23,133 |
$2.98M |
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
41,381 |
37,991 |
$2.53M |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
8,431 |
7,961 |
$2.42M |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
12,161 |
11,597 |
$2.28M |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
13,482 |
11,963 |
$1.28M |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
11,393 |
11,085 |
$812K |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
4,540 |
4,401 |
$667K |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
18,808 |
5,792 |
$375K |
| 96375 |
Therapeutic injection; each additional sequential IV push |
11,769 |
9,713 |
$363K |
| 96361 |
Intravenous infusion, hydration; each additional hour |
10,636 |
9,049 |
$333K |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
4,045 |
3,197 |
$327K |
| 71045 |
Radiologic examination, chest; single view |
8,296 |
7,838 |
$318K |
| 59025 |
Fetal non-stress test |
3,349 |
1,713 |
$285K |
| 70450 |
Computed tomography, head or brain; without contrast material |
3,312 |
3,230 |
$280K |
| 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 |
5,968 |
5,795 |
$278K |
| 96360 |
Intravenous infusion, hydration; initial, 31 minutes to 1 hour |
2,583 |
2,387 |
$249K |
| 42820 |
Tonsillectomy and adenoidectomy; younger than age 12 |
98 |
98 |
$246K |
| 93306 |
Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete |
1,102 |
1,101 |
$232K |
| 71046 |
Radiologic examination, chest; 2 views |
5,792 |
5,636 |
$216K |
| G0378 |
Hospital observation service, per hour |
838 |
803 |
$207K |
| 97530 |
Therapeutic activities, direct patient contact, each 15 minutes |
7,965 |
3,309 |
$196K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
1,702 |
1,672 |
$186K |
| 87636 |
Infectious agent detection by nucleic acid; SARS-CoV-2 and influenza virus types A and B |
2,413 |
2,345 |
$180K |
| J9271 |
Injection, pembrolizumab, 1 mg |
45 |
32 |
$161K |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
2,741 |
2,700 |
$156K |
| 70553 |
Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences |
811 |
804 |
$151K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
3,157 |
3,134 |
$144K |
| 76830 |
Ultrasound, transvaginal |
2,427 |
2,385 |
$141K |
| 92507 |
Treatment of speech, language, voice, communication, and/or auditory processing disorder |
3,610 |
1,207 |
$141K |
| 96413 |
Chemotherapy administration, intravenous infusion; up to 1 hour, single or initial substance |
1,191 |
825 |
$135K |
| 80061 |
Lipid panel |
7,688 |
7,630 |
$133K |
| 97140 |
Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) |
9,285 |
3,390 |
$133K |
| 71260 |
Computed tomography, thorax, diagnostic; with contrast material |
1,277 |
1,258 |
$126K |
| 76801 |
|
2,054 |
1,825 |
$121K |
| 97112 |
Therapeutic procedure, each 15 minutes; neuromuscular reeducation of movement, balance, coordination |
6,151 |
2,705 |
$112K |
| 97161 |
|
2,111 |
2,087 |
$104K |
| 43239 |
Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple |
331 |
328 |
$93K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
5,191 |
5,121 |
$86K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
5,186 |
5,116 |
$86K |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
8,572 |
7,585 |
$79K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
1,321 |
1,318 |
$78K |
| 80053 |
Comprehensive metabolic panel |
33,444 |
29,890 |
$74K |
| 87637 |
Infectious agent detection by nucleic acid; SARS-CoV-2, influenza, and RSV |
917 |
900 |
$74K |
| 84443 |
Thyroid stimulating hormone (TSH) |
12,491 |
12,066 |
$73K |
| 86900 |
|
2,993 |
2,835 |
$67K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
44,263 |
37,907 |
$66K |
| 36415 |
Collection of venous blood by venipuncture |
58,924 |
46,652 |
$60K |
| 96366 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour |
1,870 |
1,334 |
$55K |
| U0002 |
2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc |
2,444 |
2,347 |
$52K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
1,014 |
938 |
$50K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
13,500 |
11,527 |
$46K |
| 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 |
3,032 |
2,942 |
$44K |
| 92526 |
|
996 |
395 |
$43K |
| 71275 |
Computed tomographic angiography, chest, with contrast material |
503 |
488 |
$40K |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
3,210 |
3,196 |
$39K |
| 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 |
2,542 |
2,534 |
$38K |
| 78452 |
Myocardial perfusion imaging, tomographic (SPECT); multiple studies at rest and/or stress |
121 |
119 |
$38K |
| 97165 |
|
822 |
814 |
$38K |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
3,561 |
3,488 |
$34K |
| 87624 |
Infectious agent detection by nucleic acid; human papillomavirus (HPV), high-risk types |
1,722 |
1,717 |
$34K |
| 76642 |
|
873 |
870 |
$33K |
| 73564 |
|
1,782 |
1,763 |
$32K |
| 93971 |
|
585 |
567 |
$32K |
| 74018 |
|
1,713 |
1,628 |
$31K |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
2,010 |
1,972 |
$29K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
8,849 |
7,985 |
$29K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
6,063 |
6,000 |
$28K |
| 69436 |
Tympanostomy (requiring insertion of ventilating tube), general anesthesia |
54 |
54 |
$28K |
| 94726 |
|
477 |
476 |
$27K |
| 94060 |
|
191 |
190 |
$26K |
| 86780 |
|
3,307 |
2,483 |
$24K |
| 82728 |
|
3,437 |
3,339 |
$23K |
| 72148 |
Magnetic resonance imaging, lumbar spine; without contrast material |
245 |
242 |
$22K |
| 93017 |
|
609 |
601 |
$22K |
| 87651 |
Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe |
2,367 |
2,309 |
$22K |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
8,349 |
7,922 |
$21K |
| 64721 |
|
26 |
26 |
$19K |
| 71271 |
|
372 |
372 |
$19K |
| 73721 |
Magnetic resonance imaging, any joint of lower extremity; without contrast material |
155 |
155 |
$19K |
| G0472 |
Hepatitis c antibody screening, for individual at high risk and other covered indication(s) |
715 |
710 |
$19K |
| 76536 |
|
384 |
383 |
$18K |
| 73630 |
|
2,327 |
2,276 |
$18K |
| 73030 |
|
1,560 |
1,549 |
$17K |
| C9803 |
Hospital outpatient clinic visit specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source |
5,936 |
5,786 |
$16K |
| 85027 |
|
5,954 |
5,713 |
$16K |
| 81025 |
|
13,707 |
12,765 |
$15K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
12,203 |
11,030 |
$15K |
| 73610 |
|
2,089 |
2,032 |
$15K |
| 72110 |
|
625 |
619 |
$14K |
| 84702 |
|
2,757 |
1,980 |
$13K |
| 73130 |
|
1,925 |
1,900 |
$13K |
| 82607 |
|
1,817 |
1,799 |
$13K |
| 87641 |
|
690 |
683 |
$12K |
| 95810 |
Polysomnography; sleep staging with 4 or more additional parameters |
24 |
24 |
$12K |
| 87340 |
|
2,406 |
2,395 |
$12K |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
1,086 |
1,086 |
$12K |
| 73110 |
|
1,402 |
1,364 |
$12K |
| 45380 |
Colonoscopy, flexible; with biopsy, single or multiple |
28 |
27 |
$11K |
| 87640 |
|
606 |
601 |
$11K |
| 86762 |
|
1,491 |
1,490 |
$11K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
374 |
370 |
$11K |
| 72125 |
Computed tomography, cervical spine; without contrast material |
1,171 |
1,147 |
$11K |
| 84439 |
|
2,468 |
2,354 |
$10K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
1,113 |
1,005 |
$10K |
| 87653 |
|
559 |
558 |
$9K |
| 77065 |
Tomosynthesis, mammo |
220 |
215 |
$9K |
| 87077 |
|
3,926 |
3,429 |
$8K |
| 81001 |
|
23,277 |
21,173 |
$8K |
| 97162 |
|
206 |
205 |
$8K |
| 87186 |
|
3,523 |
3,417 |
$8K |
| 86803 |
|
1,121 |
1,113 |
$8K |
| 86850 |
|
2,982 |
2,855 |
$8K |
| 83970 |
|
369 |
361 |
$8K |
| 87150 |
|
592 |
580 |
$8K |
| 97116 |
|
784 |
437 |
$8K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
241 |
210 |
$7K |
| 87480 |
|
852 |
826 |
$7K |
| 82570 |
|
2,728 |
2,578 |
$7K |
| 87660 |
|
847 |
821 |
$7K |
| 87510 |
|
842 |
816 |
$6K |
| 83735 |
|
7,618 |
6,664 |
$6K |
| G0103 |
Prostate cancer screening; prostate specific antigen test (psa) |
605 |
600 |
$6K |
| 86787 |
|
921 |
906 |
$6K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
7,244 |
4,413 |
$6K |
| 83550 |
|
1,415 |
1,382 |
$6K |
| 83540 |
|
1,808 |
1,769 |
$6K |
| 85610 |
|
7,870 |
6,487 |
$6K |
| 72100 |
|
209 |
209 |
$6K |
| 73502 |
|
531 |
528 |
$5K |
| C9399 |
Unclassified drugs or biologicals |
134 |
132 |
$5K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
5,169 |
5,063 |
$5K |
| 93225 |
|
81 |
80 |
$5K |
| 45385 |
Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) |
12 |
12 |
$5K |
| 76775 |
|
167 |
167 |
$5K |
| 82043 |
|
1,549 |
1,535 |
$5K |
| 73221 |
|
37 |
37 |
$4K |
| 87081 |
|
3,825 |
3,734 |
$4K |
| 87210 |
|
2,092 |
2,056 |
$4K |
| 82950 |
|
1,646 |
1,644 |
$4K |
| 83880 |
|
1,612 |
1,505 |
$4K |
| 95806 |
|
51 |
51 |
$4K |
| 71250 |
|
81 |
81 |
$4K |
| 77066 |
Tomosynthesis, mammo |
74 |
74 |
$4K |
| 87070 |
|
1,904 |
1,856 |
$4K |
| 82947 |
|
1,758 |
1,755 |
$4K |
| 80076 |
|
3,965 |
3,694 |
$4K |
| G0279 |
Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066) |
349 |
336 |
$3K |
| 36430 |
|
22 |
12 |
$3K |
| 86140 |
|
2,958 |
2,704 |
$3K |
| 81003 |
|
5,481 |
4,548 |
$3K |
| 87088 |
|
1,415 |
1,376 |
$3K |
| 85652 |
|
3,076 |
2,884 |
$3K |
| 74019 |
|
110 |
110 |
$3K |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
4,322 |
3,911 |
$3K |
| 99281 |
Emergency department visit for the evaluation and management, self-limited or minor |
64 |
64 |
$3K |
| 73140 |
|
340 |
334 |
$3K |
| 87507 |
|
15 |
15 |
$3K |
| 87502 |
Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets |
302 |
298 |
$2K |
| 74022 |
|
987 |
958 |
$2K |
| 83690 |
|
8,006 |
7,387 |
$2K |
| 85730 |
|
4,909 |
4,606 |
$2K |
| 97535 |
Self-care/home management training, each 15 minutes |
135 |
108 |
$2K |
| 87634 |
|
148 |
146 |
$2K |
| 87205 |
|
1,926 |
1,857 |
$2K |
| 73080 |
|
221 |
216 |
$2K |
| 96415 |
|
62 |
51 |
$2K |
| 94010 |
|
133 |
133 |
$1K |
| 72070 |
|
78 |
78 |
$1K |
| 70491 |
|
13 |
13 |
$1K |
| 84100 |
|
1,530 |
1,230 |
$1K |
| 71101 |
|
121 |
119 |
$1K |
| 84156 |
|
851 |
753 |
$1K |
| 80069 |
|
265 |
249 |
$1K |
| 82150 |
|
2,031 |
1,970 |
$1K |
| 81002 |
|
657 |
434 |
$1K |
| 73090 |
|
169 |
161 |
$977.16 |
| 86039 |
|
177 |
172 |
$975.77 |
| 88304 |
|
677 |
671 |
$964.90 |
| 84146 |
|
97 |
94 |
$926.72 |
| 88175 |
Cytopathology, cervical or vaginal, any reporting system; collected in preservative fluid, automated thin layer |
51 |
51 |
$916.07 |
| 82746 |
|
125 |
123 |
$878.24 |
| 82077 |
|
2,966 |
2,538 |
$859.68 |
| 86901 |
|
2,986 |
2,827 |
$801.43 |
| 86038 |
|
144 |
140 |
$801.38 |
| 83001 |
|
76 |
75 |
$780.32 |
| 82565 |
|
348 |
298 |
$752.21 |
| 76770 |
|
14 |
14 |
$741.52 |
| 96417 |
|
35 |
26 |
$638.88 |
| 36591 |
|
31 |
27 |
$625.83 |
| 85379 |
|
2,318 |
2,253 |
$614.70 |
| 72131 |
|
12 |
12 |
$593.09 |
| 72114 |
|
13 |
13 |
$562.26 |
| 73590 |
|
129 |
127 |
$492.75 |
| 87807 |
|
1,059 |
1,032 |
$459.65 |
| 85046 |
|
160 |
159 |
$455.51 |
| 76870 |
|
13 |
13 |
$453.88 |
| 12001 |
|
448 |
447 |
$443.19 |
| 84403 |
|
38 |
38 |
$365.49 |
| 87040 |
|
2,399 |
2,073 |
$320.07 |
| 84703 |
|
448 |
438 |
$316.95 |
| 84550 |
|
199 |
169 |
$297.33 |
| 84484 |
|
6,682 |
4,875 |
$268.88 |
| 82962 |
|
5,102 |
4,166 |
$259.56 |
| 82248 |
|
147 |
116 |
$233.78 |
| 87522 |
Neg quan hep c or qual rna |
14 |
13 |
$225.82 |
| 86431 |
|
80 |
79 |
$210.91 |
| 88342 |
|
16 |
14 |
$210.33 |
| 87661 |
Infectious agent detection by nucleic acid; Trichomonas vaginalis, amplified probe |
13 |
13 |
$206.87 |
| 82784 |
|
42 |
28 |
$203.07 |
| 83516 |
|
26 |
26 |
$191.04 |
| 83615 |
|
103 |
97 |
$169.33 |
| 80143 |
|
1,674 |
1,510 |
$147.82 |
| 80179 |
|
1,654 |
1,491 |
$135.54 |
| 84153 |
|
12 |
12 |
$111.82 |
| 90715 |
|
917 |
905 |
$111.65 |
| 83605 |
|
5,551 |
5,012 |
$96.24 |
| 82550 |
|
88 |
81 |
$88.68 |
| 93226 |
|
68 |
68 |
$64.79 |
| 87328 |
|
12 |
12 |
$50.58 |
| 82272 |
|
142 |
138 |
$49.21 |
| 87899 |
|
13 |
12 |
$45.14 |
| 87329 |
|
12 |
12 |
$43.86 |
| 87427 |
|
13 |
12 |
$36.73 |
| 86308 |
|
73 |
73 |
$31.94 |
| 87046 |
|
13 |
12 |
$28.23 |
| 87045 |
|
13 |
12 |
$28.09 |
| 85018 |
|
29 |
25 |
$20.88 |
| 84145 |
|
59 |
57 |
$17.93 |
| 88300 |
|
177 |
177 |
$13.93 |
| 85014 |
|
13 |
12 |
$12.48 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
11,853 |
11,001 |
$11.80 |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
13,220 |
11,663 |
$0.48 |
| J7030 |
Infusion, normal saline solution , 1000 cc |
14,595 |
13,111 |
$0.24 |
| J0780 |
Injection, prochlorperazine, up to 10 mg |
764 |
722 |
$0.24 |
| J2060 |
Injection, lorazepam, 2 mg |
1,735 |
1,522 |
$0.24 |
| J2919 |
Injection, methylprednisolone sodium succinate, 5 mg |
171 |
156 |
$0.00 |
| J2270 |
Injection, morphine sulfate, up to 10 mg |
3,165 |
2,802 |
$0.00 |
| J2930 |
Injection, methylprednisolone sodium succinate, up to 125 mg |
1,569 |
1,468 |
$0.00 |
| A9575 |
Injection, gadoterate meglumine, 0.1 ml |
1,105 |
1,092 |
$0.00 |
| J1200 |
Injection, diphenhydramine hcl, up to 50 mg |
3,826 |
3,528 |
$0.00 |
| J0171 |
Injection, adrenalin, epinephrine, 0.1 mg |
313 |
281 |
$0.00 |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
5,791 |
5,602 |
$0.00 |
| J1644 |
Injection, heparin sodium, per 1000 units |
175 |
149 |
$0.00 |
| J3475 |
Injection, magnesium sulfate, per 500 mg |
352 |
305 |
$0.00 |
| G1004 |
Clinical decision support mechanism national decision support company, as defined by the medicare appropriate use criteria program |
1,713 |
1,660 |
$0.00 |
| 94729 |
|
618 |
617 |
$0.00 |
| 84112 |
|
120 |
108 |
$0.00 |
| S0028 |
Injection, famotidine, 20 mg |
28 |
26 |
$0.00 |
| C9113 |
Injection, pantoprazole sodium, per vial |
85 |
68 |
$0.00 |
| J7040 |
Infusion, normal saline solution, sterile (500 ml = 1 unit) |
158 |
136 |
$0.00 |
| C1713 |
Anchor/screw for opposing bone-to-bone or soft tissue-to-bone (implantable) |
130 |
130 |
$0.00 |
| J0665 |
Injection, bupivicaine, not otherwise specified, 0.5 mg |
202 |
201 |
$0.00 |
| J7120 |
Ringers lactate infusion, up to 1000 cc |
275 |
261 |
$0.00 |
| 76942 |
|
15 |
15 |
$0.00 |
| J1596 |
Injection, glycopyrrolate, 0.1 mg |
12 |
12 |
$0.00 |
| 12011 |
|
12 |
12 |
$0.00 |
| 29125 |
|
13 |
13 |
$0.00 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
2,650 |
2,295 |
$0.00 |
| J2765 |
Injection, metoclopramide hcl, up to 10 mg |
2,258 |
2,132 |
$0.00 |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
5,054 |
4,899 |
$0.00 |
| J3490 |
Unclassified drugs |
452 |
447 |
$0.00 |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
4,974 |
4,814 |
$0.00 |
| 96376 |
|
3,011 |
2,294 |
$0.00 |
| J2175 |
Injection, meperidine hydrochloride, per 100 mg |
867 |
861 |
$0.00 |
| J2704 |
Injection, propofol, 10 mg |
5,613 |
5,505 |
$0.00 |
| J7050 |
Infusion, normal saline solution, 250 cc |
2,153 |
1,364 |
$0.00 |
| J1170 |
Injection, hydromorphone, up to 4 mg |
1,991 |
1,671 |
$0.00 |
| J0690 |
Injection, cefazolin sodium, 500 mg |
2,787 |
2,640 |
$0.00 |
| J0330 |
Injection, succinylcholine chloride, up to 20 mg |
1,770 |
1,746 |
$0.00 |
| J1642 |
Injection, heparin sodium, (heparin lock flush), per 10 units |
90 |
69 |
$0.00 |
| J7512 |
Prednisone, immediate release or delayed release, oral, 1 mg |
300 |
289 |
$0.00 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
6,118 |
5,738 |
$0.00 |
| A9585 |
Injection, gadobutrol, 0.1 ml |
259 |
253 |
$0.00 |
| 94760 |
|
270 |
255 |
$0.00 |
| Q9963 |
High osmolar contrast material, 350-399 mg/ml iodine concentration, per ml |
40 |
40 |
$0.00 |
| A9500 |
Technetium tc-99m sestamibi, diagnostic, per study dose |
90 |
88 |
$0.00 |
| J1040 |
Injection, methylprednisolone acetate, 80 mg |
29 |
29 |
$0.00 |
| 12002 |
|
15 |
15 |
$0.00 |
| J0592 |
Injection, buprenorphine hydrochloride, 0.1 mg |
184 |
184 |
$0.00 |
| 82803 |
|
38 |
37 |
$0.00 |
| 72170 |
|
41 |
40 |
$0.00 |
| J2003 |
Injection, lidocaine hydrochloride, 1 mg |
96 |
96 |
$0.00 |
| 94644 |
|
45 |
37 |
$0.00 |
| J2371 |
Injection, phenylephrine hydrochloride, 20 micrograms |
15 |
15 |
$0.00 |
| J1630 |
Injection, haloperidol, up to 5 mg |
103 |
93 |
$0.00 |
| J2360 |
Injection, orphenadrine citrate, up to 60 mg |
38 |
38 |
$0.00 |
| J2370 |
Injection, phenylephrine hcl, up to 1 ml |
31 |
30 |
$0.00 |
| J1790 |
Injection, droperidol, up to 5 mg |
111 |
111 |
$0.00 |
| A9270 |
Non-covered item or service |
167 |
142 |
$0.00 |
| J2785 |
Injection, regadenoson, 0.1 mg |
12 |
12 |
$0.00 |
| 96368 |
|
15 |
12 |
$0.00 |
| S0020 |
Injection, bupivicaine hydrochloride, 30 ml |
12 |
12 |
$0.00 |