| Code | Description | Claims | Beneficiaries | Total Paid |
| 99284 |
|
52,999 |
48,015 |
$9.31M |
| 99283 |
|
45,800 |
41,871 |
$4.68M |
| 99285 |
|
17,524 |
15,687 |
$4.47M |
| 99213 |
|
137,055 |
116,777 |
$4.47M |
| 99214 |
|
65,402 |
58,465 |
$3.13M |
| 99212 |
|
78,737 |
68,627 |
$2.21M |
| J9271 |
Inj pembrolizumab |
595 |
406 |
$1.87M |
| 96372 |
|
59,386 |
47,317 |
$1.82M |
| 99215 |
Prolong outpt/office vis |
35,594 |
31,966 |
$1.63M |
| 93306 |
|
4,773 |
4,406 |
$1.38M |
| 87635 |
|
32,966 |
29,451 |
$1.34M |
| 99282 |
|
22,235 |
20,399 |
$1.28M |
| 96413 |
|
9,358 |
5,497 |
$1.22M |
| 80053 |
|
120,187 |
96,467 |
$880K |
| 96374 |
|
15,264 |
12,525 |
$741K |
| 80307 |
|
15,489 |
13,270 |
$683K |
| 87491 |
|
22,947 |
19,607 |
$662K |
| 87591 |
|
22,981 |
19,606 |
$657K |
| 71045 |
|
11,594 |
10,410 |
$631K |
| 85025 |
|
112,803 |
91,146 |
$597K |
| 74177 |
|
1,931 |
1,701 |
$586K |
| 87502 |
|
7,252 |
6,564 |
$572K |
| 59025 |
|
6,177 |
4,724 |
$502K |
| 96375 |
|
14,121 |
10,166 |
$477K |
| 76819 |
|
6,496 |
3,285 |
$420K |
| 93005 |
|
26,727 |
23,219 |
$409K |
| 70450 |
|
3,951 |
3,567 |
$387K |
| 71046 |
|
7,841 |
7,142 |
$372K |
| 76805 |
|
4,931 |
4,199 |
$366K |
| 36415 |
|
153,723 |
122,736 |
$322K |
| U0003 |
Cov-19 amp prb hgh thruput |
3,366 |
2,776 |
$256K |
| 77067 |
|
3,653 |
3,361 |
$252K |
| G0480 |
Drug test def 1-7 classes |
5,817 |
4,695 |
$244K |
| 99281 |
|
4,435 |
4,067 |
$239K |
| 45378 |
|
737 |
647 |
$239K |
| G0378 |
Hospital observation per hr |
1,105 |
438 |
$228K |
| 87389 |
|
12,794 |
10,803 |
$228K |
| 99211 |
|
8,923 |
6,980 |
$219K |
| 96361 |
|
10,108 |
7,582 |
$212K |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
4,663 |
4,111 |
$199K |
| 96365 |
|
2,735 |
2,209 |
$192K |
| 80050 |
|
5,360 |
4,705 |
$191K |
| 81025 |
|
29,518 |
26,373 |
$182K |
| 87661 |
|
6,985 |
5,649 |
$181K |
| 76816 |
|
2,908 |
2,468 |
$178K |
| 76817 |
|
2,387 |
1,943 |
$174K |
| 80061 |
|
17,520 |
15,836 |
$170K |
| 87651 |
|
5,373 |
4,956 |
$161K |
| M0243 |
Casirivi and imdevi inj |
705 |
433 |
$160K |
| J2469 |
Palonosetron hcl |
2,376 |
1,398 |
$155K |
| 83880 |
|
5,488 |
4,955 |
$136K |
| 87804 |
|
9,591 |
4,878 |
$131K |
| 83036 |
|
19,162 |
17,159 |
$130K |
| 67028 |
|
840 |
580 |
$129K |
| 20610 |
|
1,084 |
806 |
$113K |
| 43239 |
|
392 |
362 |
$111K |
| 87624 |
|
3,794 |
3,246 |
$99K |
| 88175 |
|
5,092 |
4,382 |
$98K |
| 92250 |
|
3,798 |
3,390 |
$97K |
| 96367 |
|
3,521 |
2,075 |
$93K |
| J9202 |
Goserelin acetate implant |
184 |
157 |
$90K |
| 84484 |
|
11,159 |
8,482 |
$83K |
| 87086 |
|
12,725 |
10,519 |
$82K |
| 80074 |
|
2,540 |
2,010 |
$75K |
| 76815 |
|
1,223 |
1,011 |
$73K |
| 81002 |
|
25,778 |
19,257 |
$73K |
| 92083 |
|
2,430 |
2,209 |
$67K |
| 84443 |
|
5,491 |
4,793 |
$64K |
| 86703 |
|
6,534 |
5,678 |
$64K |
| 92133 |
|
2,603 |
2,346 |
$61K |
| 87536 |
|
1,294 |
1,120 |
$61K |
| 96360 |
|
1,273 |
989 |
$60K |
| 81000 |
|
21,381 |
18,592 |
$58K |
| 87430 |
|
4,170 |
3,960 |
$58K |
| 87880 |
|
4,671 |
3,962 |
$57K |
| 94640 |
|
995 |
885 |
$55K |
| 73110 |
|
787 |
618 |
$55K |
| 87634 |
|
885 |
823 |
$54K |
| J0185 |
Inj., aprepitant, 1 mg |
356 |
191 |
$50K |
| 92134 |
|
1,901 |
1,672 |
$49K |
| 73564 |
|
906 |
708 |
$49K |
| 81003 |
|
26,437 |
20,836 |
$49K |
| J7030 |
Normal saline solution infus |
5,796 |
4,534 |
$48K |
| J1885 |
Ketorolac tromethamine inj |
21,974 |
19,428 |
$46K |
| 97110 |
|
2,667 |
898 |
$45K |
| 86803 |
|
4,457 |
3,805 |
$44K |
| 78452 |
|
103 |
92 |
$42K |
| 83690 |
|
7,852 |
7,118 |
$41K |
| 73610 |
|
634 |
529 |
$40K |
| 76856 |
|
444 |
410 |
$39K |
| 80055 |
|
2,263 |
1,785 |
$39K |
| 73130 |
|
572 |
454 |
$38K |
| 74176 |
|
147 |
136 |
$38K |
| 45385 |
|
274 |
232 |
$38K |
| 45380 |
|
152 |
137 |
$37K |
| 87070 |
|
3,967 |
3,743 |
$34K |
| 87400 |
|
5,154 |
2,096 |
$34K |
| 82306 |
|
1,794 |
1,479 |
$34K |
| 77063 |
|
2,713 |
2,482 |
$34K |
| 74019 |
|
564 |
536 |
$34K |
| 90686 |
|
5,071 |
4,345 |
$30K |
| 87811 |
|
720 |
704 |
$28K |
| 96401 |
|
454 |
189 |
$28K |
| J2505 |
Injection, pegfilgrastim 6mg |
36 |
12 |
$28K |
| 73562 |
|
394 |
337 |
$27K |
| 96417 |
|
623 |
394 |
$26K |
| 0002A |
|
760 |
639 |
$25K |
| 87210 |
|
5,486 |
4,970 |
$25K |
| J1050 |
Medroxyprogesterone acetate |
804 |
724 |
$24K |
| 87081 |
|
4,324 |
3,784 |
$24K |
| J3301 |
Triamcinolone acet inj nos |
3,812 |
3,534 |
$23K |
| 0001A |
|
684 |
625 |
$23K |
| 90715 |
|
1,288 |
1,081 |
$22K |
| 66984 |
|
62 |
51 |
$22K |
| 94761 |
|
9,039 |
6,765 |
$21K |
| 96402 |
|
720 |
622 |
$21K |
| 99203 |
|
653 |
590 |
$20K |
| 81001 |
|
8,191 |
7,215 |
$20K |
| 86593 |
|
6,020 |
4,646 |
$20K |
| 83735 |
|
4,352 |
3,866 |
$20K |
| 88142 |
|
1,497 |
1,396 |
$19K |
| J0696 |
Ceftriaxone sodium injection |
6,675 |
6,136 |
$18K |
| 86592 |
|
5,171 |
4,532 |
$18K |
| 97530 |
|
1,117 |
341 |
$18K |
| 93010 |
|
2,970 |
2,396 |
$17K |
| 99202 |
|
636 |
615 |
$17K |
| 88184 |
|
847 |
733 |
$17K |
| 82728 |
|
1,797 |
1,458 |
$16K |
| 73030 |
|
261 |
230 |
$16K |
| 87807 |
|
1,261 |
1,070 |
$16K |
| 80143 |
|
1,553 |
1,264 |
$16K |
| J1100 |
Dexamethasone sodium phos |
10,408 |
7,987 |
$16K |
| 86850 |
|
3,775 |
2,963 |
$14K |
| J1756 |
Iron sucrose injection |
255 |
106 |
$14K |
| 85027 |
|
2,939 |
2,172 |
$13K |
| 71260 |
|
92 |
85 |
$13K |
| 93017 |
|
102 |
92 |
$13K |
| 88305 |
|
2,518 |
1,772 |
$13K |
| 83605 |
|
1,552 |
1,293 |
$12K |
| 82607 |
|
1,055 |
923 |
$12K |
| J0702 |
Betamethasone acet&sod phosp |
1,522 |
1,416 |
$12K |
| 86140 |
|
3,546 |
3,145 |
$12K |
| 86762 |
|
1,161 |
856 |
$11K |
| J2405 |
Ondansetron hcl injection |
10,555 |
8,510 |
$11K |
| J3489 |
Zoledronic acid 1mg |
107 |
92 |
$11K |
| 87340 |
|
1,491 |
1,170 |
$11K |
| 83655 |
|
895 |
859 |
$11K |
| J7297 |
Liletta, 52 mg |
13 |
13 |
$11K |
| 72125 |
|
74 |
65 |
$11K |
| 82746 |
|
969 |
843 |
$11K |
| 80320 |
|
1,159 |
941 |
$10K |
| 94729 |
|
146 |
136 |
$10K |
| 85610 |
|
3,829 |
3,225 |
$9K |
| 92020 |
|
376 |
341 |
$9K |
| 76801 |
|
151 |
115 |
$9K |
| 82950 |
|
2,241 |
1,995 |
$9K |
| 94060 |
|
166 |
139 |
$9K |
| 94727 |
|
166 |
153 |
$9K |
| 86038 |
|
845 |
753 |
$8K |
| 86900 |
|
4,277 |
3,404 |
$8K |
| 83550 |
|
1,426 |
1,150 |
$8K |
| 86200 |
|
769 |
686 |
$8K |
| J2785 |
Regadenoson injection |
79 |
75 |
$8K |
| 82550 |
|
1,584 |
1,329 |
$8K |
| 83615 |
|
1,887 |
1,483 |
$8K |
| 84702 |
|
611 |
534 |
$8K |
| 86901 |
|
4,290 |
3,419 |
$8K |
| J0897 |
Denosumab injection |
36 |
26 |
$8K |
| 87040 |
|
1,067 |
522 |
$7K |
| 99391 |
|
365 |
319 |
$7K |
| J1453 |
Fosaprepitant injection |
33 |
24 |
$7K |
| 82570 |
|
1,859 |
1,632 |
$7K |
| J7120 |
Ringers lactate infusion |
2,437 |
2,053 |
$6K |
| J1642 |
Inj heparin sodium per 10 u |
4,363 |
2,731 |
$6K |
| 83540 |
|
1,505 |
1,219 |
$6K |
| 92012 |
|
140 |
124 |
$6K |
| 94664 |
|
102 |
96 |
$6K |
| 85660 |
|
1,298 |
1,072 |
$6K |
| 0004A |
|
160 |
140 |
$6K |
| 80048 |
|
963 |
769 |
$6K |
| 82043 |
|
1,373 |
1,245 |
$6K |
| 83021 |
|
489 |
288 |
$5K |
| J1030 |
Methylprednisolone 40 mg inj |
406 |
383 |
$5K |
| 82962 |
|
1,887 |
1,540 |
$5K |
| 86361 |
|
294 |
264 |
$5K |
| U0005 |
Infec agen detec ampli probe |
351 |
257 |
$5K |
| 93246 |
|
132 |
129 |
$5K |
| 92507 |
|
228 |
90 |
$4K |
| 11721 |
|
344 |
297 |
$4K |
| 73721 |
|
19 |
19 |
$4K |
| 57454 |
|
16 |
13 |
$4K |
| 96161 |
|
293 |
269 |
$4K |
| J2930 |
Methylprednisolone injection |
795 |
702 |
$4K |
| 83020 |
|
727 |
288 |
$4K |
| 72100 |
|
83 |
75 |
$4K |
| 84439 |
|
644 |
539 |
$4K |
| 76818 |
|
48 |
38 |
$4K |
| 88720 |
|
1,194 |
1,049 |
$4K |
| 86431 |
|
865 |
765 |
$4K |
| A9502 |
Tc99m tetrofosmin |
102 |
92 |
$4K |
| 76811 |
|
21 |
12 |
$4K |
| 20611 |
|
19 |
13 |
$4K |
| 82784 |
|
552 |
234 |
$4K |
| J1200 |
Diphenhydramine hcl injectio |
2,096 |
1,580 |
$4K |
| 11719 |
|
275 |
238 |
$4K |
| 99204 |
|
87 |
80 |
$4K |
| 0071A |
|
102 |
83 |
$3K |
| 85007 |
|
1,700 |
1,139 |
$3K |
| J9263 |
Oxaliplatin |
44 |
24 |
$3K |
| 0072A |
|
90 |
67 |
$3K |
| J0561 |
Penicillin g benzathine inj |
31 |
26 |
$3K |
| 84156 |
|
1,112 |
753 |
$3K |
| 85045 |
|
1,160 |
942 |
$3K |
| 94760 |
|
2,702 |
2,209 |
$3K |
| 96415 |
|
104 |
66 |
$3K |
| 80081 |
|
49 |
43 |
$3K |
| 84550 |
|
743 |
583 |
$3K |
| 73630 |
|
56 |
50 |
$3K |
| J1170 |
Hydromorphone injection |
2,196 |
1,530 |
$3K |
| 11056 |
|
111 |
98 |
$3K |
| 96409 |
|
22 |
12 |
$3K |
| 76830 |
|
33 |
33 |
$2K |
| 71270 |
|
14 |
12 |
$2K |
| J2704 |
Inj, propofol, 10 mg |
7,035 |
5,634 |
$2K |
| J7050 |
Normal saline solution infus |
506 |
232 |
$2K |
| 90471 |
|
285 |
224 |
$2K |
| 82378 |
|
212 |
163 |
$2K |
| 86235 |
|
324 |
78 |
$2K |
| 90656 |
|
369 |
255 |
$2K |
| 85651 |
|
848 |
755 |
$2K |
| J0131 |
Inj, acetaminophen (nos) |
1,335 |
1,146 |
$2K |
| J2270 |
Morphine sulfate injection |
1,084 |
919 |
$2K |
| U0002 |
Covid-19 lab test non-cdc |
51 |
46 |
$2K |
| 0064A |
|
81 |
59 |
$2K |
| 96376 |
|
87 |
73 |
$2K |
| 85018 |
|
753 |
721 |
$2K |
| J9206 |
Irinotecan injection |
66 |
38 |
$2K |
| 99392 |
|
75 |
66 |
$2K |
| J0780 |
Prochlorperazine injection |
271 |
239 |
$2K |
| 90732 |
|
29 |
26 |
$2K |
| C1713 |
Anchor/screw bn/bn,tis/bn |
31 |
25 |
$2K |
| 85652 |
|
1,304 |
1,137 |
$2K |
| 82105 |
|
110 |
98 |
$2K |
| 90677 |
|
37 |
14 |
$2K |
| 93922 |
|
32 |
27 |
$2K |
| C1760 |
Closure dev, vasc |
12 |
12 |
$1K |
| 97164 |
|
60 |
53 |
$1K |
| 86039 |
|
139 |
126 |
$1K |
| 76511 |
|
12 |
12 |
$1K |
| 86704 |
|
131 |
106 |
$1K |
| 96523 |
|
112 |
94 |
$1K |
| 85379 |
|
173 |
145 |
$1K |
| 84153 |
|
111 |
90 |
$1K |
| 84165 |
|
212 |
183 |
$1K |
| 0003A |
|
40 |
31 |
$1K |
| J3490 |
Drugs unclassified injection |
607 |
350 |
$1K |
| J0690 |
Cefazolin sodium injection |
1,730 |
1,155 |
$971.05 |
| 94618 |
|
18 |
15 |
$951.39 |
| J9045 |
Carboplatin injection |
31 |
24 |
$930.91 |
| 82553 |
|
110 |
105 |
$913.57 |
| 90472 |
|
92 |
57 |
$858.22 |
| 83521 |
|
115 |
39 |
$820.37 |
| 74018 |
|
13 |
13 |
$779.94 |
| 86706 |
|
119 |
46 |
$770.52 |
| 85730 |
|
364 |
296 |
$754.05 |
| 92132 |
|
13 |
12 |
$739.30 |
| 99238 |
|
17 |
12 |
$736.58 |
| 99464 |
|
14 |
12 |
$730.80 |
| 86225 |
|
76 |
65 |
$728.22 |
| 84100 |
|
215 |
163 |
$712.26 |
| Q0162 |
Ondansetron oral |
1,284 |
786 |
$704.63 |
| 82150 |
|
146 |
134 |
$699.44 |
| 80179 |
|
62 |
55 |
$685.02 |
| A9575 |
Inj gadoterate meglumi 0.1ml |
32 |
24 |
$681.89 |
| 87186 |
|
121 |
95 |
$674.96 |
| J2919 |
Inj, methylpred sod succ 5mg |
245 |
155 |
$639.38 |
| J3010 |
Fentanyl citrate injection |
3,882 |
3,271 |
$577.01 |
| A9698 |
Non-rad contrast materialnoc |
305 |
272 |
$559.32 |
| 83516 |
|
90 |
55 |
$542.85 |
| 11055 |
|
29 |
25 |
$518.68 |
| 87077 |
|
95 |
72 |
$509.04 |
| C1894 |
Intro/sheath, non-laser |
54 |
51 |
$499.18 |
| J8540 |
Oral dexamethasone |
186 |
53 |
$496.34 |
| G2066 |
Inter devc remote 30d |
35 |
33 |
$491.02 |
| 81511 |
|
383 |
249 |
$490.70 |
| J1644 |
Inj heparin sodium per 1000u |
60 |
51 |
$489.00 |
| 84163 |
|
41 |
32 |
$466.55 |
| 73560 |
|
14 |
12 |
$442.10 |
| 87147 |
|
141 |
83 |
$434.80 |
| 84630 |
|
51 |
45 |
$434.30 |
| 93270 |
|
16 |
16 |
$411.32 |
| 84466 |
|
40 |
34 |
$407.94 |
| J2360 |
Orphenadrine injection |
82 |
74 |
$401.34 |
| 76514 |
|
52 |
50 |
$382.29 |
| J1630 |
Haloperidol injection |
80 |
70 |
$369.96 |
| 94762 |
|
17 |
12 |
$355.95 |
| 82247 |
|
93 |
65 |
$353.70 |
| 99462 |
|
14 |
12 |
$349.72 |
| 80323 |
|
24 |
17 |
$337.96 |
| J0665 |
Inj, bupivacaine, nos, 0.5mg |
682 |
561 |
$305.31 |
| J0461 |
Atropine sulfate injection |
81 |
50 |
$301.94 |
| 84154 |
|
31 |
26 |
$294.24 |
| J2765 |
Metoclopramide hcl injection |
131 |
125 |
$292.64 |
| G0463 |
Hospital outpt clinic visit |
25,318 |
21,642 |
$287.66 |
| 86780 |
|
36 |
27 |
$278.04 |
| J2272 |
Inj, morphine (fresenius) |
242 |
135 |
$277.96 |
| 83883 |
|
60 |
29 |
$261.28 |
| 84145 |
|
14 |
13 |
$255.70 |
| J2003 |
Inj, lidocaine hcl, 1 mg |
309 |
267 |
$218.94 |
| 84146 |
|
12 |
12 |
$216.80 |
| 82810 |
|
49 |
45 |
$206.46 |
| 83921 |
|
16 |
12 |
$190.89 |
| C1769 |
Guide wire |
25 |
25 |
$184.66 |
| 96377 |
|
22 |
12 |
$182.03 |
| 82077 |
|
19 |
17 |
$181.30 |
| 82270 |
|
60 |
59 |
$170.66 |
| 93296 |
|
31 |
29 |
$157.31 |
| 90714 |
|
12 |
12 |
$149.04 |
| Q0111 |
Wet mounts/ w preparations |
523 |
296 |
$143.47 |
| J2060 |
Lorazepam injection |
77 |
63 |
$143.11 |
| 85046 |
|
27 |
25 |
$116.97 |
| 80076 |
|
12 |
12 |
$108.68 |
| J2175 |
Meperidine hydrochl /100 mg |
77 |
37 |
$108.03 |
| J2250 |
Inj midazolam hydrochloride |
667 |
552 |
$102.00 |
| Q9969 |
Non-heu tc-99m add-on/dose |
16 |
14 |
$99.81 |
| J1650 |
Inj enoxaparin sodium |
19 |
13 |
$97.29 |
| J7510 |
Prednisolone oral per 5 mg |
54 |
53 |
$83.36 |
| 99459 |
|
251 |
191 |
$77.02 |
| 96380 |
|
55 |
47 |
$76.48 |
| 99152 |
|
44 |
37 |
$72.63 |
| 84155 |
|
49 |
38 |
$64.33 |
| 90698 |
|
2,478 |
2,215 |
$62.22 |
| J0360 |
Hydralazine hcl injection |
13 |
12 |
$58.26 |
| 82803 |
|
12 |
12 |
$57.15 |
| J2001 |
Lidocaine injection |
256 |
198 |
$52.66 |
| 99395 |
|
42 |
31 |
$43.96 |
| 00811 |
|
656 |
628 |
$39.33 |
| 90633 |
|
594 |
496 |
$33.48 |
| 97140 |
|
31 |
14 |
$33.12 |
| J7512 |
Prednisone ir or dr oral 1mg |
82 |
63 |
$29.70 |
| J7040 |
Normal saline solution infus |
20 |
12 |
$28.65 |
| 36416 |
|
17 |
12 |
$26.50 |
| J2550 |
Promethazine hcl injection |
13 |
13 |
$25.04 |
| 00813 |
|
91 |
87 |
$22.47 |
| 99396 |
|
15 |
12 |
$21.98 |
| J3370 |
Vancomycin hcl injection |
40 |
13 |
$21.46 |
| 90662 |
|
22 |
13 |
$13.74 |
| J1171 |
Inj, hydromorphone, 0.1 mg |
28 |
15 |
$1.81 |
| G0008 |
Admin influenza virus vac |
281 |
278 |
$0.65 |
| 3078F |
|
97 |
94 |
$0.29 |
| 3074F |
|
46 |
45 |
$0.07 |
| 3077F |
|
14 |
14 |
$0.02 |
| 90670 |
|
2,687 |
2,394 |
$0.00 |
| 90685 |
|
68 |
51 |
$0.00 |
| 91300 |
|
1,484 |
1,263 |
$0.00 |
| Q0243 |
Casirivimab and imdevimab |
93 |
88 |
$0.00 |
| 88312 |
|
193 |
139 |
$0.00 |
| J0171 |
Adrenalin epinephrine inject |
47 |
38 |
$0.00 |
| 00731 |
|
26 |
26 |
$0.00 |
| Q0244 |
Casirivi and imdevi 1200 mg |
355 |
294 |
$0.00 |
| 90710 |
|
167 |
155 |
$0.00 |
| J0689 |
Inj cefazolin sodium, baxter |
30 |
16 |
$0.00 |
| C9257 |
Bevacizumab injection |
52 |
36 |
$0.00 |
| 90460 |
|
27 |
26 |
$0.00 |
| 90707 |
|
19 |
15 |
$0.00 |
| 90744 |
|
1,548 |
1,335 |
$0.00 |
| 91303 |
|
35 |
26 |
$0.00 |
| J0178 |
Aflibercept injection |
45 |
26 |
$0.00 |
| 90694 |
|
15 |
15 |
$0.00 |
| 90680 |
|
1,393 |
1,274 |
$0.00 |
| 88304 |
|
147 |
125 |
$0.00 |
| A9270 |
Non-covered item or service |
137 |
111 |
$0.00 |
| 90696 |
|
50 |
43 |
$0.00 |
| 88307 |
|
18 |
12 |
$0.00 |
| 91306 |
|
48 |
41 |
$0.00 |
| J1097 |
Phenylep ketorolac opth soln |
31 |
27 |
$0.00 |
| J0330 |
Succinycholine chloride inj |
42 |
36 |
$0.00 |
| 91307 |
|
166 |
109 |
$0.00 |
| 90647 |
|
14 |
12 |
$0.00 |
| V2632 |
Post chmbr intraocular lens |
18 |
12 |
$0.00 |
| 90716 |
|
20 |
16 |
$0.00 |