| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99284 |
Emergency department visit for the evaluation and management, high severity |
24,458 |
22,396 |
$4.33M |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
11,780 |
11,088 |
$1.93M |
| 96361 |
Intravenous infusion, hydration; each additional hour |
7,450 |
6,019 |
$1.60M |
| 59025 |
Fetal non-stress test |
7,324 |
4,750 |
$1.15M |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
3,051 |
3,008 |
$952K |
| 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 |
12,249 |
11,957 |
$946K |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
5,266 |
5,059 |
$941K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
27,432 |
26,864 |
$905K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
27,447 |
26,881 |
$863K |
| 87631 |
|
6,837 |
6,752 |
$815K |
| 93306 |
Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete |
2,870 |
2,829 |
$739K |
| 70450 |
Computed tomography, head or brain; without contrast material |
2,335 |
2,307 |
$734K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
28,922 |
22,709 |
$660K |
| 43239 |
Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple |
972 |
966 |
$655K |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
3,999 |
3,819 |
$604K |
| 87661 |
Infectious agent detection by nucleic acid; Trichomonas vaginalis, amplified probe |
18,343 |
18,100 |
$563K |
| 45380 |
Colonoscopy, flexible; with biopsy, single or multiple |
778 |
776 |
$557K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
8,337 |
8,325 |
$549K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
1,670 |
1,658 |
$537K |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
2,479 |
2,312 |
$435K |
| 71275 |
Computed tomographic angiography, chest, with contrast material |
1,087 |
1,078 |
$381K |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
4,536 |
3,839 |
$355K |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
7,300 |
6,820 |
$328K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
4,015 |
3,989 |
$293K |
| 87480 |
|
15,857 |
15,448 |
$290K |
| G0378 |
Hospital observation service, per hour |
1,753 |
1,573 |
$288K |
| 87510 |
|
15,638 |
15,236 |
$287K |
| 99281 |
Emergency department visit for the evaluation and management, self-limited or minor |
1,849 |
1,657 |
$278K |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
6,200 |
4,576 |
$236K |
| 76801 |
|
4,331 |
4,136 |
$205K |
| 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 |
6,853 |
6,844 |
$203K |
| 86850 |
|
7,810 |
7,517 |
$197K |
| 76811 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, detailed |
3,111 |
3,110 |
$196K |
| 87660 |
|
11,088 |
10,850 |
$194K |
| 87624 |
Infectious agent detection by nucleic acid; human papillomavirus (HPV), high-risk types |
5,729 |
5,716 |
$188K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
7,024 |
6,185 |
$184K |
| 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 |
7,445 |
7,291 |
$182K |
| 76830 |
Ultrasound, transvaginal |
3,821 |
3,791 |
$170K |
| 45385 |
Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) |
286 |
285 |
$167K |
| 80076 |
|
12,210 |
11,214 |
$160K |
| 80053 |
Comprehensive metabolic panel |
9,911 |
8,906 |
$158K |
| 96366 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour |
927 |
765 |
$150K |
| 70553 |
Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences |
394 |
393 |
$147K |
| 88307 |
|
1,628 |
1,339 |
$143K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
2,880 |
2,843 |
$143K |
| 47562 |
|
49 |
49 |
$130K |
| 86901 |
|
7,780 |
7,501 |
$124K |
| 83970 |
|
2,862 |
2,843 |
$123K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
3,004 |
2,455 |
$121K |
| 96360 |
Intravenous infusion, hydration; initial, 31 minutes to 1 hour |
621 |
613 |
$120K |
| 77066 |
Tomosynthesis, mammo |
1,762 |
1,758 |
$120K |
| 77065 |
Tomosynthesis, mammo |
1,591 |
1,534 |
$117K |
| 86900 |
|
7,844 |
7,563 |
$105K |
| 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 |
1,621 |
1,452 |
$98K |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
12,420 |
12,044 |
$97K |
| 96375 |
Therapeutic injection; each additional sequential IV push |
4,061 |
3,428 |
$95K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
2,293 |
2,261 |
$94K |
| 93971 |
|
925 |
913 |
$92K |
| G0108 |
Diabetes outpatient self-management training services, individual, per 30 minutes |
1,847 |
1,644 |
$91K |
| 73721 |
Magnetic resonance imaging, any joint of lower extremity; without contrast material |
239 |
237 |
$80K |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
1,221 |
1,206 |
$80K |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
2,663 |
2,658 |
$78K |
| 76642 |
|
2,940 |
2,900 |
$72K |
| 87150 |
|
1,989 |
1,976 |
$69K |
| 76700 |
Ultrasound, abdominal, real time with image documentation; complete |
894 |
893 |
$69K |
| 93017 |
|
1,014 |
1,006 |
$69K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
2,093 |
1,942 |
$68K |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
7,623 |
7,611 |
$65K |
| 71046 |
Radiologic examination, chest; 2 views |
3,935 |
3,864 |
$64K |
| 97803 |
|
1,492 |
1,457 |
$63K |
| 97161 |
|
570 |
561 |
$58K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
5,675 |
5,646 |
$55K |
| 93320 |
|
521 |
520 |
$54K |
| 58661 |
|
25 |
25 |
$52K |
| 93350 |
|
482 |
482 |
$52K |
| 84443 |
Thyroid stimulating hormone (TSH) |
3,650 |
3,632 |
$51K |
| 82607 |
|
3,501 |
3,489 |
$50K |
| 82728 |
|
3,579 |
3,558 |
$49K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
3,169 |
2,596 |
$49K |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
2,456 |
2,450 |
$48K |
| 76770 |
|
140 |
140 |
$47K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
828 |
786 |
$44K |
| 82746 |
|
3,259 |
3,253 |
$44K |
| 88342 |
|
759 |
690 |
$43K |
| 74183 |
|
120 |
119 |
$42K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
582 |
550 |
$42K |
| 76641 |
|
1,350 |
1,345 |
$42K |
| 76813 |
|
1,337 |
1,334 |
$42K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
12,076 |
10,309 |
$41K |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
6,006 |
3,487 |
$41K |
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
2,430 |
1,971 |
$41K |
| 93970 |
|
119 |
118 |
$41K |
| 76376 |
|
604 |
599 |
$39K |
| Q9956 |
Injection, octafluoropropane microspheres, per ml |
788 |
502 |
$38K |
| 97165 |
|
325 |
324 |
$36K |
| 19083 |
|
26 |
26 |
$35K |
| 97802 |
|
693 |
693 |
$34K |
| 87081 |
|
5,650 |
5,606 |
$34K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
3,666 |
3,477 |
$33K |
| 83880 |
|
924 |
896 |
$32K |
| 86780 |
|
2,480 |
2,472 |
$32K |
| 85027 |
|
6,340 |
5,985 |
$31K |
| 87651 |
Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe |
783 |
778 |
$31K |
| 93225 |
|
382 |
382 |
$28K |
| G0121 |
Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk |
37 |
37 |
$27K |
| 96376 |
|
1,383 |
947 |
$26K |
| 72148 |
Magnetic resonance imaging, lumbar spine; without contrast material |
83 |
82 |
$24K |
| 88142 |
|
343 |
341 |
$24K |
| G0124 |
Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, requiring interpretation by physician |
887 |
887 |
$23K |
| 73562 |
|
1,638 |
1,604 |
$23K |
| 83540 |
|
3,567 |
3,553 |
$22K |
| 82570 |
|
4,789 |
4,622 |
$22K |
| 87186 |
|
2,614 |
2,573 |
$21K |
| 84702 |
|
1,725 |
1,549 |
$21K |
| 0071A |
|
487 |
480 |
$21K |
| 0124A |
|
464 |
463 |
$21K |
| 86803 |
|
1,578 |
1,577 |
$20K |
| G2066 |
Interrogation device evaluation(s), (remote) up to 30 days; implantable cardiovascular physiologic monitor system, implantable loop recorder system, or subcutaneous cardiac rhythm monitor system, remote data acquisition(s), receipt of transmissions and technician review, technical support and distribution of results |
290 |
290 |
$20K |
| Q9950 |
Injection, sulfur hexafluoride lipid microspheres, per ml |
421 |
310 |
$20K |
| 84425 |
|
954 |
953 |
$19K |
| 73030 |
|
1,138 |
1,099 |
$19K |
| 0001A |
|
426 |
399 |
$17K |
| 87158 |
|
3,348 |
3,300 |
$17K |
| 58558 |
|
12 |
12 |
$16K |
| 93325 |
|
610 |
609 |
$16K |
| 73502 |
|
1,323 |
1,289 |
$16K |
| 87340 |
|
1,566 |
1,564 |
$16K |
| 73564 |
|
666 |
664 |
$16K |
| 82043 |
|
2,781 |
2,776 |
$16K |
| 71045 |
Radiologic examination, chest; single view |
544 |
529 |
$16K |
| 88304 |
|
252 |
249 |
$16K |
| 87529 |
|
235 |
235 |
$15K |
| A9573 |
Injection, gadopiclenol, 1 ml |
396 |
226 |
$14K |
| 82947 |
|
5,001 |
3,651 |
$14K |
| 80061 |
Lipid panel |
1,216 |
1,205 |
$14K |
| 81001 |
|
5,050 |
4,934 |
$13K |
| 0004A |
|
286 |
284 |
$13K |
| J1170 |
Injection, hydromorphone, up to 4 mg |
2,798 |
2,219 |
$12K |
| 99152 |
|
385 |
379 |
$12K |
| 72100 |
|
762 |
757 |
$11K |
| 83655 |
|
912 |
910 |
$11K |
| 86762 |
|
961 |
959 |
$11K |
| 97116 |
|
233 |
143 |
$11K |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
618 |
535 |
$11K |
| 72110 |
|
382 |
382 |
$10K |
| 0241U |
Neonatal screening for hereditary disorders, genomic sequence analysis panel |
1,206 |
1,176 |
$10K |
| 73630 |
|
896 |
866 |
$10K |
| J7120 |
Ringers lactate infusion, up to 1000 cc |
3,236 |
2,997 |
$10K |
| 93975 |
|
25 |
25 |
$10K |
| 83690 |
|
4,595 |
4,207 |
$10K |
| G0123 |
Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, screening by cytotechnologist under physician supervision |
372 |
372 |
$9K |
| 76819 |
Fetal biophysical profile; without non-stress testing |
212 |
175 |
$9K |
| 84439 |
|
1,049 |
1,042 |
$9K |
| A9579 |
Injection, gadolinium-based magnetic resonance contrast agent, not otherwise specified (nos), per ml |
314 |
312 |
$9K |
| 76821 |
|
396 |
217 |
$9K |
| 71260 |
Computed tomography, thorax, diagnostic; with contrast material |
68 |
68 |
$9K |
| 82150 |
|
5,339 |
4,880 |
$8K |
| A9576 |
Injection, gadoteridol, (prohance multipack), per ml |
444 |
438 |
$8K |
| 73610 |
|
490 |
476 |
$8K |
| 85380 |
|
349 |
346 |
$8K |
| 85610 |
|
1,946 |
1,836 |
$8K |
| 71271 |
|
341 |
341 |
$8K |
| 84156 |
|
2,203 |
2,031 |
$7K |
| 76820 |
|
569 |
329 |
$7K |
| 77336 |
|
25 |
12 |
$7K |
| 73130 |
|
561 |
552 |
$7K |
| J2704 |
Injection, propofol, 10 mg |
2,629 |
2,584 |
$7K |
| 94010 |
|
149 |
145 |
$6K |
| 0054A |
|
133 |
133 |
$6K |
| U0002 |
2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc |
119 |
118 |
$6K |
| 90715 |
|
192 |
192 |
$6K |
| 73560 |
|
677 |
650 |
$6K |
| 36415 |
Collection of venous blood by venipuncture |
2,872 |
2,707 |
$6K |
| 84163 |
|
390 |
390 |
$6K |
| 77062 |
|
184 |
184 |
$6K |
| 73221 |
|
18 |
18 |
$6K |
| 0072A |
|
125 |
125 |
$5K |
| 87641 |
|
148 |
147 |
$5K |
| 93226 |
|
78 |
78 |
$4K |
| 85730 |
|
650 |
642 |
$4K |
| 84484 |
|
906 |
556 |
$4K |
| 81329 |
|
41 |
41 |
$4K |
| 76536 |
|
122 |
122 |
$4K |
| 0003A |
|
87 |
87 |
$4K |
| 81508 |
|
95 |
95 |
$4K |
| 85014 |
|
970 |
936 |
$4K |
| 82950 |
|
750 |
750 |
$3K |
| 74018 |
|
288 |
279 |
$3K |
| 84703 |
|
1,267 |
1,223 |
$3K |
| 87502 |
Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets |
51 |
50 |
$3K |
| 0002A |
|
74 |
74 |
$3K |
| 0081A |
|
67 |
67 |
$3K |
| 81220 |
CFTR (cystic fibrosis transmembrane conductance regulator) gene analysis; common variants |
12 |
12 |
$3K |
| 97804 |
|
116 |
116 |
$3K |
| 86787 |
|
297 |
297 |
$3K |
| J0690 |
Injection, cefazolin sodium, 500 mg |
1,340 |
1,080 |
$3K |
| 82565 |
|
798 |
794 |
$3K |
| 87070 |
|
394 |
387 |
$3K |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
3,020 |
2,945 |
$2K |
| 83735 |
|
742 |
588 |
$2K |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
4,536 |
4,028 |
$2K |
| J2710 |
Injection, neostigmine methylsulfate, up to 0.5 mg |
231 |
230 |
$2K |
| 93922 |
|
26 |
26 |
$2K |
| 73110 |
|
140 |
137 |
$2K |
| 81025 |
|
392 |
386 |
$2K |
| 76882 |
|
72 |
70 |
$2K |
| 86140 |
|
644 |
568 |
$2K |
| 77061 |
|
53 |
53 |
$2K |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
5,029 |
4,476 |
$2K |
| 93299 |
|
44 |
44 |
$1K |
| 99153 |
Mod sedat endo service >5yrs |
39 |
39 |
$1K |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
2,261 |
2,206 |
$1K |
| 96367 |
|
12 |
12 |
$1K |
| 87634 |
|
26 |
26 |
$1K |
| J2550 |
Injection, promethazine hcl, up to 50 mg |
1,177 |
926 |
$1K |
| 87040 |
|
139 |
102 |
$1K |
| 92558 |
|
41 |
39 |
$1K |
| 82105 |
|
82 |
80 |
$1K |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
3,315 |
3,251 |
$1K |
| J2270 |
Injection, morphine sulfate, up to 10 mg |
572 |
497 |
$1K |
| 94726 |
|
12 |
12 |
$1K |
| 0051A |
|
24 |
24 |
$1K |
| 83605 |
|
173 |
162 |
$1K |
| 85018 |
|
505 |
492 |
$1K |
| 81003 |
|
738 |
730 |
$992.78 |
| 97530 |
Therapeutic activities, direct patient contact, each 15 minutes |
27 |
12 |
$898.69 |
| 83020 |
|
68 |
68 |
$887.87 |
| A9585 |
Injection, gadobutrol, 0.1 ml |
92 |
91 |
$887.25 |
| 94729 |
|
53 |
51 |
$884.42 |
| 87205 |
|
312 |
304 |
$884.21 |
| 76377 |
|
13 |
13 |
$846.00 |
| 0053A |
|
18 |
18 |
$808.00 |
| 76857 |
|
12 |
12 |
$778.67 |
| 88341 |
|
14 |
12 |
$761.83 |
| 85652 |
|
539 |
471 |
$757.51 |
| 72072 |
|
25 |
25 |
$717.27 |
| 73590 |
|
25 |
25 |
$661.24 |
| 97535 |
Self-care/home management training, each 15 minutes |
26 |
26 |
$658.38 |
| 0082A |
|
13 |
13 |
$638.00 |
| J1650 |
Injection, enoxaparin sodium, 10 mg |
218 |
107 |
$626.62 |
| 82805 |
|
14 |
14 |
$597.88 |
| 0154A |
|
12 |
12 |
$592.00 |
| J0330 |
Injection, succinylcholine chloride, up to 20 mg |
110 |
109 |
$575.86 |
| 87798 |
Infectious agent detection by nucleic acid; not otherwise specified, amplified probe, each organism |
18 |
17 |
$569.05 |
| 0074A |
|
12 |
12 |
$552.00 |
| 90686 |
|
49 |
49 |
$531.98 |
| J1644 |
Injection, heparin sodium, per 1000 units |
476 |
382 |
$531.39 |
| 74022 |
|
15 |
15 |
$526.00 |
| 82310 |
|
155 |
151 |
$496.43 |
| 88175 |
Cytopathology, cervical or vaginal, any reporting system; collected in preservative fluid, automated thin layer |
12 |
12 |
$410.19 |
| 72050 |
|
28 |
28 |
$387.60 |
| 73080 |
|
12 |
12 |
$386.08 |
| 82248 |
|
147 |
146 |
$384.56 |
| 82040 |
|
128 |
125 |
$370.65 |
| 80305 |
|
47 |
47 |
$345.95 |
| J0665 |
Injection, bupivicaine, not otherwise specified, 0.5 mg |
158 |
155 |
$335.80 |
| 85007 |
|
228 |
193 |
$319.80 |
| 80050 |
General health panel |
12 |
12 |
$316.94 |
| 82247 |
|
141 |
137 |
$307.19 |
| G0008 |
Administration of influenza virus vaccine |
89 |
89 |
$289.06 |
| 84460 |
|
111 |
111 |
$275.50 |
| J1200 |
Injection, diphenhydramine hcl, up to 50 mg |
445 |
336 |
$247.96 |
| J1630 |
Injection, haloperidol, up to 5 mg |
317 |
308 |
$213.45 |
| 84075 |
|
76 |
76 |
$201.06 |
| 80069 |
|
13 |
12 |
$173.50 |
| 81002 |
|
65 |
65 |
$134.49 |
| J2765 |
Injection, metoclopramide hcl, up to 10 mg |
256 |
232 |
$129.27 |
| J0780 |
Injection, prochlorperazine, up to 10 mg |
43 |
43 |
$120.84 |
| 73522 |
|
12 |
12 |
$120.57 |
| 87184 |
|
13 |
13 |
$110.45 |
| 84155 |
|
75 |
75 |
$106.77 |
| 86706 |
|
12 |
12 |
$105.18 |
| 83550 |
|
14 |
14 |
$104.32 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
14 |
14 |
$92.69 |
| 84520 |
|
81 |
80 |
$75.84 |
| J1171 |
Injection, hydromorphone, 0.1 mg |
41 |
37 |
$69.38 |
| J1815 |
Injection, insulin, per 5 units |
58 |
40 |
$59.89 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
71 |
65 |
$54.09 |
| J3415 |
Injection, pyridoxine hcl, 100 mg |
13 |
12 |
$44.34 |
| J2003 |
Injection, lidocaine hydrochloride, 1 mg |
50 |
46 |
$33.26 |
| 90694 |
|
13 |
13 |
$28.05 |
| 84100 |
|
31 |
25 |
$27.46 |
| J2001 |
Injection, lidocaine hcl for intravenous infusion, 10 mg |
64 |
62 |
$21.73 |
| S0020 |
Injection, bupivicaine hydrochloride, 30 ml |
15 |
15 |
$17.81 |
| 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 |
180 |
158 |
$14.50 |
| J2370 |
Injection, phenylephrine hcl, up to 1 ml |
26 |
26 |
$12.32 |
| 82374 |
|
16 |
16 |
$4.67 |
| 84295 |
|
16 |
16 |
$4.60 |
| 82435 |
|
16 |
16 |
$4.38 |