| Code | Description | Claims | Beneficiaries | Total Paid |
| 99285 |
|
3,766 |
3,456 |
$316K |
| 99284 |
|
5,259 |
5,033 |
$248K |
| 99283 |
|
7,655 |
7,261 |
$231K |
| 99214 |
|
17,834 |
17,218 |
$208K |
| 99213 |
|
68,341 |
64,568 |
$181K |
| 97110 |
|
8,095 |
2,459 |
$129K |
| 99215 |
Prolong outpt/office vis |
2,242 |
2,167 |
$129K |
| 99223 |
Prolong inpt eval add15 m |
665 |
617 |
$118K |
| 99204 |
|
1,089 |
1,079 |
$92K |
| 99291 |
|
534 |
335 |
$76K |
| 95810 |
|
158 |
158 |
$70K |
| 99203 |
|
1,751 |
1,738 |
$61K |
| 92507 |
|
1,706 |
483 |
$57K |
| 99222 |
|
273 |
267 |
$57K |
| 93306 |
|
420 |
411 |
$54K |
| 88305 |
|
1,315 |
1,244 |
$49K |
| 97530 |
|
1,793 |
493 |
$48K |
| 01967 |
|
123 |
123 |
$46K |
| 77067 |
|
739 |
739 |
$43K |
| 99211 |
|
11,137 |
9,495 |
$42K |
| T4541 |
Large disposable underpad |
1,781 |
1,771 |
$41K |
| 99233 |
Prolong inpt eval add15 m |
1,344 |
490 |
$35K |
| 87491 |
|
11,244 |
10,680 |
$34K |
| 70551 |
|
142 |
139 |
$32K |
| 72148 |
|
133 |
133 |
$30K |
| 76700 |
|
817 |
806 |
$30K |
| 76641 |
|
479 |
326 |
$28K |
| 99232 |
|
1,391 |
493 |
$27K |
| 92012 |
|
479 |
464 |
$26K |
| T4523 |
Adult size brief/diaper lg |
356 |
355 |
$24K |
| 74177 |
|
358 |
341 |
$24K |
| 70450 |
|
726 |
671 |
$23K |
| A6250 |
Skin seal protect moisturizr |
1,391 |
1,383 |
$23K |
| 74176 |
|
489 |
469 |
$22K |
| 70553 |
|
76 |
74 |
$22K |
| 73721 |
|
95 |
91 |
$22K |
| 71045 |
|
3,244 |
2,466 |
$22K |
| T4522 |
Adult size brief/diaper med |
415 |
413 |
$21K |
| 97112 |
|
4,348 |
1,191 |
$21K |
| 00731 |
|
215 |
211 |
$20K |
| 76830 |
|
455 |
441 |
$20K |
| S0199 |
Med abortion inc all ex drug |
39 |
39 |
$18K |
| 00790 |
|
66 |
66 |
$18K |
| 97001 |
|
448 |
431 |
$17K |
| 93010 |
|
2,084 |
1,823 |
$17K |
| 99212 |
|
7,253 |
6,590 |
$16K |
| 77066 |
Tomosynthesis, mammo |
138 |
138 |
$16K |
| T4530 |
Ped size brief/diaper lg |
296 |
291 |
$16K |
| 72141 |
|
60 |
60 |
$16K |
| 76856 |
|
464 |
458 |
$15K |
| 95117 |
|
1,148 |
358 |
$15K |
| T4535 |
Disposable liner/shield/pad |
670 |
657 |
$15K |
| 88307 |
|
146 |
146 |
$14K |
| 76805 |
|
360 |
350 |
$14K |
| 95811 |
|
101 |
101 |
$13K |
| 97140 |
|
7,374 |
2,188 |
$13K |
| 99244 |
|
265 |
262 |
$12K |
| 78452 |
|
40 |
40 |
$12K |
| 00170 |
|
78 |
76 |
$12K |
| 99202 |
|
266 |
258 |
$12K |
| A4335 |
Incontinence supply |
1,378 |
1,353 |
$11K |
| 00811 |
|
146 |
146 |
$10K |
| T4526 |
Adult size pull-on med |
201 |
201 |
$10K |
| 76815 |
|
425 |
370 |
$10K |
| 71046 |
|
1,152 |
1,117 |
$10K |
| 31231 |
|
50 |
49 |
$10K |
| A4322 |
Irrigation syringe |
414 |
411 |
$10K |
| 85025 |
|
22,663 |
20,944 |
$10K |
| 99201 |
|
80 |
80 |
$10K |
| 99243 |
|
273 |
270 |
$9K |
| 76813 |
|
163 |
163 |
$9K |
| T4534 |
Youth size pull-on |
232 |
230 |
$9K |
| A4267 |
Male condom |
447 |
435 |
$9K |
| 00840 |
|
44 |
44 |
$9K |
| 88304 |
|
278 |
277 |
$8K |
| 76770 |
|
159 |
157 |
$8K |
| T4524 |
Adult size brief/diaper xl |
124 |
124 |
$7K |
| 99282 |
|
331 |
307 |
$7K |
| 74178 |
|
28 |
28 |
$7K |
| 76801 |
|
160 |
150 |
$7K |
| 77065 |
Tomosynthesis, mammo |
60 |
60 |
$7K |
| A6402 |
Sterile gauze <= 16 sq in |
442 |
435 |
$7K |
| T4527 |
Adult size pull-on lg |
188 |
188 |
$7K |
| 85018 |
|
3,556 |
3,530 |
$7K |
| 76705 |
|
286 |
274 |
$6K |
| 80053 |
|
24,804 |
23,662 |
$6K |
| 71250 |
|
61 |
59 |
$6K |
| 99396 |
|
130 |
130 |
$6K |
| 99205 |
Prolong outpt/office vis |
60 |
59 |
$5K |
| 92134 |
|
193 |
181 |
$5K |
| 93351 |
|
16 |
16 |
$5K |
| 93970 |
|
97 |
94 |
$5K |
| 92250 |
|
501 |
498 |
$5K |
| 80048 |
|
2,374 |
2,009 |
$5K |
| T4521 |
Adult size brief/diaper sm |
66 |
64 |
$5K |
| 95144 |
|
60 |
60 |
$5K |
| 76536 |
|
109 |
109 |
$5K |
| 76817 |
|
108 |
100 |
$4K |
| 73221 |
|
13 |
12 |
$4K |
| 43239 |
|
235 |
235 |
$4K |
| A4927 |
Non-sterile gloves |
275 |
269 |
$4K |
| 81025 |
|
1,672 |
1,594 |
$4K |
| 95115 |
|
717 |
270 |
$3K |
| T4525 |
Adult size pull-on sm |
52 |
52 |
$3K |
| J3490 |
Drugs unclassified injection |
656 |
579 |
$3K |
| 72125 |
|
65 |
64 |
$3K |
| 92557 |
|
38 |
38 |
$3K |
| 93971 |
|
93 |
92 |
$3K |
| 95913 |
|
12 |
12 |
$3K |
| 71260 |
|
26 |
25 |
$3K |
| 92014 |
|
33 |
33 |
$3K |
| 95816 |
|
12 |
12 |
$3K |
| 80307 |
|
663 |
616 |
$3K |
| 99395 |
|
149 |
148 |
$2K |
| 99239 |
|
73 |
71 |
$2K |
| T4528 |
Adult size pull-on xl |
37 |
36 |
$2K |
| 72100 |
|
163 |
162 |
$2K |
| 93975 |
|
12 |
12 |
$2K |
| 90686 |
|
4,867 |
4,860 |
$2K |
| 99238 |
|
359 |
351 |
$2K |
| 87806 |
|
167 |
167 |
$2K |
| 82306 |
|
3,182 |
3,170 |
$2K |
| 73610 |
|
221 |
198 |
$2K |
| 73030 |
|
150 |
124 |
$2K |
| 99607 |
|
113 |
104 |
$2K |
| 73130 |
|
213 |
183 |
$2K |
| 83615 |
|
338 |
295 |
$2K |
| 83036 |
|
17,249 |
17,017 |
$2K |
| 99281 |
|
101 |
94 |
$2K |
| 81001 |
|
6,369 |
6,192 |
$2K |
| 99606 |
|
95 |
93 |
$2K |
| 73562 |
|
172 |
150 |
$1K |
| 74018 |
|
226 |
207 |
$1K |
| 73630 |
|
227 |
203 |
$1K |
| 87040 |
|
240 |
201 |
$1K |
| 96127 |
|
806 |
802 |
$1K |
| 93224 |
|
14 |
14 |
$1K |
| 93000 |
|
408 |
405 |
$1K |
| 77080 |
|
31 |
31 |
$1K |
| 73110 |
|
138 |
118 |
$1K |
| 70486 |
|
12 |
12 |
$1K |
| 97161 |
|
25 |
24 |
$963.31 |
| 81002 |
|
3,054 |
2,527 |
$956.88 |
| 71275 |
|
17 |
17 |
$951.49 |
| 80076 |
|
875 |
814 |
$925.52 |
| 94621 |
|
16 |
16 |
$896.49 |
| 86038 |
|
959 |
952 |
$881.32 |
| 76870 |
|
32 |
29 |
$859.86 |
| 72040 |
|
61 |
58 |
$822.40 |
| 99460 |
|
13 |
12 |
$770.00 |
| 88313 |
|
113 |
99 |
$759.71 |
| 99394 |
|
427 |
426 |
$678.50 |
| 87086 |
|
4,922 |
4,700 |
$672.72 |
| 94060 |
|
12 |
12 |
$655.75 |
| 90471 |
|
362 |
362 |
$622.19 |
| 86592 |
|
5,194 |
5,142 |
$619.81 |
| 12001 |
|
39 |
39 |
$618.82 |
| 17110 |
|
14 |
14 |
$598.68 |
| S4993 |
Contraceptive pills for bc |
80 |
80 |
$567.82 |
| 11721 |
|
135 |
134 |
$551.07 |
| 96110 |
|
39 |
38 |
$533.70 |
| 99392 |
|
1,566 |
1,562 |
$518.28 |
| 92523 |
|
12 |
12 |
$515.18 |
| 82728 |
|
1,065 |
962 |
$501.38 |
| 99393 |
|
1,551 |
1,551 |
$477.56 |
| 85007 |
|
107 |
66 |
$472.05 |
| 85027 |
|
2,382 |
2,251 |
$453.72 |
| 73090 |
|
94 |
84 |
$446.81 |
| 45380 |
|
25 |
25 |
$442.29 |
| 87088 |
|
3,023 |
2,930 |
$426.62 |
| 73590 |
|
84 |
76 |
$405.86 |
| 92226 |
|
13 |
13 |
$382.86 |
| 76642 |
|
19 |
15 |
$381.13 |
| 99391 |
|
119 |
119 |
$377.74 |
| 90734 |
|
159 |
158 |
$377.35 |
| 90746 |
|
13 |
13 |
$370.48 |
| 82607 |
|
1,202 |
1,194 |
$340.66 |
| 92552 |
|
106 |
106 |
$330.40 |
| 73080 |
|
73 |
63 |
$321.79 |
| Q0144 |
Azithromycin dihydrate, oral |
40 |
39 |
$307.32 |
| 73560 |
|
33 |
28 |
$297.30 |
| 85610 |
|
1,871 |
1,639 |
$294.11 |
| 84460 |
|
312 |
307 |
$286.62 |
| A4657 |
Syringe w/wo needle |
30 |
26 |
$278.22 |
| 94150 |
|
1,146 |
358 |
$271.89 |
| 86361 |
|
740 |
738 |
$263.08 |
| J3301 |
Triamcinolone acet inj nos |
12 |
12 |
$259.11 |
| 97032 |
|
1,711 |
528 |
$254.37 |
| 84481 |
|
271 |
268 |
$247.76 |
| 71010 |
|
112 |
52 |
$244.11 |
| 90698 |
|
45 |
45 |
$233.29 |
| A4245 |
Alcohol wipes per box |
120 |
119 |
$224.06 |
| 69210 |
|
96 |
95 |
$217.53 |
| 83540 |
|
961 |
945 |
$217.52 |
| 82947 |
|
162 |
161 |
$211.94 |
| 83605 |
|
76 |
61 |
$210.79 |
| 87536 |
|
787 |
780 |
$209.65 |
| 73140 |
|
100 |
96 |
$204.90 |
| 29125 |
|
26 |
24 |
$200.01 |
| 12011 |
|
30 |
30 |
$184.04 |
| 87070 |
|
1,131 |
1,084 |
$183.29 |
| 84100 |
|
567 |
422 |
$182.38 |
| 86803 |
|
2,434 |
2,429 |
$175.98 |
| 87624 |
|
2,419 |
2,407 |
$170.46 |
| 73564 |
|
29 |
28 |
$169.74 |
| 87340 |
|
688 |
685 |
$139.53 |
| 83970 |
|
171 |
163 |
$139.36 |
| 90834 |
|
301 |
141 |
$133.00 |
| 82962 |
|
530 |
468 |
$132.79 |
| 87077 |
|
1,084 |
1,043 |
$131.99 |
| 3077F |
|
2,514 |
2,415 |
$130.00 |
| 86901 |
|
85 |
81 |
$126.41 |
| A4450 |
Non-waterproof tape |
54 |
54 |
$125.47 |
| 87591 |
|
11,221 |
10,657 |
$124.48 |
| 92551 |
|
6,816 |
6,798 |
$121.22 |
| 87081 |
|
632 |
598 |
$120.23 |
| 73502 |
|
13 |
13 |
$119.64 |
| 71020 |
|
78 |
41 |
$116.08 |
| 83690 |
|
808 |
754 |
$115.07 |
| 85730 |
|
1,417 |
1,359 |
$112.28 |
| 83550 |
|
888 |
873 |
$110.66 |
| 82120 |
|
30 |
29 |
$102.31 |
| 84480 |
|
303 |
299 |
$94.94 |
| 86706 |
|
1,051 |
1,050 |
$93.15 |
| 80061 |
|
17,930 |
17,844 |
$90.14 |
| 81003 |
|
990 |
961 |
$87.16 |
| 83735 |
|
764 |
587 |
$86.28 |
| 90744 |
|
34 |
34 |
$83.56 |
| 80081 |
|
535 |
533 |
$81.58 |
| 1126F |
|
70,818 |
66,789 |
$77.26 |
| 92133 |
|
18 |
18 |
$71.58 |
| 80305 |
|
868 |
858 |
$71.40 |
| 88312 |
|
60 |
47 |
$69.76 |
| 86704 |
|
157 |
156 |
$68.88 |
| 84703 |
|
195 |
189 |
$68.40 |
| 96372 |
|
25 |
25 |
$68.06 |
| 87210 |
|
493 |
484 |
$66.75 |
| 88141 |
|
381 |
381 |
$63.89 |
| 84484 |
|
404 |
341 |
$62.61 |
| 84153 |
|
830 |
827 |
$60.60 |
| 92015 |
|
160 |
160 |
$59.48 |
| 90710 |
|
30 |
30 |
$56.04 |
| 87205 |
|
107 |
97 |
$54.19 |
| 92060 |
|
28 |
28 |
$51.77 |
| 82570 |
|
5,012 |
4,925 |
$49.01 |
| 83880 |
|
93 |
79 |
$47.98 |
| 82652 |
|
142 |
142 |
$47.94 |
| 97003 |
|
17 |
17 |
$44.46 |
| 81000 |
|
313 |
294 |
$42.72 |
| 36415 |
|
20,600 |
19,669 |
$42.65 |
| 97014 |
|
982 |
430 |
$40.00 |
| 3008F |
|
5,535 |
5,446 |
$37.50 |
| 84443 |
|
13,781 |
13,641 |
$34.34 |
| 99000 |
|
170 |
167 |
$33.48 |
| 87880 |
|
812 |
795 |
$32.87 |
| 87186 |
|
1,116 |
1,064 |
$32.69 |
| 84156 |
|
283 |
276 |
$31.27 |
| 99497 |
|
20 |
20 |
$30.00 |
| 88142 |
|
87 |
87 |
$28.84 |
| 88342 |
|
331 |
325 |
$27.49 |
| 87045 |
|
100 |
99 |
$26.83 |
| 83986 |
|
56 |
55 |
$25.81 |
| 87522 |
Neg quan hep c or qual rna |
195 |
190 |
$24.95 |
| 87177 |
|
63 |
63 |
$24.23 |
| 88175 |
|
3,210 |
3,189 |
$23.50 |
| 84450 |
|
263 |
257 |
$23.36 |
| 86140 |
|
1,229 |
1,143 |
$23.36 |
| 82378 |
|
168 |
161 |
$23.01 |
| 86780 |
|
276 |
272 |
$22.80 |
| 85045 |
|
160 |
155 |
$20.48 |
| 86039 |
|
223 |
221 |
$20.28 |
| 87147 |
|
494 |
487 |
$19.30 |
| 84702 |
|
724 |
625 |
$17.76 |
| 86880 |
|
15 |
15 |
$17.31 |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
128 |
127 |
$14.00 |
| 90677 |
|
38 |
38 |
$13.38 |
| 90472 |
|
12 |
12 |
$11.05 |
| 83655 |
|
400 |
393 |
$10.63 |
| 85014 |
|
29 |
29 |
$9.71 |
| 80074 |
|
1,337 |
1,334 |
$8.36 |
| 82247 |
|
14 |
12 |
$8.17 |
| 86900 |
|
34 |
32 |
$6.95 |
| 82565 |
|
48 |
41 |
$6.33 |
| 84550 |
|
830 |
825 |
$6.16 |
| 82550 |
|
311 |
300 |
$5.80 |
| 81015 |
|
134 |
132 |
$5.80 |
| 85652 |
|
1,377 |
1,340 |
$5.34 |
| 82043 |
|
4,707 |
4,653 |
$5.08 |
| 87400 |
|
13 |
12 |
$2.32 |
| 84165 |
|
49 |
49 |
$1.92 |
| 84436 |
|
653 |
650 |
$1.21 |
| 84479 |
|
469 |
467 |
$1.14 |
| 82248 |
|
806 |
755 |
$0.88 |
| 86593 |
|
225 |
219 |
$0.80 |
| 1158F |
|
28,621 |
27,377 |
$0.00 |
| 1160F |
|
37,737 |
35,463 |
$0.00 |
| 99173 |
|
7,164 |
7,143 |
$0.00 |
| 3078F |
|
57,541 |
54,372 |
$0.00 |
| 82274 |
|
2,351 |
2,335 |
$0.00 |
| 0575F |
|
5,442 |
5,416 |
$0.00 |
| J8499 |
Oral prescrip drug non chemo |
761 |
648 |
$0.00 |
| 84439 |
|
2,871 |
2,847 |
$0.00 |
| 86708 |
|
706 |
706 |
$0.00 |
| J7610 |
Albuterol comp con |
611 |
462 |
$0.00 |
| 99334 |
|
438 |
343 |
$0.00 |
| 87338 |
|
411 |
410 |
$0.00 |
| 84403 |
|
463 |
462 |
$0.00 |
| 76942 |
|
26 |
25 |
$0.00 |
| 86431 |
|
702 |
698 |
$0.00 |
| 82785 |
|
304 |
302 |
$0.00 |
| 86480 |
|
450 |
445 |
$0.00 |
| 99199 |
|
273 |
250 |
$0.00 |
| 90648 |
|
14 |
14 |
$0.00 |
| 90670 |
|
218 |
215 |
$0.00 |
| 85378 |
|
16 |
14 |
$0.00 |
| J1200 |
Diphenhydramine hcl injectio |
14 |
13 |
$0.00 |
| 90460 |
|
378 |
375 |
$0.00 |
| 1159F |
|
164 |
157 |
$0.00 |
| 83516 |
|
84 |
75 |
$0.00 |
| 86003 |
|
366 |
364 |
$0.00 |
| 86200 |
|
221 |
220 |
$0.00 |
| 87427 |
|
96 |
95 |
$0.00 |
| 87075 |
|
52 |
49 |
$0.00 |
| 99358 |
Prolong nursin fac eval 15m |
98 |
97 |
$0.00 |
| 76775 |
|
13 |
12 |
$0.00 |
| B9002 |
Enter nutr inf pump any type |
170 |
170 |
$0.00 |
| E0601 |
Cont airway pressure device |
80 |
79 |
$0.00 |
| 87209 |
|
63 |
63 |
$0.00 |
| 84146 |
|
376 |
371 |
$0.00 |
| 82272 |
|
202 |
199 |
$0.00 |
| 83013 |
|
84 |
83 |
$0.00 |
| B4035 |
Enteral feed supp pump per d |
26 |
26 |
$0.00 |
| 82977 |
|
54 |
54 |
$0.00 |
| 90715 |
|
83 |
83 |
$0.00 |
| 81220 |
|
195 |
195 |
$0.00 |
| H1003 |
Prenatal at risk education |
225 |
148 |
$0.00 |
| 86765 |
|
31 |
31 |
$0.00 |
| 99401 |
|
106 |
79 |
$0.00 |
| 97116 |
|
690 |
205 |
$0.00 |
| 0001M |
|
12 |
12 |
$0.00 |
| 87804 |
|
35 |
35 |
$0.00 |
| 86705 |
|
13 |
13 |
$0.00 |
| J0135 |
Adalimumab injection |
12 |
12 |
$0.00 |
| 86735 |
|
31 |
31 |
$0.00 |
| 86787 |
|
39 |
39 |
$0.00 |
| 90633 |
|
79 |
77 |
$0.00 |
| E1390 |
Oxygen concentrator |
195 |
191 |
$0.00 |
| 90700 |
|
14 |
14 |
$0.00 |
| 86235 |
|
527 |
526 |
$0.00 |
| 92504 |
|
16 |
16 |
$0.00 |
| 86696 |
|
138 |
137 |
$0.00 |
| 99242 |
|
30 |
30 |
$0.00 |
| 90713 |
|
12 |
12 |
$0.00 |
| 90685 |
|
29 |
29 |
$0.00 |
| 74000 |
|
23 |
14 |
$0.00 |
| 90461 |
|
183 |
182 |
$0.00 |
| 92550 |
|
12 |
12 |
$0.00 |
| 87799 |
|
159 |
58 |
$0.00 |
| 3045F |
|
52 |
52 |
$0.00 |
| 96413 |
|
12 |
12 |
$0.00 |
| 2028F |
|
41 |
41 |
$0.00 |
| 87512 |
|
38 |
38 |
$0.00 |
| J7699 |
Inhalation solution for dme |
14 |
13 |
$0.00 |
| 92083 |
|
16 |
16 |
$0.00 |
| 0502F |
|
91 |
59 |
$0.00 |
| 84681 |
|
13 |
13 |
$0.00 |
| 99152 |
|
38 |
38 |
$0.00 |
| 67028 |
|
12 |
12 |
$0.00 |
| 93015 |
|
15 |
15 |
$0.00 |
| 99336 |
|
13 |
13 |
$0.00 |
| 1033F |
|
130 |
120 |
$0.00 |
| G8427 |
Docrev cur meds by elig clin |
12 |
12 |
$0.00 |
| 93325 |
|
17 |
17 |
$0.00 |
| 99051 |
|
16 |
14 |
$0.00 |
| 11056 |
|
12 |
12 |
$0.00 |
| G8417 |
Calc bmi abv up param f/u |
40 |
40 |
$0.00 |
| 2024F |
|
19 |
13 |
$0.00 |
| 1125F |
|
12,063 |
11,747 |
$0.00 |
| 3351F |
|
72,448 |
62,934 |
$0.00 |
| G8510 |
Scr dep neg, no plan reqd |
23,062 |
20,641 |
$0.00 |
| 36416 |
|
3,353 |
3,287 |
$0.00 |
| 3079F |
|
9,489 |
9,186 |
$0.00 |
| 81508 |
|
5,073 |
5,056 |
$0.00 |
| 3075F |
|
4,610 |
4,505 |
$0.00 |
| 3074F |
|
57,294 |
54,040 |
$0.00 |
| 86701 |
|
2,839 |
2,832 |
$0.00 |
| G0447 |
Behavior counsel obesity 15m |
37,088 |
27,569 |
$0.00 |
| 82270 |
|
189 |
187 |
$0.00 |
| 84402 |
|
197 |
196 |
$0.00 |
| 82746 |
|
955 |
951 |
$0.00 |
| 87389 |
|
7,812 |
7,783 |
$0.00 |
| 86702 |
|
2,840 |
2,833 |
$0.00 |
| 83002 |
|
342 |
341 |
$0.00 |
| 82951 |
|
143 |
143 |
$0.00 |
| 87661 |
|
1,040 |
1,034 |
$0.00 |
| 0501F |
|
3,247 |
2,345 |
$0.00 |
| J3010 |
Fentanyl citrate injection |
26 |
26 |
$0.00 |
| G9226 |
3 comp foot exam completed |
1,184 |
1,128 |
$0.00 |
| 86255 |
|
397 |
337 |
$0.00 |
| J1885 |
Ketorolac tromethamine inj |
43 |
39 |
$0.00 |
| 87625 |
|
510 |
508 |
$0.00 |
| B4150 |
Ef complet w/intact nutrient |
13 |
12 |
$0.00 |
| 99335 |
|
250 |
235 |
$0.00 |
| 82271 |
|
202 |
199 |
$0.00 |
| D0150 |
|
12 |
12 |
$0.00 |
| 95886 |
|
16 |
16 |
$0.00 |
| 86376 |
|
166 |
165 |
$0.00 |
| 82950 |
|
835 |
833 |
$0.00 |
| 84144 |
|
14 |
14 |
$0.00 |
| 3353F |
|
14 |
13 |
$0.00 |
| A9500 |
Tc99m sestamibi |
15 |
15 |
$0.00 |
| E0776 |
Iv pole |
153 |
153 |
$0.00 |
| J7644 |
Ipratropium bromide non-comp |
77 |
59 |
$0.00 |
| A9579 |
Gad-base mr contrast nos,1ml |
62 |
61 |
$0.00 |
| 82150 |
|
148 |
144 |
$0.00 |
| 82670 |
|
202 |
201 |
$0.00 |
| 86762 |
|
52 |
52 |
$0.00 |
| 83001 |
|
414 |
413 |
$0.00 |
| 90651 |
|
464 |
463 |
$0.00 |
| 87046 |
|
95 |
94 |
$0.00 |
| 86225 |
|
226 |
224 |
$0.00 |
| 94640 |
|
246 |
227 |
$0.00 |
| 1000F |
|
35 |
33 |
$0.00 |
| E0562 |
Humidifier heated used w pap |
158 |
156 |
$0.00 |
| G0480 |
Drug test def 1-7 classes |
109 |
109 |
$0.00 |
| G0328 |
Fecal blood scrn immunoassay |
201 |
197 |
$0.00 |
| 84154 |
|
66 |
66 |
$0.00 |
| 86800 |
|
91 |
90 |
$0.00 |
| B9998 |
Enteral supp not otherwise c |
99 |
85 |
$0.00 |
| 87801 |
|
38 |
38 |
$0.00 |
| 97035 |
|
92 |
39 |
$0.00 |
| B4160 |
Ef ped caloric dense>/=0.7kc |
234 |
216 |
$0.00 |
| 86695 |
|
134 |
133 |
$0.00 |
| H0049 |
Alcohol/drug screening |
128 |
128 |
$0.00 |
| J2250 |
Inj midazolam hydrochloride |
26 |
26 |
$0.00 |
| 96415 |
|
12 |
12 |
$0.00 |
| 1036F |
|
209 |
196 |
$0.00 |
| 86160 |
|
172 |
167 |
$0.00 |
| E0431 |
Portable gaseous 02 |
95 |
95 |
$0.00 |
| 3352F |
|
31 |
25 |
$0.00 |
| 1031F |
|
118 |
108 |
$0.00 |
| 86317 |
|
17 |
17 |
$0.00 |
| 88341 |
|
25 |
25 |
$0.00 |
| 90688 |
|
26 |
26 |
$0.00 |
| 82105 |
|
65 |
65 |
$0.00 |
| 3080F |
|
26 |
26 |
$0.00 |
| J2785 |
Regadenoson injection |
15 |
15 |
$0.00 |
| 3072F |
|
20 |
20 |
$0.00 |
| 94760 |
|
43 |
43 |
$0.00 |
| 92567 |
|
12 |
12 |
$0.00 |
| J1100 |
Dexamethasone sodium phos |
131 |
96 |
$0.00 |
| 88311 |
|
12 |
12 |
$0.00 |
| K0001 |
Standard wheelchair |
25 |
25 |
$0.00 |
| 86850 |
|
15 |
13 |
$0.00 |
| 3044F |
|
13 |
12 |
$0.00 |
| 83520 |
|
15 |
15 |
$0.00 |
| 86304 |
|
27 |
27 |
$0.00 |
| 82784 |
|
31 |
31 |
$0.00 |
| B4088 |
Gastro/jejuno tube, low-pro |
13 |
13 |
$0.00 |
| 82952 |
|
58 |
58 |
$0.00 |
| G9637 |
Doc >1 dose reduc tech |
22 |
15 |
$0.00 |
| 96375 |
|
12 |
12 |
$0.00 |
| 93320 |
|
17 |
17 |
$0.00 |