| Procedure | Description | Number Submitted | Medicare Payment |
| J2704
|
Inj, propofol, 10 mg
|
XXXXXXX
|
-
|
| J2795
|
Ropivacaine hcl injection
|
XXXXXX
|
-
|
| J0131
|
Inj, acetaminophen (nos)
|
XXXXXX
|
-
|
| J2001
|
Lidocaine injection
|
XXXXXX
|
-
|
| J3262
|
Tocilizumab injection
|
XXXXXX
|
$XXXXXX.XX
|
| J0878
|
Daptomycin injection
|
XXXXXX
|
-
|
| J3380
|
Injection, vedolizumab
|
XXXXX
|
$XXXXXXX.XX
|
| J0485
|
Belatacept injection
|
XXXXX
|
$XXXXXX.XX
|
| J1756
|
Iron sucrose injection
|
XXXXX
|
-
|
| J2405
|
Ondansetron hcl injection
|
XXXXX
|
-
|
| J1100
|
Dexamethasone sodium phos
|
XXXXX
|
-
|
| J3490
|
Drugs unclassified injection
|
XXXXX
|
-
|
| J7192
|
Factor viii recombinant nos
|
XXXXX
|
$XXXXX.XX
|
| J1569
|
Gammagard liquid injection
|
XXXXX
|
$XXXXXXX.XX
|
| J9176
|
Injection, elotuzumab, 1mg
|
XXXXX
|
$XXXXXX.XX
|
| J9144
|
Daratumumab, hyaluronidase
|
XXXXX
|
$XXXXXXX.XX
|
| J0690
|
Cefazolin sodium injection
|
XXXXX
|
-
|
| J0897
|
Denosumab injection
|
XXXXX
|
$XXXXXX.XX
|
| J1439
|
Inj ferric carboxymaltos 1mg
|
XXXXX
|
$XXXXX.XX
|
| J2250
|
Inj midazolam hydrochloride
|
XXXXX
|
-
|
| J7207
|
Factor viii pegylated recomb
|
XXXXX
|
$XXXXX.XX
|
| J3010
|
Fentanyl citrate injection
|
XXXXX
|
-
|
| J0881
|
Darbepoetin alfa, non-esrd
|
XXXXX
|
$XXXXX.XX
|
| J3111
|
Inj. romosozumab-aqqg 1 mg
|
XXXXX
|
$XXXXXX.XX
|
| J1745
|
Infliximab not biosimil 10mg
|
XXXXX
|
$XXXXXXX.XX
|
| J1644
|
Inj heparin sodium per 1000u
|
XXXXX
|
-
|
| J1442
|
Inj filgrastim excl biosimil
|
XXXXX
|
$XXXXX.XX
|
| J0330
|
Succinycholine chloride inj
|
XXXXX
|
-
|
| J1453
|
Fosaprepitant injection
|
XXXXX
|
$XXXX.XX
|
| J7187
|
Humate-p, inj
|
XXXXX
|
$XXXXX.XX
|
| J0171
|
Adrenalin epinephrine inject
|
XXXXX
|
-
|
