| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
27,341 |
25,672 |
$3.42M |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
18,719 |
17,261 |
$3.40M |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
9,262 |
8,618 |
$2.32M |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
12,872 |
11,515 |
$1.11M |
| G0378 |
Hospital observation service, per hour |
1,176 |
1,077 |
$668K |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
4,276 |
4,161 |
$587K |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
7,015 |
6,760 |
$559K |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
4,988 |
4,281 |
$391K |
| 70450 |
Computed tomography, head or brain; without contrast material |
3,932 |
3,814 |
$328K |
| 96361 |
Intravenous infusion, hydration; each additional hour |
11,604 |
9,461 |
$303K |
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
5,466 |
4,184 |
$301K |
| 96360 |
Intravenous infusion, hydration; initial, 31 minutes to 1 hour |
3,424 |
3,195 |
$293K |
| 96375 |
Therapeutic injection; each additional sequential IV push |
10,666 |
9,087 |
$281K |
| 71046 |
Radiologic examination, chest; 2 views |
7,191 |
6,988 |
$246K |
| 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 |
5,086 |
4,851 |
$232K |
| 71045 |
Radiologic examination, chest; single view |
6,083 |
5,760 |
$194K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
1,960 |
1,926 |
$194K |
| 93306 |
Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete |
855 |
852 |
$187K |
| 59025 |
Fetal non-stress test |
1,767 |
941 |
$168K |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
6,581 |
2,053 |
$156K |
| 99291 |
Critical care, evaluation and management of the critically ill patient, first 30-74 minutes |
364 |
355 |
$140K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
2,668 |
2,667 |
$133K |
| 86900 |
|
3,209 |
2,988 |
$124K |
| 84443 |
Thyroid stimulating hormone (TSH) |
15,728 |
15,387 |
$112K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
6,252 |
6,191 |
$111K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
6,251 |
6,190 |
$109K |
| 80061 |
Lipid panel |
10,455 |
10,400 |
$103K |
| 80053 |
Comprehensive metabolic panel |
37,894 |
33,755 |
$96K |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
1,696 |
1,669 |
$94K |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
8,160 |
7,667 |
$92K |
| 92507 |
Treatment of speech, language, voice, communication, and/or auditory processing disorder |
2,190 |
810 |
$91K |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
5,323 |
5,293 |
$80K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
45,417 |
39,224 |
$75K |
| 36415 |
Collection of venous blood by venipuncture |
41,575 |
37,118 |
$75K |
| 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 |
4,264 |
4,094 |
$58K |
| 96366 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour |
2,065 |
1,469 |
$54K |
| 87624 |
Infectious agent detection by nucleic acid; human papillomavirus (HPV), high-risk types |
2,367 |
2,365 |
$48K |
| 88175 |
Cytopathology, cervical or vaginal, any reporting system; collected in preservative fluid, automated thin layer |
3,019 |
3,018 |
$46K |
| U0002 |
2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc |
2,070 |
1,998 |
$45K |
| 71275 |
Computed tomographic angiography, chest, with contrast material |
519 |
511 |
$43K |
| 81514 |
|
404 |
403 |
$42K |
| 42820 |
Tonsillectomy and adenoidectomy; younger than age 12 |
13 |
13 |
$37K |
| 97112 |
Therapeutic procedure, each 15 minutes; neuromuscular reeducation of movement, balance, coordination |
1,720 |
592 |
$37K |
| 69436 |
Tympanostomy (requiring insertion of ventilating tube), general anesthesia |
95 |
95 |
$34K |
| 84439 |
|
9,233 |
9,024 |
$34K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
6,446 |
6,397 |
$31K |
| 76830 |
Ultrasound, transvaginal |
579 |
572 |
$31K |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
10,630 |
10,150 |
$31K |
| 86780 |
|
3,839 |
3,810 |
$30K |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
2,205 |
2,204 |
$29K |
| 70553 |
Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences |
125 |
125 |
$28K |
| 82607 |
|
3,535 |
3,503 |
$26K |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
3,609 |
3,590 |
$26K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
13,917 |
12,675 |
$24K |
| 97140 |
Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) |
1,676 |
644 |
$23K |
| 72100 |
|
997 |
992 |
$23K |
| 87150 |
|
1,245 |
1,239 |
$21K |
| 80074 |
|
1,294 |
1,288 |
$21K |
| 71260 |
Computed tomography, thorax, diagnostic; with contrast material |
179 |
176 |
$20K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
8,864 |
7,921 |
$19K |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
1,963 |
1,938 |
$19K |
| 82728 |
|
2,932 |
2,888 |
$18K |
| 84702 |
|
3,492 |
2,625 |
$17K |
| 97530 |
Therapeutic activities, direct patient contact, each 15 minutes |
687 |
279 |
$17K |
| 85027 |
|
6,828 |
6,487 |
$16K |
| 73630 |
|
2,001 |
1,868 |
$16K |
| 83550 |
|
3,624 |
3,576 |
$16K |
| 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 |
961 |
960 |
$15K |
| 73030 |
|
1,347 |
1,271 |
$15K |
| 76642 |
|
368 |
322 |
$14K |
| 73610 |
|
1,718 |
1,637 |
$14K |
| 74018 |
|
1,039 |
1,011 |
$14K |
| 87651 |
Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe |
728 |
723 |
$13K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
249 |
249 |
$13K |
| 87660 |
|
1,255 |
1,242 |
$13K |
| 73562 |
|
1,627 |
1,454 |
$13K |
| 87480 |
|
1,255 |
1,242 |
$13K |
| 83540 |
|
3,958 |
3,905 |
$13K |
| 87510 |
|
1,255 |
1,242 |
$13K |
| 45380 |
Colonoscopy, flexible; with biopsy, single or multiple |
26 |
26 |
$12K |
| 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 |
2,312 |
2,051 |
$12K |
| 97162 |
|
211 |
210 |
$12K |
| M0245 |
Intravenous infusion, bamlanivimab and etesevimab, includes infusion and post administration monitoring |
54 |
54 |
$12K |
| 73130 |
|
1,670 |
1,551 |
$12K |
| M0243 |
Intravenous infusion or subcutaneous injection, casirivimab and imdevimab includes infusion or injection, and post administration monitoring |
47 |
47 |
$12K |
| 90834 |
Psychotherapy, 45 minutes with patient |
235 |
129 |
$11K |
| 86803 |
|
2,004 |
1,997 |
$11K |
| 72125 |
Computed tomography, cervical spine; without contrast material |
1,263 |
1,249 |
$10K |
| 71250 |
|
188 |
187 |
$10K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
186 |
176 |
$10K |
| 83655 |
|
1,427 |
1,424 |
$10K |
| 87077 |
|
3,299 |
3,201 |
$10K |
| 72148 |
Magnetic resonance imaging, lumbar spine; without contrast material |
96 |
96 |
$10K |
| 87186 |
|
2,929 |
2,853 |
$9K |
| 83880 |
|
2,439 |
2,232 |
$9K |
| 73721 |
Magnetic resonance imaging, any joint of lower extremity; without contrast material |
81 |
77 |
$9K |
| 96367 |
|
399 |
348 |
$9K |
| 73110 |
|
960 |
912 |
$8K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
2,431 |
2,393 |
$8K |
| 82746 |
|
1,216 |
1,206 |
$8K |
| 83735 |
|
12,360 |
10,655 |
$7K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
8,051 |
6,883 |
$7K |
| 87661 |
Infectious agent detection by nucleic acid; Trichomonas vaginalis, amplified probe |
504 |
495 |
$7K |
| 87340 |
|
2,387 |
2,380 |
$7K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
825 |
768 |
$6K |
| G0103 |
Prostate cancer screening; prostate specific antigen test (psa) |
579 |
578 |
$6K |
| 81001 |
|
7,884 |
7,425 |
$6K |
| 80076 |
|
1,763 |
1,629 |
$6K |
| G0279 |
Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066) |
458 |
458 |
$6K |
| 78452 |
Myocardial perfusion imaging, tomographic (SPECT); multiple studies at rest and/or stress |
12 |
12 |
$6K |
| M0247 |
Intravenous infusion, sotrovimab, includes infusion and post administration monitoring |
24 |
24 |
$6K |
| 97535 |
Self-care/home management training, each 15 minutes |
348 |
235 |
$6K |
| 96413 |
Chemotherapy administration, intravenous infusion; up to 1 hour, single or initial substance |
35 |
25 |
$5K |
| 84146 |
|
514 |
511 |
$5K |
| 72110 |
|
110 |
110 |
$5K |
| 82043 |
|
1,588 |
1,567 |
$5K |
| 84481 |
|
551 |
548 |
$5K |
| 82950 |
|
1,744 |
1,741 |
$5K |
| 87070 |
|
1,796 |
1,741 |
$5K |
| 82570 |
|
1,728 |
1,609 |
$4K |
| 93017 |
|
142 |
140 |
$4K |
| 86038 |
|
778 |
774 |
$4K |
| 85610 |
|
11,714 |
10,027 |
$4K |
| 87081 |
|
1,137 |
1,134 |
$4K |
| 86140 |
|
2,835 |
2,670 |
$4K |
| 73502 |
|
307 |
302 |
$4K |
| 76775 |
|
107 |
107 |
$4K |
| U0004 |
2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc, making use of high throughput technologies as described by cms-2020-01-r |
100 |
100 |
$4K |
| 99281 |
Emergency department visit for the evaluation and management, self-limited or minor |
66 |
64 |
$3K |
| 82670 |
|
196 |
194 |
$3K |
| 93971 |
|
55 |
54 |
$3K |
| 86787 |
|
1,949 |
1,945 |
$3K |
| 70486 |
|
102 |
102 |
$3K |
| 0241U |
Neonatal screening for hereditary disorders, genomic sequence analysis panel |
485 |
473 |
$3K |
| 86762 |
|
1,900 |
1,894 |
$3K |
| 76801 |
|
42 |
42 |
$2K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
318 |
292 |
$2K |
| 82565 |
|
372 |
352 |
$2K |
| 74022 |
|
912 |
894 |
$2K |
| 84403 |
|
171 |
169 |
$2K |
| 85652 |
|
2,121 |
2,044 |
$2K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
39 |
39 |
$2K |
| 83001 |
|
231 |
227 |
$2K |
| 83690 |
|
7,712 |
7,028 |
$2K |
| 81003 |
|
17,943 |
16,714 |
$2K |
| 86003 |
|
28 |
28 |
$2K |
| 82550 |
|
1,692 |
1,588 |
$2K |
| 77066 |
Tomosynthesis, mammo |
26 |
26 |
$2K |
| 83525 |
|
254 |
253 |
$2K |
| 82150 |
|
2,486 |
2,368 |
$2K |
| 93975 |
|
16 |
15 |
$2K |
| 73221 |
|
13 |
12 |
$2K |
| 76536 |
|
30 |
29 |
$1K |
| 0012A |
|
38 |
38 |
$1K |
| 97161 |
|
27 |
27 |
$1K |
| 85379 |
|
3,455 |
3,356 |
$1K |
| 73080 |
|
204 |
198 |
$1K |
| 87205 |
|
1,162 |
1,115 |
$1K |
| 77065 |
Tomosynthesis, mammo |
30 |
26 |
$1K |
| 0011A |
|
45 |
45 |
$1K |
| 87088 |
|
339 |
334 |
$1K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
54 |
54 |
$1K |
| 84550 |
|
707 |
618 |
$1K |
| 36591 |
|
125 |
66 |
$1K |
| 85730 |
|
8,306 |
7,849 |
$1K |
| 90833 |
Psychotherapy, 30 minutes with patient when performed with an E&M service (add-on) |
29 |
29 |
$1K |
| 86696 |
|
97 |
96 |
$1K |
| 81025 |
|
10,778 |
10,103 |
$1K |
| 71101 |
|
91 |
89 |
$983.24 |
| 72072 |
|
25 |
25 |
$969.52 |
| 83002 |
|
101 |
101 |
$961.79 |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
17 |
16 |
$919.53 |
| 82784 |
|
131 |
128 |
$864.03 |
| 92586 |
|
12 |
12 |
$853.35 |
| 83970 |
|
54 |
53 |
$785.43 |
| 90832 |
Psychotherapy, 30 minutes with patient |
24 |
14 |
$763.95 |
| 87507 |
|
26 |
26 |
$718.16 |
| 86431 |
|
289 |
289 |
$708.84 |
| 87502 |
Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets |
17 |
17 |
$701.85 |
| 86695 |
|
97 |
96 |
$700.52 |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
48 |
41 |
$599.00 |
| 87807 |
|
463 |
459 |
$585.13 |
| 83721 |
|
111 |
111 |
$578.10 |
| 73590 |
|
61 |
61 |
$543.75 |
| 84484 |
|
8,182 |
7,262 |
$538.53 |
| 73564 |
|
16 |
13 |
$533.08 |
| 84100 |
|
403 |
290 |
$508.89 |
| 72050 |
|
12 |
12 |
$475.82 |
| 87147 |
|
185 |
179 |
$410.08 |
| 84153 |
|
38 |
37 |
$393.95 |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
2,800 |
2,575 |
$388.58 |
| 86800 |
|
38 |
38 |
$367.15 |
| 82248 |
|
200 |
179 |
$350.55 |
| 82105 |
|
38 |
38 |
$344.27 |
| 86376 |
|
39 |
39 |
$336.53 |
| 84703 |
|
997 |
982 |
$296.42 |
| 87522 |
Neg quan hep c or qual rna |
12 |
12 |
$271.35 |
| 82947 |
|
104 |
104 |
$258.30 |
| 84156 |
|
199 |
173 |
$244.81 |
| 83615 |
|
228 |
187 |
$239.85 |
| 87040 |
|
1,140 |
1,100 |
$226.18 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
3,535 |
3,484 |
$214.82 |
| 86850 |
|
2,904 |
2,738 |
$183.23 |
| 96376 |
|
3,336 |
2,433 |
$151.30 |
| 84460 |
|
54 |
53 |
$134.08 |
| 83605 |
|
3,624 |
3,345 |
$100.81 |
| 86141 |
|
12 |
12 |
$94.86 |
| 80164 |
|
13 |
12 |
$90.18 |
| 85018 |
|
122 |
108 |
$79.19 |
| 86705 |
|
12 |
12 |
$75.29 |
| 82077 |
|
2,780 |
2,508 |
$70.77 |
| 36600 |
|
71 |
67 |
$66.58 |
| 90715 |
|
697 |
694 |
$61.63 |
| 73090 |
|
28 |
27 |
$49.10 |
| 84145 |
|
496 |
468 |
$48.09 |
| 86901 |
|
3,124 |
2,918 |
$42.85 |
| 84450 |
|
13 |
13 |
$31.52 |
| 85014 |
|
43 |
38 |
$27.30 |
| 80069 |
|
12 |
12 |
$24.44 |
| 84520 |
|
12 |
12 |
$22.69 |
| 80143 |
|
1,688 |
1,578 |
$21.80 |
| C9803 |
Hospital outpatient clinic visit specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source |
37 |
37 |
$14.23 |
| J0665 |
Injection, bupivicaine, not otherwise specified, 0.5 mg |
302 |
197 |
$10.67 |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
3,512 |
3,366 |
$9.00 |
| Q0245 |
Injection, bamlanivimab and etesevimab, 2100 mg |
51 |
45 |
$6.06 |
| 94760 |
|
598 |
556 |
$6.01 |
| J2272 |
Injection, morphine sulfate (fresenius kabi), not therapeutically equivalent to j2270, up to 10 mg |
27 |
26 |
$4.30 |
| J3475 |
Injection, magnesium sulfate, per 500 mg |
58 |
56 |
$2.29 |
| Q0247 |
Injection, sotrovimab, 500 mg |
24 |
24 |
$1.46 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
1,287 |
1,191 |
$0.77 |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
1,432 |
1,281 |
$0.00 |
| 94664 |
|
2,282 |
2,186 |
$0.00 |
| 80179 |
|
1,657 |
1,560 |
$0.00 |
| J0780 |
Injection, prochlorperazine, up to 10 mg |
168 |
152 |
$0.00 |
| J2930 |
Injection, methylprednisolone sodium succinate, up to 125 mg |
174 |
162 |
$0.00 |
| A9577 |
Injection, gadobenate dimeglumine (multihance), per ml |
138 |
137 |
$0.00 |
| J1756 |
Injection, iron sucrose, 1 mg |
32 |
12 |
$0.00 |
| J1200 |
Injection, diphenhydramine hcl, up to 50 mg |
686 |
606 |
$0.00 |
| C1751 |
Catheter, infusion, inserted peripherally, centrally or midline (other than hemodialysis) |
98 |
97 |
$0.00 |
| J1171 |
Injection, hydromorphone, 0.1 mg |
14 |
12 |
$0.00 |
| J2919 |
Injection, methylprednisolone sodium succinate, 5 mg |
117 |
100 |
$0.00 |
| L8613 |
Ossicula implant |
17 |
17 |
$0.00 |
| G1004 |
Clinical decision support mechanism national decision support company, as defined by the medicare appropriate use criteria program |
30 |
29 |
$0.00 |
| J1596 |
Injection, glycopyrrolate, 0.1 mg |
40 |
40 |
$0.00 |
| 82800 |
|
17 |
15 |
$0.00 |
| 82010 |
|
33 |
28 |
$0.00 |
| 0202U |
Oncology (prostate), multianalyte, gene expression profiling |
24 |
24 |
$0.00 |
| Q0244 |
Injection, casirivimab and imdevimab, 1200 mg |
19 |
19 |
$0.00 |
| J7050 |
Infusion, normal saline solution, 250 cc |
369 |
199 |
$0.00 |
| 82803 |
|
72 |
68 |
$0.00 |
| A9579 |
Injection, gadolinium-based magnetic resonance contrast agent, not otherwise specified (nos), per ml |
624 |
617 |
$0.00 |
| J2003 |
Injection, lidocaine hydrochloride, 1 mg |
97 |
95 |
$0.00 |
| J2360 |
Injection, orphenadrine citrate, up to 60 mg |
75 |
73 |
$0.00 |
| J1642 |
Injection, heparin sodium, (heparin lock flush), per 10 units |
182 |
90 |
$0.00 |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
404 |
387 |
$0.00 |
| J0690 |
Injection, cefazolin sodium, 500 mg |
183 |
167 |
$0.00 |
| A9270 |
Non-covered item or service |
73 |
68 |
$0.00 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
200 |
181 |
$0.00 |
| J1170 |
Injection, hydromorphone, up to 4 mg |
155 |
132 |
$0.00 |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
529 |
506 |
$0.00 |
| 12001 |
|
337 |
336 |
$0.00 |
| J2060 |
Injection, lorazepam, 2 mg |
184 |
164 |
$0.00 |
| J2175 |
Injection, meperidine hydrochloride, per 100 mg |
60 |
60 |
$0.00 |
| J2001 |
Injection, lidocaine hcl for intravenous infusion, 10 mg |
130 |
126 |
$0.00 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
719 |
679 |
$0.00 |
| J3480 |
Injection, potassium chloride, per 2 meq |
68 |
50 |
$0.00 |
| 91301 |
|
88 |
88 |
$0.00 |
| J2704 |
Injection, propofol, 10 mg |
595 |
585 |
$0.00 |
| J2765 |
Injection, metoclopramide hcl, up to 10 mg |
102 |
96 |
$0.00 |
| J3490 |
Unclassified drugs |
13 |
13 |
$0.00 |
| A9500 |
Technetium tc-99m sestamibi, diagnostic, per study dose |
13 |
13 |
$0.00 |
| 96368 |
|
13 |
12 |
$0.00 |