| Code | Description | Claims | Beneficiaries | Total Paid |
| 90999 |
Unlisted dialysis procedure, inpatient or outpatient |
33,932 |
2,580 |
$13.59M |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
67,014 |
61,915 |
$6.97M |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
50,589 |
43,698 |
$5.38M |
| J1270 |
Injection, doxercalciferol, 1 mcg |
14,362 |
1,462 |
$4.95M |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
18,060 |
15,812 |
$2.82M |
| J0882 |
Injection, darbepoetin alfa, 1 microgram (for esrd on dialysis) |
5,231 |
1,590 |
$1.88M |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
13,910 |
13,088 |
$1.72M |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
17,171 |
3,356 |
$1.72M |
| 70450 |
Computed tomography, head or brain; without contrast material |
7,532 |
6,558 |
$1.50M |
| J2916 |
Injection, sodium ferric gluconate complex in sucrose injection, 12.5 mg |
3,989 |
1,051 |
$1.31M |
| 92507 |
Treatment of speech, language, voice, communication, and/or auditory processing disorder |
18,924 |
4,420 |
$1.23M |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
2,526 |
2,312 |
$1.11M |
| 80053 |
Comprehensive metabolic panel |
30,367 |
25,715 |
$1.07M |
| A4216 |
Sterile water, saline and/or dextrose, diluent/flush, 10 ml |
3,095 |
2,281 |
$1.06M |
| 96361 |
Intravenous infusion, hydration; each additional hour |
14,707 |
11,020 |
$931K |
| 84100 |
|
3,658 |
3,128 |
$734K |
| 85027 |
|
7,815 |
6,695 |
$716K |
| J1200 |
Injection, diphenhydramine hcl, up to 50 mg |
4,589 |
2,310 |
$708K |
| 97530 |
Therapeutic activities, direct patient contact, each 15 minutes |
12,488 |
2,951 |
$689K |
| 85018 |
|
2,323 |
2,037 |
$661K |
| 81001 |
|
36,185 |
32,483 |
$646K |
| 59025 |
Fetal non-stress test |
9,145 |
6,938 |
$475K |
| G0378 |
Hospital observation service, per hour |
14,753 |
6,004 |
$464K |
| 72125 |
Computed tomography, cervical spine; without contrast material |
2,001 |
1,617 |
$418K |
| U0002 |
2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc |
17,367 |
16,200 |
$413K |
| 83970 |
|
1,514 |
1,363 |
$412K |
| 87502 |
Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets |
20,947 |
19,998 |
$404K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
9,764 |
7,933 |
$335K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
1,048 |
933 |
$329K |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
3,566 |
3,172 |
$314K |
| 87070 |
|
10,488 |
9,971 |
$273K |
| 54161 |
|
736 |
713 |
$269K |
| 82728 |
|
1,324 |
1,182 |
$258K |
| 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 |
2,818 |
2,729 |
$257K |
| 71275 |
Computed tomographic angiography, chest, with contrast material |
552 |
472 |
$245K |
| 83540 |
|
903 |
804 |
$235K |
| 83550 |
|
877 |
780 |
$235K |
| 96360 |
Intravenous infusion, hydration; initial, 31 minutes to 1 hour |
6,174 |
5,615 |
$235K |
| 70553 |
Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences |
1,317 |
1,262 |
$211K |
| 0202U |
Oncology (prostate), multianalyte, gene expression profiling |
1,187 |
1,145 |
$177K |
| S0028 |
Injection, famotidine, 20 mg |
1,957 |
1,565 |
$176K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
10,293 |
8,724 |
$162K |
| 76819 |
Fetal biophysical profile; without non-stress testing |
5,635 |
4,373 |
$152K |
| 71046 |
Radiologic examination, chest; 2 views |
10,072 |
9,530 |
$130K |
| 86803 |
|
380 |
337 |
$122K |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
3,897 |
3,665 |
$119K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
1,227 |
1,077 |
$115K |
| 93306 |
Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete |
664 |
581 |
$111K |
| 71045 |
Radiologic examination, chest; single view |
9,955 |
8,664 |
$110K |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
4,772 |
4,209 |
$106K |
| J3490 |
Unclassified drugs |
880 |
483 |
$101K |
| 70551 |
Magnetic resonance imaging, brain; without contrast material |
560 |
510 |
$93K |
| 81025 |
|
14,258 |
13,025 |
$86K |
| 86706 |
|
198 |
186 |
$77K |
| 76770 |
|
1,270 |
1,227 |
$74K |
| 74018 |
|
2,353 |
2,206 |
$72K |
| J0606 |
Injection, etelcalcetide, 0.1 mg |
118 |
12 |
$71K |
| J8499 |
Prescription drug, oral, non chemotherapeutic, nos |
1,434 |
659 |
$68K |
| 76700 |
Ultrasound, abdominal, real time with image documentation; complete |
1,022 |
982 |
$65K |
| 90935 |
Hemodialysis procedure with single evaluation by a physician |
193 |
37 |
$63K |
| A9576 |
Injection, gadoteridol, (prohance multipack), per ml |
675 |
663 |
$62K |
| J7050 |
Infusion, normal saline solution, 250 cc |
8,466 |
6,005 |
$62K |
| 36430 |
|
519 |
390 |
$58K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
36,797 |
30,503 |
$58K |
| 11042 |
Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm |
1,436 |
542 |
$58K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
1,410 |
1,338 |
$53K |
| 99281 |
Emergency department visit for the evaluation and management, self-limited or minor |
487 |
442 |
$52K |
| 82570 |
|
1,786 |
1,520 |
$50K |
| 36415 |
Collection of venous blood by venipuncture |
3,086 |
2,380 |
$50K |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
5,506 |
3,412 |
$50K |
| S5010 |
5% dextrose and 0.45% normal saline, 1000 ml |
559 |
404 |
$48K |
| Q5105 |
Injection, epoetin alfa-epbx, biosimilar, (retacrit) (for esrd on dialysis), 100 units |
416 |
76 |
$43K |
| 82962 |
|
7,275 |
3,524 |
$43K |
| 92523 |
|
921 |
878 |
$42K |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
2,362 |
2,001 |
$42K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
2,726 |
2,414 |
$42K |
| 87631 |
|
587 |
572 |
$41K |
| 97163 |
|
394 |
352 |
$41K |
| 74019 |
|
1,986 |
1,935 |
$37K |
| 12011 |
|
615 |
569 |
$36K |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
14,804 |
12,854 |
$32K |
| 70486 |
|
620 |
554 |
$30K |
| 76801 |
|
2,470 |
2,316 |
$30K |
| 87340 |
|
323 |
274 |
$29K |
| J1815 |
Injection, insulin, per 5 units |
523 |
258 |
$27K |
| 87651 |
Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe |
13,478 |
12,958 |
$27K |
| S0077 |
Injection, clindamycin phosphate, 300 mg |
339 |
245 |
$25K |
| 74022 |
|
1,009 |
952 |
$24K |
| 84702 |
|
5,140 |
4,180 |
$24K |
| 90686 |
|
93 |
81 |
$24K |
| 87801 |
Infectious agent detection by nucleic acid; amplified probe, multiple organisms |
7,170 |
6,863 |
$23K |
| J7030 |
Infusion, normal saline solution , 1000 cc |
16,957 |
13,665 |
$21K |
| 72128 |
|
46 |
42 |
$20K |
| 72131 |
|
256 |
228 |
$19K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
503 |
397 |
$19K |
| J7512 |
Prednisone, immediate release or delayed release, oral, 1 mg |
917 |
804 |
$18K |
| A9270 |
Non-covered item or service |
3,357 |
1,594 |
$17K |
| G0008 |
Administration of influenza virus vaccine |
81 |
73 |
$17K |
| 92567 |
|
829 |
809 |
$17K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
2,342 |
2,004 |
$16K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
7,956 |
6,603 |
$15K |
| 12001 |
|
351 |
320 |
$15K |
| 87632 |
|
2,090 |
2,026 |
$14K |
| 96376 |
|
3,646 |
2,077 |
$14K |
| 92587 |
|
1,011 |
982 |
$14K |
| 87040 |
|
5,499 |
4,691 |
$14K |
| 96375 |
Therapeutic injection; each additional sequential IV push |
9,446 |
7,411 |
$13K |
| 87205 |
|
2,248 |
2,024 |
$13K |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
639 |
585 |
$13K |
| 77072 |
|
290 |
279 |
$13K |
| 73630 |
|
801 |
719 |
$13K |
| 86850 |
|
6,230 |
5,561 |
$12K |
| 82731 |
|
842 |
764 |
$12K |
| 92526 |
|
360 |
76 |
$11K |
| 73562 |
|
795 |
721 |
$11K |
| 85610 |
|
6,191 |
5,173 |
$11K |
| 80069 |
|
620 |
568 |
$11K |
| 76830 |
Ultrasound, transvaginal |
497 |
458 |
$11K |
| 73610 |
|
765 |
699 |
$11K |
| 86900 |
|
6,516 |
5,812 |
$11K |
| 69436 |
Tympanostomy (requiring insertion of ventilating tube), general anesthesia |
153 |
122 |
$11K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
415 |
380 |
$10K |
| 76536 |
|
167 |
161 |
$10K |
| 96366 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour |
649 |
468 |
$9K |
| 86901 |
|
7,012 |
6,236 |
$9K |
| 76885 |
|
126 |
120 |
$9K |
| 93971 |
|
489 |
401 |
$9K |
| 82247 |
|
1,193 |
882 |
$9K |
| 74455 |
|
117 |
116 |
$9K |
| 93970 |
|
274 |
231 |
$9K |
| P9016 |
Red blood cells, leukocytes reduced, each unit |
459 |
365 |
$9K |
| 73130 |
|
687 |
631 |
$8K |
| 73090 |
|
485 |
432 |
$8K |
| 97168 |
|
84 |
83 |
$8K |
| 73590 |
|
458 |
411 |
$8K |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
5,340 |
4,802 |
$8K |
| J7040 |
Infusion, normal saline solution, sterile (500 ml = 1 unit) |
3,236 |
2,952 |
$8K |
| 97167 |
|
89 |
84 |
$7K |
| 97162 |
|
304 |
236 |
$7K |
| 84484 |
|
5,234 |
3,501 |
$7K |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
12,637 |
11,062 |
$7K |
| 72100 |
|
676 |
616 |
$7K |
| 72170 |
|
450 |
375 |
$7K |
| 73030 |
|
761 |
665 |
$7K |
| J2704 |
Injection, propofol, 10 mg |
6,022 |
5,521 |
$6K |
| 92585 |
|
129 |
126 |
$6K |
| 01922 |
|
413 |
405 |
$6K |
| 73110 |
|
309 |
288 |
$6K |
| 85730 |
|
4,666 |
3,941 |
$6K |
| 76870 |
|
166 |
160 |
$5K |
| 97164 |
|
64 |
62 |
$5K |
| 72040 |
|
152 |
140 |
$5K |
| 94664 |
|
1,976 |
1,854 |
$5K |
| 83690 |
|
7,104 |
6,311 |
$5K |
| 87186 |
|
2,227 |
2,064 |
$4K |
| 84443 |
Thyroid stimulating hormone (TSH) |
2,540 |
2,227 |
$4K |
| 87045 |
|
274 |
261 |
$4K |
| 87077 |
|
2,212 |
2,058 |
$4K |
| J7120 |
Ringers lactate infusion, up to 1000 cc |
8,718 |
7,338 |
$4K |
| 93886 |
|
40 |
40 |
$4K |
| 84439 |
|
1,452 |
1,328 |
$4K |
| 10060 |
|
67 |
63 |
$4K |
| 86920 |
|
612 |
524 |
$4K |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
13,564 |
12,779 |
$3K |
| 82270 |
|
91 |
88 |
$3K |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
6,695 |
5,562 |
$3K |
| J2270 |
Injection, morphine sulfate, up to 10 mg |
3,670 |
2,836 |
$3K |
| 96450 |
|
14 |
12 |
$3K |
| 84112 |
|
269 |
250 |
$3K |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
2,348 |
2,095 |
$3K |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
4,985 |
4,177 |
$3K |
| 82550 |
|
3,210 |
2,402 |
$3K |
| 83735 |
|
4,672 |
3,724 |
$3K |
| 80061 |
Lipid panel |
482 |
429 |
$3K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
85 |
72 |
$3K |
| 92579 |
|
51 |
51 |
$2K |
| 73140 |
|
39 |
38 |
$2K |
| 43762 |
|
12 |
12 |
$2K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
1,444 |
1,356 |
$2K |
| 82248 |
|
1,670 |
1,291 |
$2K |
| 83605 |
|
2,124 |
1,729 |
$2K |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
7,421 |
6,893 |
$2K |
| 80076 |
|
544 |
480 |
$2K |
| 36416 |
|
381 |
327 |
$2K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
119 |
114 |
$2K |
| 73620 |
|
66 |
61 |
$2K |
| J1170 |
Injection, hydromorphone, up to 4 mg |
1,789 |
1,193 |
$2K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
1,715 |
1,605 |
$2K |
| 84703 |
|
732 |
679 |
$1K |
| 87210 |
|
1,952 |
1,787 |
$1K |
| J2060 |
Injection, lorazepam, 2 mg |
295 |
231 |
$1K |
| 12002 |
|
65 |
62 |
$1K |
| 73080 |
|
178 |
165 |
$1K |
| 92557 |
|
25 |
24 |
$1K |
| 76506 |
|
16 |
16 |
$1K |
| J0690 |
Injection, cefazolin sodium, 500 mg |
1,584 |
1,295 |
$1K |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
429 |
399 |
$1K |
| 86140 |
|
7,781 |
7,119 |
$1K |
| 99001 |
|
4,723 |
4,394 |
$1K |
| 85046 |
|
1,213 |
927 |
$1K |
| 83880 |
|
1,283 |
1,047 |
$1K |
| 29125 |
|
308 |
292 |
$936.53 |
| 85379 |
|
1,335 |
1,170 |
$933.47 |
| 71260 |
Computed tomography, thorax, diagnostic; with contrast material |
70 |
64 |
$914.06 |
| J2765 |
Injection, metoclopramide hcl, up to 10 mg |
2,262 |
1,983 |
$898.92 |
| 76775 |
|
12 |
12 |
$835.13 |
| 86738 |
|
392 |
357 |
$789.67 |
| 84550 |
|
1,459 |
1,266 |
$757.62 |
| 97140 |
Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) |
207 |
40 |
$684.18 |
| 83615 |
|
1,259 |
1,121 |
$660.83 |
| 82803 |
|
16 |
14 |
$648.41 |
| 73552 |
|
73 |
62 |
$645.48 |
| 90715 |
|
607 |
509 |
$642.44 |
| 00300 |
|
14 |
14 |
$594.69 |
| 71250 |
|
15 |
12 |
$569.64 |
| 82610 |
|
358 |
349 |
$567.59 |
| J0330 |
Injection, succinylcholine chloride, up to 20 mg |
1,039 |
893 |
$539.50 |
| 82150 |
|
932 |
867 |
$537.08 |
| J0131 |
Injection, acetaminophen, not otherwise specified,10 mg |
1,065 |
915 |
$522.49 |
| 87581 |
|
162 |
159 |
$518.86 |
| 87088 |
|
1,629 |
1,517 |
$515.30 |
| 76857 |
|
27 |
25 |
$511.52 |
| 87636 |
Infectious agent detection by nucleic acid; SARS-CoV-2 and influenza virus types A and B |
1,303 |
1,246 |
$505.87 |
| 73060 |
|
15 |
13 |
$487.15 |
| J0702 |
Injection, betamethasone acetate 3 mg and betamethasone sodium phosphate 3 mg |
464 |
269 |
$454.24 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
280 |
233 |
$439.34 |
| 85384 |
|
1,045 |
912 |
$425.71 |
| 84156 |
|
1,646 |
1,392 |
$379.36 |
| 97116 |
|
132 |
24 |
$373.65 |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
1,803 |
1,735 |
$360.98 |
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
26 |
12 |
$302.76 |
| 92652 |
|
26 |
25 |
$270.10 |
| 85651 |
|
1,460 |
1,291 |
$254.77 |
| 82784 |
|
16 |
15 |
$254.22 |
| 76882 |
|
15 |
15 |
$224.38 |
| 96367 |
|
46 |
36 |
$216.41 |
| J2930 |
Injection, methylprednisolone sodium succinate, up to 125 mg |
487 |
428 |
$210.54 |
| 83002 |
|
15 |
13 |
$200.22 |
| 89051 |
|
49 |
37 |
$197.63 |
| 73564 |
|
14 |
13 |
$176.02 |
| J1644 |
Injection, heparin sodium, per 1000 units |
107 |
39 |
$159.01 |
| 73502 |
|
46 |
38 |
$151.80 |
| J2360 |
Injection, orphenadrine citrate, up to 60 mg |
89 |
79 |
$114.58 |
| 76641 |
|
13 |
12 |
$108.61 |
| J7999 |
Compounded drug, not otherwise classified |
59 |
40 |
$83.01 |
| 87400 |
|
39 |
37 |
$78.13 |
| J2920 |
Injection, methylprednisolone sodium succinate, up to 40 mg |
478 |
345 |
$70.85 |
| C9113 |
Injection, pantoprazole sodium, per vial |
273 |
222 |
$69.24 |
| J0561 |
Injection, penicillin g benzathine, 100,000 units |
250 |
238 |
$62.17 |
| 82043 |
|
173 |
158 |
$58.15 |
| 87420 |
|
21 |
20 |
$57.19 |
| 87109 |
|
13 |
12 |
$48.63 |
| 86308 |
|
61 |
55 |
$25.88 |
| 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 |
544 |
527 |
$25.00 |
| 85362 |
|
44 |
40 |
$21.70 |
| J7121 |
5% dextrose in lactated ringers infusion, up to 1000 cc |
86 |
78 |
$17.24 |
| 86592 |
|
52 |
43 |
$15.35 |
| 87430 |
|
53 |
50 |
$15.06 |
| 87081 |
|
46 |
36 |
$15.03 |
| J2710 |
Injection, neostigmine methylsulfate, up to 0.5 mg |
29 |
28 |
$10.65 |
| J3105 |
Injection, terbutaline sulfate, up to 1 mg |
15 |
13 |
$8.68 |
| J0360 |
Injection, hydralazine hcl, up to 20 mg |
51 |
38 |
$8.52 |
| 99218 |
|
179 |
92 |
$7.53 |
| 87185 |
|
109 |
106 |
$6.47 |
| J1940 |
Injection, furosemide, up to 20 mg |
50 |
26 |
$6.39 |
| 85660 |
|
26 |
24 |
$6.09 |
| 00170 |
Anesthesia for intraoral procedures, including biopsy |
50 |
47 |
$4.30 |
| 00126 |
|
153 |
124 |
$4.30 |
| J1953 |
Injection, levetiracetam, 10 mg |
77 |
60 |
$2.17 |
| 87425 |
|
12 |
12 |
$2.17 |
| 00920 |
|
691 |
672 |
$1.95 |
| J1643 |
Injection, heparin sodium (pfizer), not therapeutically equivalent to j1644, per 1000 units |
69 |
26 |
$0.00 |
| J0665 |
Injection, bupivicaine, not otherwise specified, 0.5 mg |
109 |
105 |
$0.00 |
| 84145 |
|
31 |
27 |
$0.00 |
| 87806 |
|
21 |
14 |
$0.00 |
| 85007 |
|
79 |
68 |
$0.00 |
| J9260 |
Injection, methotrexate sodium, 50 mg |
34 |
24 |
$0.00 |
| 29515 |
|
12 |
12 |
$0.00 |
| 82010 |
|
13 |
12 |
$0.00 |
| A4649 |
Surgical supply; miscellaneous |
15 |
12 |
$0.00 |
| 51600 |
|
122 |
121 |
$0.00 |
| J1642 |
Injection, heparin sodium, (heparin lock flush), per 10 units |
946 |
604 |
$0.00 |
| A4217 |
Sterile water/saline, 500 ml |
498 |
431 |
$0.00 |
| J2795 |
Injection, ropivacaine hydrochloride, 1 mg |
34 |
28 |
$0.00 |
| J7042 |
5% dextrose/normal saline (500 ml = 1 unit) |
125 |
93 |
$0.00 |
| 88300 |
|
16 |
13 |
$0.00 |
| S0020 |
Injection, bupivicaine hydrochloride, 30 ml |
133 |
125 |
$0.00 |
| 88108 |
|
16 |
13 |
$0.00 |
| 88342 |
|
12 |
12 |
$0.00 |
| 88304 |
|
25 |
24 |
$0.00 |
| 00160 |
|
13 |
13 |
$0.00 |
| 86762 |
|
17 |
14 |
$0.00 |
| J3480 |
Injection, potassium chloride, per 2 meq |
14 |
12 |
$0.00 |
| 42820 |
Tonsillectomy and adenoidectomy; younger than age 12 |
26 |
25 |
$0.00 |