| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| U0003 |
Cov-19 amp prb hgh thruput |
1,406,305 |
412,026 |
$99.14M |
| 99213 |
|
552,614 |
485,889 |
$46.05M |
| 97530 |
|
531,363 |
159,366 |
$35.37M |
| 99211 |
|
1,427,961 |
397,225 |
$34.73M |
| U0005 |
Infec agen detec ampli probe |
1,403,917 |
411,667 |
$33.01M |
| 97110 |
|
670,554 |
193,646 |
$20.37M |
| 99214 |
|
161,940 |
145,677 |
$18.79M |
| 77067 |
|
122,330 |
122,243 |
$15.81M |
| 90837 |
|
113,778 |
34,682 |
$14.94M |
| 97112 |
|
481,751 |
139,801 |
$13.55M |
| 92507 |
|
179,456 |
44,836 |
$13.06M |
| 99212 |
|
218,150 |
124,965 |
$12.74M |
| 97140 |
|
574,708 |
167,094 |
$12.14M |
| 76700 |
|
86,598 |
86,437 |
$9.14M |
| 76641 |
|
78,392 |
50,102 |
$8.47M |
| 99203 |
|
81,384 |
81,260 |
$8.24M |
| 90834 |
|
65,131 |
23,957 |
$5.72M |
| 77063 |
|
101,726 |
101,677 |
$5.15M |
| 76830 |
|
34,755 |
34,357 |
$3.99M |
| 87635 |
|
119,606 |
25,565 |
$3.78M |
| 76536 |
|
33,737 |
33,490 |
$3.60M |
| 99204 |
|
23,501 |
23,473 |
$3.47M |
| 93975 |
|
17,193 |
16,872 |
$3.36M |
| 76856 |
|
29,426 |
29,299 |
$2.57M |
| 93306 |
|
14,783 |
14,728 |
$2.51M |
| 97533 |
|
43,001 |
8,464 |
$2.34M |
| 87426 |
|
54,417 |
34,713 |
$2.26M |
| 99202 |
|
28,913 |
28,782 |
$2.13M |
| 93880 |
|
13,173 |
13,148 |
$2.13M |
| 92014 |
|
16,813 |
16,798 |
$2.02M |
| 71046 |
|
64,369 |
64,108 |
$1.99M |
| 90791 |
|
13,332 |
12,773 |
$1.90M |
| G0283 |
Elec stim other than wound |
212,362 |
62,093 |
$1.77M |
| 76825 |
|
6,074 |
6,005 |
$1.66M |
| 77065 |
Tomosynthesis, mammo |
12,202 |
11,566 |
$1.55M |
| 70551 |
|
7,642 |
7,613 |
$1.53M |
| 72148 |
|
7,763 |
7,757 |
$1.52M |
| 93970 |
|
8,645 |
8,581 |
$1.46M |
| 73721 |
|
7,015 |
6,487 |
$1.40M |
| 90833 |
|
22,713 |
17,094 |
$1.33M |
| 19083 |
|
2,353 |
2,347 |
$1.28M |
| 97161 |
|
20,837 |
20,754 |
$1.28M |
| 77066 |
Tomosynthesis, mammo |
7,838 |
7,788 |
$1.27M |
| 87811 |
|
36,975 |
33,601 |
$1.26M |
| 97162 |
|
20,114 |
20,014 |
$1.26M |
| 90853 |
|
47,843 |
15,884 |
$1.23M |
| 70553 |
|
3,726 |
3,713 |
$1.16M |
| 72197 |
|
3,315 |
3,312 |
$1.12M |
| 95923 |
|
10,757 |
10,740 |
$1.11M |
| 92004 |
|
7,235 |
7,234 |
$1.04M |
| 90785 |
|
75,273 |
25,932 |
$1.04M |
| 97535 |
|
41,712 |
14,066 |
$1.01M |
| 90460 |
|
31,519 |
30,659 |
$997K |
| 93925 |
|
4,513 |
4,507 |
$956K |
| 95004 |
|
4,126 |
3,781 |
$923K |
| 76642 |
|
11,020 |
9,421 |
$910K |
| 76811 |
|
5,042 |
5,040 |
$889K |
| 93886 |
|
4,467 |
4,457 |
$850K |
| 95886 |
|
6,951 |
6,464 |
$804K |
| 73562 |
|
19,870 |
14,082 |
$802K |
| 76770 |
|
10,079 |
10,052 |
$799K |
| 92526 |
|
23,783 |
5,247 |
$750K |
| 93979 |
|
6,626 |
6,624 |
$747K |
| 93890 |
|
3,866 |
3,853 |
$740K |
| 99392 |
|
6,414 |
6,389 |
$719K |
| 74178 |
|
2,045 |
2,041 |
$717K |
| 99393 |
|
6,361 |
6,333 |
$700K |
| 73630 |
|
20,369 |
16,059 |
$698K |
| 97032 |
|
62,721 |
19,032 |
$677K |
| 93976 |
|
8,256 |
7,756 |
$671K |
| 72100 |
|
16,733 |
16,711 |
$649K |
| 74183 |
|
1,857 |
1,857 |
$636K |
| 93922 |
|
8,076 |
8,002 |
$634K |
| 73221 |
|
3,133 |
2,965 |
$617K |
| 74177 |
|
2,734 |
2,676 |
$610K |
| 99396 |
|
4,644 |
4,634 |
$601K |
| 99391 |
|
5,548 |
5,405 |
$593K |
| 36466 |
|
467 |
302 |
$581K |
| 78815 |
|
384 |
384 |
$580K |
| 96365 |
|
9,773 |
5,822 |
$580K |
| 95165 |
|
5,450 |
2,963 |
$564K |
| 43239 |
|
1,717 |
1,712 |
$563K |
| 72141 |
|
3,173 |
3,167 |
$553K |
| 90846 |
|
6,000 |
4,125 |
$539K |
| 97124 |
|
22,640 |
6,194 |
$536K |
| 95921 |
|
7,024 |
7,023 |
$516K |
| 93892 |
|
3,124 |
3,120 |
$516K |
| L3001 |
Foot insert remov molded spe |
4,594 |
2,297 |
$515K |
| 95912 |
|
3,056 |
2,866 |
$510K |
| 74176 |
|
2,927 |
2,907 |
$503K |
| 97165 |
|
5,358 |
5,351 |
$498K |
| 87804 |
|
33,690 |
21,999 |
$497K |
| 67210 |
|
1,179 |
1,057 |
$496K |
| 92012 |
|
6,196 |
5,885 |
$495K |
| 87880 |
|
141,892 |
137,132 |
$493K |
| 31231 |
|
2,822 |
2,735 |
$485K |
| 19081 |
|
898 |
894 |
$475K |
| 99443 |
|
4,319 |
3,971 |
$473K |
| 71250 |
|
3,715 |
3,708 |
$471K |
| 77080 |
|
15,856 |
15,843 |
$461K |
| 99394 |
|
3,912 |
3,893 |
$456K |
| 88305 |
|
6,003 |
5,410 |
$442K |
| 77062 |
|
7,050 |
7,043 |
$441K |
| 76816 |
|
4,094 |
3,039 |
$435K |
| J0585 |
Injection,onabotulinumtoxina |
749 |
391 |
$425K |
| 93923 |
|
3,706 |
3,637 |
$424K |
| 92523 |
|
2,807 |
2,782 |
$406K |
| 99401 |
|
23,285 |
20,772 |
$395K |
| 73030 |
|
11,008 |
9,435 |
$375K |
| 70486 |
|
2,793 |
2,791 |
$368K |
| 87651 |
|
19,042 |
17,448 |
$357K |
| 92250 |
|
9,928 |
9,889 |
$353K |
| 99051 |
|
75,268 |
43,378 |
$347K |
| 76705 |
|
4,133 |
4,120 |
$332K |
| 97035 |
|
33,152 |
9,285 |
$326K |
| 77061 |
|
6,993 |
6,967 |
$325K |
| 76817 |
|
3,482 |
2,967 |
$312K |
| 99442 |
|
4,169 |
3,901 |
$308K |
| 97164 |
|
8,181 |
7,207 |
$303K |
| 95913 |
|
1,432 |
1,395 |
$290K |
| 93000 |
|
19,735 |
19,370 |
$268K |
| 73610 |
|
7,372 |
6,196 |
$266K |
| 97116 |
|
14,477 |
4,224 |
$266K |
| 73130 |
|
7,315 |
5,589 |
$264K |
| A9575 |
Inj gadoterate meglumi 0.1ml |
12,251 |
12,030 |
$254K |
| 90832 |
|
3,678 |
1,219 |
$253K |
| 76775 |
|
5,700 |
5,673 |
$253K |
| 99490 |
Ccm add 20min |
7,770 |
7,751 |
$248K |
| 72050 |
|
4,624 |
4,615 |
$245K |
| 11730 |
|
3,007 |
2,933 |
$240K |
| 73718 |
|
1,072 |
1,022 |
$237K |
| 82306 |
|
7,516 |
7,482 |
$231K |
| 90836 |
|
3,005 |
2,836 |
$224K |
| 93971 |
|
2,007 |
1,966 |
$223K |
| 87636 |
|
1,740 |
1,709 |
$221K |
| 95911 |
|
1,380 |
1,307 |
$216K |
| 83970 |
|
5,086 |
5,066 |
$216K |
| 29200 |
|
8,827 |
2,667 |
$212K |
| 72110 |
|
4,277 |
4,273 |
$211K |
| 87798 |
|
18,678 |
17,387 |
$211K |
| 93978 |
|
1,425 |
1,421 |
$210K |
| 73110 |
|
5,194 |
4,391 |
$209K |
| 70450 |
|
2,735 |
2,677 |
$208K |
| 17110 |
|
1,916 |
1,672 |
$200K |
| 98928 |
|
3,573 |
2,449 |
$198K |
| 94010 |
|
7,926 |
7,215 |
$194K |
| 76870 |
|
1,991 |
1,990 |
$192K |
| 58340 |
|
805 |
801 |
$191K |
| 99395 |
|
1,631 |
1,624 |
$190K |
| G0101 |
Ca screen;pelvic/breast exam |
4,618 |
4,614 |
$180K |
| 77049 |
|
516 |
516 |
$176K |
| 92134 |
|
5,147 |
4,874 |
$174K |
| 92540 |
|
2,239 |
2,234 |
$172K |
| 71271 |
|
1,327 |
1,326 |
$168K |
| 92546 |
|
2,221 |
2,216 |
$159K |
| 36478 |
|
147 |
95 |
$158K |
| 93325 |
|
6,116 |
6,032 |
$152K |
| 92587 |
|
4,166 |
4,153 |
$149K |
| 72040 |
|
4,079 |
4,067 |
$147K |
| 90847 |
|
1,405 |
594 |
$147K |
| 95924 |
|
1,271 |
1,270 |
$147K |
| 99215 |
Prolong outpt/office vis |
972 |
803 |
$144K |
| 92060 |
|
2,306 |
2,299 |
$141K |
| 93931 |
|
1,502 |
1,501 |
$141K |
| 95910 |
|
1,185 |
1,145 |
$141K |
| 76819 |
|
1,818 |
1,320 |
$139K |
| 10061 |
|
875 |
764 |
$137K |
| L3219 |
Orthopedic mens shoes oxford |
1,535 |
767 |
$135K |
| 20611 |
|
1,454 |
1,253 |
$135K |
| 29515 |
|
1,821 |
1,816 |
$134K |
| L3215 |
Orthopedic ftwear ladies oxf |
1,638 |
859 |
$129K |
| 72082 |
|
1,884 |
1,879 |
$128K |
| 72070 |
|
4,089 |
4,071 |
$124K |
| 75574 |
|
511 |
508 |
$124K |
| L3060 |
Foot arch supp longitud/meta |
2,297 |
1,219 |
$123K |
| 99050 |
|
23,125 |
14,855 |
$123K |
| 73502 |
|
2,638 |
2,628 |
$123K |
| 99308 |
|
2,201 |
997 |
$122K |
| 10040 |
|
1,061 |
926 |
$122K |
| A9552 |
F18 fdg |
413 |
413 |
$122K |
| 29520 |
|
5,025 |
1,434 |
$122K |
| 90838 |
|
1,088 |
958 |
$117K |
| 76801 |
|
1,034 |
1,025 |
$115K |
| 95117 |
|
9,503 |
4,314 |
$112K |
| 95816 |
|
381 |
381 |
$111K |
| 88312 |
|
2,280 |
2,275 |
$110K |
| 82308 |
|
4,031 |
4,008 |
$110K |
| 29125 |
|
1,585 |
1,579 |
$109K |
| 82670 |
|
3,421 |
3,397 |
$101K |
| 84146 |
|
5,008 |
4,973 |
$101K |
| 12001 |
|
1,010 |
1,005 |
$99K |
| 92235 |
|
891 |
890 |
$99K |
| 93888 |
|
1,004 |
1,003 |
$98K |
| 67028 |
|
966 |
875 |
$97K |
| 76815 |
|
1,452 |
1,088 |
$93K |
| 64615 |
|
635 |
631 |
$93K |
| 92552 |
|
5,178 |
5,145 |
$92K |
| 36475 |
|
108 |
92 |
$92K |
| 78452 |
|
217 |
215 |
$89K |
| 29530 |
|
4,185 |
1,094 |
$88K |
| 77072 |
|
3,364 |
3,364 |
$88K |
| 72195 |
|
390 |
387 |
$87K |
| 88313 |
|
2,993 |
2,974 |
$87K |
| 72146 |
|
527 |
523 |
$86K |
| 73140 |
|
2,379 |
2,338 |
$85K |
| 84403 |
|
3,079 |
3,052 |
$85K |
| 84681 |
|
4,078 |
3,955 |
$83K |
| 99232 |
|
1,388 |
788 |
$82K |
| 70544 |
|
694 |
686 |
$81K |
| 84439 |
|
9,190 |
9,149 |
$80K |
| 84443 |
|
9,284 |
9,236 |
$80K |
| 20610 |
|
1,250 |
850 |
$80K |
| 73560 |
|
2,270 |
1,662 |
$78K |
| 73522 |
|
1,417 |
1,417 |
$75K |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
9,382 |
9,315 |
$74K |
| 92002 |
|
939 |
939 |
$74K |
| 90792 |
|
505 |
495 |
$74K |
| 87491 |
|
3,394 |
3,381 |
$72K |
| 87591 |
|
3,392 |
3,379 |
$72K |
| 83001 |
|
3,694 |
3,668 |
$71K |
| 74018 |
|
2,386 |
2,338 |
$71K |
| 73080 |
|
2,120 |
1,866 |
$70K |
| 76882 |
|
1,574 |
1,292 |
$70K |
| 29240 |
|
3,137 |
825 |
$70K |
| 77085 |
|
1,355 |
1,355 |
$69K |
| L3202 |
Oxford w/ supinat/pronator c |
1,941 |
972 |
$68K |
| 83036 |
|
7,032 |
7,015 |
$68K |
| G8510 |
Scr dep neg, no plan reqd |
9,060 |
8,487 |
$67K |
| 86376 |
|
4,768 |
4,735 |
$67K |
| 83002 |
|
3,508 |
3,482 |
$67K |
| 69210 |
|
1,211 |
1,207 |
$65K |
| L3010 |
Foot longitudinal arch suppo |
570 |
290 |
$65K |
| A5500 |
Diab shoe for density insert |
514 |
513 |
$64K |
| 99385 |
|
541 |
540 |
$63K |
| 99284 |
|
835 |
825 |
$63K |
| 10060 |
|
533 |
498 |
$63K |
| U0002 |
Covid-19 lab test non-cdc |
1,227 |
1,224 |
$63K |
| 86800 |
|
4,761 |
4,728 |
$62K |
| 71260 |
|
560 |
560 |
$61K |
| 84144 |
|
2,874 |
2,861 |
$60K |
| 92567 |
|
4,376 |
4,124 |
$60K |
| 96372 |
|
4,596 |
2,899 |
$59K |
| 95938 |
|
394 |
390 |
$59K |
| 10005 |
|
449 |
448 |
$59K |
| 90471 |
|
4,080 |
4,001 |
$59K |
| 93229 |
|
161 |
160 |
$58K |
| 87070 |
|
7,422 |
6,791 |
$58K |
| 92537 |
|
2,187 |
2,182 |
$58K |
| 11721 |
|
2,351 |
2,338 |
$56K |
| 82024 |
|
1,362 |
1,356 |
$56K |
| G0444 |
Depression screen annual |
4,913 |
4,887 |
$54K |
| G2023 |
Specimen collect covid-19 |
10,329 |
5,036 |
$53K |
| 76377 |
|
1,324 |
1,263 |
$52K |
| J1756 |
Iron sucrose injection |
2,414 |
897 |
$52K |
| 92083 |
|
871 |
869 |
$51K |
| 88342 |
|
1,412 |
1,209 |
$51K |
| 82607 |
|
4,069 |
4,051 |
$51K |
| 92522 |
|
683 |
682 |
$50K |
| 83525 |
|
4,199 |
3,898 |
$50K |
| 31575 |
|
433 |
432 |
$49K |
| 92588 |
|
906 |
897 |
$48K |
| 74740 |
|
547 |
546 |
$47K |
| 92524 |
|
631 |
631 |
$46K |
| 94060 |
|
1,028 |
997 |
$46K |
| 11056 |
|
1,160 |
1,149 |
$45K |
| 99222 |
|
381 |
378 |
$45K |
| 97113 |
|
660 |
204 |
$44K |
| 73218 |
|
168 |
164 |
$44K |
| 73590 |
|
1,362 |
1,151 |
$44K |
| 80053 |
|
4,408 |
4,403 |
$43K |
| 76000 |
|
1,007 |
908 |
$43K |
| 82626 |
|
1,810 |
1,801 |
$43K |
| 81002 |
|
21,720 |
18,362 |
$43K |
| L3332 |
Shoe lifts tapered to one-ha |
898 |
441 |
$42K |
| 94729 |
|
1,114 |
1,095 |
$42K |
| 82728 |
|
3,058 |
3,055 |
$42K |
| 92286 |
|
1,164 |
1,156 |
$41K |
| 84481 |
|
4,637 |
4,604 |
$41K |
| 99350 |
Prolong home eval add 15m |
239 |
131 |
$40K |
| A9581 |
Gadoxetate disodium inj |
341 |
340 |
$39K |
| 45378 |
|
118 |
118 |
$39K |
| 92025 |
|
1,269 |
1,248 |
$39K |
| 99497 |
|
797 |
796 |
$39K |
| 82746 |
|
3,067 |
3,064 |
$38K |
| 76881 |
|
931 |
585 |
$37K |
| 70491 |
|
194 |
194 |
$37K |
| 97166 |
|
389 |
389 |
$36K |
| 92133 |
|
1,087 |
1,086 |
$35K |
| 72220 |
|
1,130 |
1,103 |
$35K |
| 88112 |
|
1,975 |
1,956 |
$35K |
| 96360 |
|
2,375 |
2,221 |
$35K |
| 99205 |
Prolong outpt/office vis |
158 |
158 |
$34K |
| 92610 |
|
521 |
518 |
$34K |
| 87637 |
|
271 |
267 |
$34K |
| 84442 |
|
3,951 |
3,928 |
$34K |
| 19084 |
|
84 |
70 |
$34K |
| L3000 |
Ft insert ucb berkeley shell |
156 |
85 |
$34K |
| A5512 |
Multi den insert direct form |
514 |
512 |
$33K |
| 76827 |
|
469 |
453 |
$33K |
| 95943 |
|
400 |
399 |
$33K |
| 11732 |
|
1,296 |
1,290 |
$32K |
| 82533 |
|
1,905 |
1,898 |
$32K |
| 94727 |
|
1,111 |
1,092 |
$31K |
| 93015 |
|
512 |
509 |
$31K |
| 70480 |
|
194 |
194 |
$31K |
| 92557 |
|
967 |
962 |
$31K |
| 80307 |
|
3,751 |
3,424 |
$30K |
| 99439 |
|
657 |
656 |
$30K |
| 87624 |
|
1,063 |
1,062 |
$29K |
| 71045 |
|
2,399 |
2,037 |
$29K |
| 92551 |
|
4,557 |
4,556 |
$27K |
| 80061 |
|
4,406 |
4,396 |
$26K |
| 87184 |
|
4,204 |
3,953 |
$26K |
| 45380 |
|
92 |
91 |
$26K |
| 93702 |
|
258 |
255 |
$26K |
| 11421 |
|
260 |
135 |
$25K |
| 99441 |
|
607 |
570 |
$25K |
| 84480 |
|
4,421 |
4,413 |
$25K |
| 96413 |
|
198 |
78 |
$25K |
| 92081 |
|
802 |
800 |
$25K |
| 12011 |
|
198 |
198 |
$24K |
| 76805 |
|
203 |
203 |
$24K |
| 85025 |
|
7,682 |
6,877 |
$24K |
| 73564 |
|
532 |
353 |
$24K |
| 76820 |
|
520 |
370 |
$23K |
| 76818 |
|
207 |
62 |
$23K |
| A9502 |
Tc99m tetrofosmin |
104 |
104 |
$23K |
| 73700 |
|
176 |
164 |
$22K |
| 68761 |
|
138 |
108 |
$22K |
| 87428 |
|
690 |
685 |
$22K |
| 83735 |
|
4,358 |
4,354 |
$22K |
| 11901 |
|
358 |
290 |
$22K |
| 90686 |
|
6,235 |
6,222 |
$21K |
| 76885 |
|
193 |
192 |
$21K |
| L4396 |
Static or dynami afo pre cst |
161 |
106 |
$21K |
| 82977 |
|
4,215 |
4,202 |
$21K |
| 90849 |
|
620 |
197 |
$21K |
| 84100 |
|
4,347 |
4,343 |
$21K |
| 70543 |
|
62 |
61 |
$21K |
| 73090 |
|
700 |
680 |
$21K |
| 96367 |
|
309 |
157 |
$20K |
| 86769 |
|
599 |
373 |
$20K |
| 99386 |
|
148 |
148 |
$20K |
| 11755 |
|
206 |
206 |
$19K |
| J0702 |
Betamethasone acet&sod phosp |
1,100 |
984 |
$19K |
| 76857 |
|
503 |
498 |
$19K |
| 10120 |
|
111 |
111 |
$19K |
| 92579 |
|
681 |
664 |
$18K |
| 81000 |
|
4,955 |
4,836 |
$18K |
| 97163 |
|
295 |
294 |
$18K |
| 29131 |
|
301 |
294 |
$18K |
| 99349 |
|
150 |
85 |
$18K |
| 99406 |
|
1,557 |
1,222 |
$18K |
| 72114 |
|
270 |
270 |
$17K |
| 83615 |
|
3,312 |
3,307 |
$17K |
| 72052 |
|
264 |
264 |
$16K |
| 82550 |
|
3,253 |
3,248 |
$16K |
| 84550 |
|
3,499 |
3,491 |
$16K |
| 73552 |
|
433 |
381 |
$16K |
| 92653 |
|
280 |
278 |
$16K |
| 92555 |
|
1,112 |
1,097 |
$16K |
| 71100 |
|
415 |
415 |
$15K |
| 82627 |
|
687 |
687 |
$15K |
| 92201 |
|
715 |
715 |
$15K |
| 83540 |
|
3,021 |
3,018 |
$15K |
| 92550 |
|
1,051 |
1,032 |
$15K |
| 99305 |
|
215 |
182 |
$15K |
| 93268 |
|
95 |
95 |
$15K |
| 94618 |
|
604 |
604 |
$15K |
| 11720 |
|
688 |
684 |
$15K |
| G0447 |
Behavior counsel obesity 15m |
1,927 |
1,580 |
$15K |
| 71275 |
|
139 |
136 |
$14K |
| 90674 |
|
638 |
634 |
$14K |
| 90756 |
|
482 |
480 |
$14K |
| 90960 |
|
78 |
78 |
$14K |
| T1013 |
Sign lang/oral interpreter |
1,246 |
1,038 |
$14K |
| 93351 |
|
76 |
76 |
$14K |
| J3415 |
Pyridoxine hcl 100 mg |
1,286 |
502 |
$14K |
| 29540 |
|
1,388 |
766 |
$14K |
| 80305 |
|
1,958 |
1,826 |
$13K |
| 76514 |
|
1,311 |
1,294 |
$13K |
| A9500 |
Tc99m sestamibi |
72 |
72 |
$13K |
| 72170 |
|
441 |
440 |
$13K |
| 99402 |
|
2,343 |
2,029 |
$12K |
| 95930 |
|
148 |
146 |
$12K |
| 11900 |
|
264 |
237 |
$12K |
| J3301 |
Triamcinolone acet inj nos |
4,276 |
3,101 |
$12K |
| 20553 |
|
195 |
183 |
$12K |
| 93224 |
|
152 |
148 |
$12K |
| 27096 |
|
66 |
40 |
$11K |
| 88120 |
|
64 |
62 |
$11K |
| 76821 |
|
130 |
100 |
$11K |
| 83550 |
|
2,166 |
2,164 |
$11K |
| 57150 |
|
224 |
219 |
$11K |
| M0244 |
Casirivi and imdevi inj hm |
14 |
14 |
$11K |
| 70220 |
|
274 |
274 |
$11K |
| A9579 |
Gad-base mr contrast nos,1ml |
568 |
550 |
$10K |
| 73060 |
|
319 |
295 |
$10K |
| 97026 |
|
2,095 |
725 |
$10K |
| 87340 |
|
958 |
957 |
$10K |
| 93298 |
|
532 |
532 |
$10K |
| L2820 |
Soft interface below knee se |
148 |
93 |
$10K |
| J3420 |
Vitamin b12 injection |
6,327 |
3,945 |
$10K |
| 76813 |
|
78 |
78 |
$10K |
| 86708 |
|
960 |
959 |
$10K |
| 86803 |
|
963 |
960 |
$10K |
| 00731 |
|
85 |
85 |
$10K |
| 99243 |
|
93 |
91 |
$9K |
| 99239 |
|
87 |
86 |
$9K |
| 98927 |
|
156 |
147 |
$9K |
| 74181 |
|
51 |
51 |
$9K |
| G0268 |
Removal of impacted wax md |
190 |
188 |
$9K |
| 92521 |
|
90 |
90 |
$9K |
| 90694 |
|
205 |
205 |
$9K |
| 74019 |
|
230 |
229 |
$9K |
| 99309 |
|
202 |
121 |
$9K |
| L1971 |
Afo w/ankle joint, prefab |
53 |
38 |
$9K |
| 95812 |
|
27 |
27 |
$8K |
| 92145 |
|
648 |
634 |
$8K |
| 98925 |
|
264 |
187 |
$8K |
| 93350 |
|
52 |
52 |
$8K |
| 87110 |
|
994 |
993 |
$8K |
| Q0091 |
Obtaining screen pap smear |
1,446 |
1,442 |
$8K |
| 11102 |
|
78 |
78 |
$7K |
| 72084 |
|
74 |
74 |
$7K |
| 92020 |
|
301 |
300 |
$7K |
| 64483 |
|
30 |
30 |
$7K |
| 99307 |
|
329 |
306 |
$7K |
| 86706 |
|
960 |
959 |
$7K |
| 86704 |
|
958 |
957 |
$7K |
| 95044 |
|
30 |
30 |
$7K |
| 86328 |
|
249 |
125 |
$7K |
| 92548 |
|
537 |
537 |
$7K |
| 95700 |
|
26 |
26 |
$7K |
| 99457 |
|
874 |
873 |
$7K |
| 73620 |
|
243 |
174 |
$6K |
| 93272 |
|
199 |
197 |
$6K |
| 99238 |
|
114 |
114 |
$6K |
| 72131 |
|
54 |
54 |
$6K |
| 84305 |
|
296 |
296 |
$6K |
| 81025 |
|
3,165 |
3,056 |
$6K |
| J1030 |
Methylprednisolone 40 mg inj |
590 |
543 |
$6K |
| 88174 |
|
303 |
302 |
$6K |
| 99283 |
|
121 |
121 |
$6K |
| 96127 |
|
1,079 |
1,022 |
$5K |
| J9035 |
Bevacizumab injection |
68 |
64 |
$5K |
| 86580 |
|
1,074 |
1,072 |
$5K |
| 76981 |
|
374 |
374 |
$5K |
| 97150 |
|
408 |
198 |
$5K |
| 51741 |
|
436 |
423 |
$5K |
| 0072A |
|
114 |
114 |
$5K |
| G0483 |
Drug test def 22+ classes |
1,219 |
1,009 |
$5K |
| L3485 |
Shoe heel pad removable for |
144 |
72 |
$5K |
| 92508 |
|
209 |
136 |
$5K |
| 95819 |
|
13 |
12 |
$5K |
| 95708 |
|
72 |
27 |
$5K |
| 99201 |
|
94 |
94 |
$5K |
| 0071A |
|
105 |
105 |
$5K |
| J2785 |
Regadenoson injection |
24 |
24 |
$5K |
| 11100 |
|
78 |
78 |
$5K |
| 92225 |
|
160 |
82 |
$4K |
| J7040 |
Normal saline solution infus |
3,511 |
2,735 |
$4K |
| 90688 |
|
252 |
252 |
$4K |
| 99407 |
|
309 |
292 |
$4K |
| 83003 |
|
254 |
254 |
$4K |
| 17000 |
|
192 |
190 |
$4K |
| 51798 |
|
456 |
450 |
$4K |
| 0012A |
|
99 |
99 |
$4K |
| L3100 |
Hallus-valgus nt dyn pre ots |
106 |
53 |
$4K |
| 84702 |
|
324 |
318 |
$4K |
| 86762 |
|
256 |
256 |
$4K |
| 93356 |
|
292 |
291 |
$4K |
| 36415 |
|
61,515 |
57,806 |
$4K |
| 97168 |
|
64 |
64 |
$4K |
| 71101 |
|
90 |
90 |
$4K |
| 81003 |
|
2,020 |
1,981 |
$4K |
| J1040 |
Methylprednisolone 80 mg inj |
370 |
341 |
$4K |
| 92226 |
|
134 |
68 |
$4K |
| 80414 |
|
70 |
70 |
$4K |
| 86765 |
|
244 |
244 |
$3K |
| 84270 |
|
539 |
531 |
$3K |
| 72158 |
|
12 |
12 |
$3K |
| 92202 |
|
316 |
315 |
$3K |
| 92586 |
|
648 |
626 |
$3K |
| 99233 |
Prolong inpt eval add15 m |
33 |
13 |
$3K |
| 74170 |
|
13 |
13 |
$3K |
| 0011A |
|
79 |
79 |
$3K |
| 62323 |
|
14 |
14 |
$3K |
| 77081 |
|
852 |
852 |
$3K |
| 97760 |
|
97 |
97 |
$3K |
| 78306 |
|
12 |
12 |
$3K |
| 0031A |
|
103 |
103 |
$3K |
| 97039 |
|
421 |
131 |
$3K |
| 64484 |
|
30 |
30 |
$3K |
| 98926 |
|
76 |
71 |
$3K |
| 31237 |
|
18 |
13 |
$3K |
| 87081 |
|
561 |
555 |
$3K |
| J0610 |
Calcium glucon (fresenius) |
715 |
274 |
$3K |
| G2211 |
Complex e/m visit add on |
420 |
332 |
$3K |
| 99231 |
|
69 |
42 |
$3K |
| 95027 |
|
109 |
109 |
$3K |
| 72202 |
|
68 |
68 |
$3K |
| 99454 |
|
361 |
359 |
$3K |
| 99285 |
|
24 |
24 |
$3K |
| 95723 |
|
12 |
12 |
$3K |
| G0438 |
Ppps, initial visit |
14 |
14 |
$3K |
| 73660 |
|
94 |
91 |
$3K |
| J3411 |
Thiamine hcl 100 mg |
1,131 |
435 |
$3K |
| 87807 |
|
219 |
212 |
$2K |
| 93320 |
|
39 |
39 |
$2K |
| G0297 |
Ldct for lung ca screen |
12 |
12 |
$2K |
| 92570 |
|
88 |
86 |
$2K |
| G2066 |
Inter devc remote 30d |
1,307 |
1,307 |
$2K |
| 94621 |
|
15 |
15 |
$2K |
| 86141 |
|
234 |
234 |
$2K |
| 90656 |
|
1,269 |
1,264 |
$2K |
| 87210 |
|
639 |
639 |
$2K |
| 82784 |
|
72 |
72 |
$2K |
| A9585 |
Gadobutrol injection |
96 |
96 |
$2K |
| 90658 |
|
640 |
632 |
$2K |
| 99188 |
|
161 |
161 |
$2K |
| 57454 |
|
12 |
12 |
$2K |
| 87502 |
|
41 |
41 |
$2K |
| 72125 |
|
48 |
47 |
$2K |
| 73200 |
|
14 |
14 |
$2K |
| 93882 |
|
19 |
19 |
$2K |
| 86735 |
|
244 |
244 |
$2K |
| 86787 |
|
244 |
244 |
$2K |
| 88341 |
|
36 |
36 |
$2K |
| 72275 |
|
28 |
25 |
$2K |
| 86592 |
|
584 |
584 |
$2K |
| 86003 |
|
15 |
15 |
$2K |
| 0399T |
|
44 |
43 |
$2K |
| 93010 |
|
249 |
234 |
$2K |
| 93040 |
|
215 |
214 |
$2K |
| 76942 |
|
41 |
38 |
$2K |
| 96110 |
|
11,097 |
10,976 |
$2K |
| 93228 |
|
161 |
160 |
$2K |
| 29580 |
|
42 |
40 |
$2K |
| 99383 |
|
12 |
12 |
$2K |
| A9576 |
Inj prohance multipack |
80 |
77 |
$2K |
| 90715 |
|
349 |
349 |
$2K |
| L3260 |
Ambulatory surgical boot eac |
68 |
68 |
$2K |
| 97010 |
|
31,107 |
11,988 |
$2K |
| 87801 |
|
37 |
35 |
$1K |
| 96366 |
|
69 |
53 |
$1K |
| 99381 |
|
12 |
12 |
$1K |
| 82565 |
|
329 |
329 |
$1K |
| 87631 |
|
35 |
35 |
$1K |
| J3475 |
Inj magnesium sulfate |
1,555 |
621 |
$1K |
| 82950 |
|
231 |
203 |
$1K |
| 60300 |
|
12 |
12 |
$1K |
| J7050 |
Normal saline solution infus |
2,033 |
874 |
$1K |
| 70360 |
|
36 |
36 |
$1K |
| L3216 |
Orthoped ladies shoes dpth i |
13 |
13 |
$1K |
| 99342 |
|
14 |
14 |
$1K |
| 72081 |
|
26 |
26 |
$1K |
| 86677 |
|
466 |
457 |
$1K |
| 0004A |
|
23 |
23 |
$1K |
| 92585 |
|
12 |
12 |
$978.12 |
| 94640 |
|
154 |
144 |
$956.92 |
| 29550 |
|
78 |
69 |
$956.30 |
| 36406 |
|
70 |
68 |
$886.56 |
| 92652 |
|
12 |
12 |
$883.92 |
| J2920 |
Methylprednisolone injection |
214 |
187 |
$864.84 |
| 99304 |
|
13 |
13 |
$854.75 |
| 92553 |
|
41 |
41 |
$814.20 |
| 95012 |
|
94 |
83 |
$789.94 |
| 87077 |
|
77 |
75 |
$737.20 |
| Q9966 |
Locm 200-299mg/ml iodine,1ml |
363 |
316 |
$731.85 |
| 84153 |
|
40 |
40 |
$710.09 |
| 86160 |
|
72 |
72 |
$693.66 |
| 70547 |
|
17 |
17 |
$675.09 |
| G0008 |
Admin influenza virus vac |
161 |
161 |
$661.14 |
| 0013A |
|
26 |
26 |
$650.00 |
| J0613 |
Calcium glucon (wg critical) |
374 |
146 |
$629.89 |
| 94375 |
|
90 |
90 |
$624.04 |
| E0116 |
Crutch underarm each no wood |
51 |
51 |
$584.50 |
| 92511 |
|
13 |
13 |
$582.42 |
| 0134A |
|
17 |
17 |
$581.25 |
| L3908 |
Who cock-up nonmolde pre ots |
13 |
13 |
$570.00 |
| 90655 |
|
42 |
42 |
$568.48 |
| 71110 |
|
12 |
12 |
$564.58 |
| 0064A |
|
12 |
12 |
$541.32 |
| 99422 |
|
30 |
25 |
$529.92 |
| 11420 |
|
26 |
26 |
$492.80 |
| 0003A |
|
16 |
16 |
$480.00 |
| 73600 |
|
14 |
12 |
$427.64 |
| 0124A |
|
12 |
12 |
$426.25 |
| 94762 |
|
245 |
235 |
$423.36 |
| 97014 |
|
8,531 |
2,971 |
$412.78 |
| G2012 |
Brief check in by md/qhp |
29 |
28 |
$404.57 |
| 90472 |
|
25 |
25 |
$375.00 |
| G0446 |
Intens behave ther cardio dx |
94 |
89 |
$366.17 |
| 87625 |
|
13 |
13 |
$365.69 |
| 85651 |
|
182 |
181 |
$363.78 |
| 92015 |
|
13,142 |
13,107 |
$363.14 |
| 84703 |
|
168 |
168 |
$338.80 |
| 88323 |
|
14 |
14 |
$330.56 |
| 69209 |
|
19 |
19 |
$328.38 |
| 94726 |
|
39 |
39 |
$321.23 |
| 90710 |
|
135 |
135 |
$299.42 |
| 81005 |
|
167 |
163 |
$298.74 |
| 96381 |
|
13 |
13 |
$292.76 |
| 83690 |
|
49 |
49 |
$283.97 |
| 90461 |
|
3,904 |
3,866 |
$274.14 |
| 99459 |
|
13 |
13 |
$270.48 |
| 94664 |
|
157 |
157 |
$263.32 |
| 83655 |
|
171 |
166 |
$259.24 |
| 76376 |
|
236 |
235 |
$257.51 |
| 87486 |
|
12 |
12 |
$257.16 |
| 87581 |
|
12 |
12 |
$257.16 |
| 97810 |
|
154 |
89 |
$254.08 |
| 84154 |
|
12 |
12 |
$249.81 |
| 11305 |
|
14 |
14 |
$245.28 |
| 96361 |
|
16 |
12 |
$243.84 |
| 0001A |
|
31 |
31 |
$240.00 |
| Q2035 |
Afluria vacc, 3 yrs & >, im |
14 |
14 |
$230.40 |
| 96130 |
|
138 |
130 |
$225.04 |
| 94200 |
|
220 |
200 |
$219.48 |
| 94760 |
|
11,661 |
9,956 |
$212.00 |
| 82310 |
|
44 |
44 |
$203.20 |
| 90707 |
|
397 |
396 |
$200.00 |
| 86403 |
|
52 |
50 |
$195.00 |
| 11719 |
|
13 |
13 |
$194.04 |
| 82150 |
|
37 |
37 |
$187.36 |
| 92285 |
|
191 |
187 |
$182.17 |
| 84295 |
|
37 |
37 |
$177.97 |
| 96101 |
|
120 |
118 |
$167.52 |
| G0442 |
Annual alcohol screen 15 min |
69 |
69 |
$167.33 |
| 86703 |
|
14 |
14 |
$163.10 |
| J1020 |
Methylprednisolone 20 mg inj |
35 |
35 |
$162.96 |
| 90901 |
|
688 |
208 |
$161.72 |
| 90716 |
|
856 |
855 |
$160.00 |
| 36000 |
|
951 |
773 |
$151.64 |
| 86140 |
|
36 |
36 |
$147.60 |
| 85018 |
|
87 |
87 |
$138.58 |
| 84132 |
|
37 |
37 |
$138.04 |
| 84520 |
|
41 |
41 |
$132.48 |
| 83861 |
|
346 |
341 |
$125.45 |
| 90744 |
|
1,050 |
1,049 |
$122.88 |
| J1885 |
Ketorolac tromethamine inj |
188 |
179 |
$107.87 |
| G0445 |
High inten beh couns std 30m |
40 |
40 |
$102.58 |
| 99173 |
|
13,264 |
13,217 |
$94.29 |
| 90672 |
|
198 |
198 |
$86.79 |
| 82962 |
|
1,523 |
1,086 |
$78.80 |
| J1100 |
Dexamethasone sodium phos |
235 |
118 |
$73.42 |
| 97802 |
|
6,444 |
6,408 |
$70.10 |
| 36410 |
|
1,444 |
1,328 |
$64.38 |
| J2704 |
Inj, propofol, 10 mg |
99 |
92 |
$58.54 |
| J2405 |
Ondansetron hcl injection |
104 |
36 |
$52.69 |
| 82270 |
|
14 |
14 |
$47.60 |
| 90633 |
|
981 |
980 |
$44.16 |
| 96161 |
|
14 |
13 |
$40.88 |
| 29130 |
|
27 |
27 |
$35.99 |
| 97803 |
|
1,090 |
1,081 |
$34.35 |
| 95831 |
|
30 |
27 |
$33.20 |
| 92547 |
|
746 |
744 |
$32.81 |
| P3001 |
Screening pap smear by phys |
16 |
16 |
$32.39 |
| 96160 |
|
13 |
13 |
$31.50 |
| J1200 |
Diphenhydramine hcl injectio |
43 |
24 |
$28.86 |
| 0241U |
|
15 |
15 |
$28.53 |
| 84436 |
|
887 |
864 |
$28.50 |
| J0696 |
Ceftriaxone sodium injection |
13 |
13 |
$13.47 |
| G0506 |
Comp asses care plan ccm svc |
97 |
90 |
$10.79 |
| J7610 |
Albuterol comp con |
67 |
61 |
$9.56 |
| 99174 |
|
625 |
625 |
$7.27 |
| 99177 |
|
142 |
141 |
$5.81 |
| 82247 |
|
186 |
185 |
$5.02 |
| 94761 |
|
54 |
41 |
$5.00 |
| J0612 |
Inj, calcium gluconate, nos |
59 |
29 |
$2.95 |
| H0033 |
Oral med adm direct observe |
56 |
53 |
$1.12 |
| G8427 |
Docrev cur meds by elig clin |
16,838 |
14,917 |
$0.92 |
| 99001 |
|
441 |
415 |
$0.58 |
| G0439 |
Ppps, subseq visit |
19 |
19 |
$0.17 |
| H0001 |
Alcohol and/or drug assess |
1,976 |
1,956 |
$0.16 |
| 99000 |
|
40,168 |
34,323 |
$0.12 |
| J2001 |
Lidocaine injection |
174 |
159 |
$0.03 |
| H0049 |
Alcohol/drug screening |
232 |
227 |
$0.01 |
| 90651 |
|
73 |
72 |
$0.01 |
| 99072 |
|
22,448 |
16,012 |
$0.00 |
| 90713 |
|
1,798 |
1,795 |
$0.00 |
| G8752 |
Sys bp less 140 |
1,184 |
1,073 |
$0.00 |
| 90670 |
|
2,338 |
2,333 |
$0.00 |
| 99080 |
|
844 |
839 |
$0.00 |
| G8417 |
Calc bmi abv up param f/u |
5,134 |
4,383 |
$0.00 |
| 90700 |
|
2,320 |
2,318 |
$0.00 |
| 98960 |
|
4,243 |
4,228 |
$0.00 |
| G8979 |
Mobility goal status |
573 |
554 |
$0.00 |
| 90648 |
|
723 |
723 |
$0.00 |
| A4550 |
Surgical trays |
726 |
664 |
$0.00 |
| G8978 |
Mobility current status |
573 |
554 |
$0.00 |
| 90734 |
|
422 |
422 |
$0.00 |
| G9622 |
No unheal etoh user |
1,036 |
999 |
$0.00 |
| 99354 |
|
60 |
53 |
$0.00 |
| G9820 |
Doc chlam scr test w/follow |
2,256 |
2,131 |
$0.00 |
| G8476 |
Bp sys <140 and dias <90 |
40 |
39 |
$0.00 |
| A4595 |
Tens suppl 2 lead per month |
532 |
528 |
$0.00 |
| G8783 |
Bp scrn perf rec interval |
1,069 |
979 |
$0.00 |
| 92582 |
|
525 |
519 |
$0.00 |
| 90671 |
|
450 |
449 |
$0.00 |
| S9470 |
Nutritional counseling, diet |
629 |
607 |
$0.00 |
| G9316 |
Doc comm risk calc |
99 |
83 |
$0.00 |
| G9551 |
Imag no les |
454 |
454 |
$0.00 |
| 87633 |
|
207 |
195 |
$0.00 |
| G9744 |
Pt not eli d/t act dig htn |
224 |
203 |
$0.00 |
| 92504 |
|
89 |
88 |
$0.00 |
| 97799 |
|
457 |
108 |
$0.00 |
| G8984 |
Carry current status |
199 |
189 |
$0.00 |
| 97012 |
|
115 |
50 |
$0.00 |
| 4040F |
|
27 |
26 |
$0.00 |
| G8598 |
Asa/antiplat ther used |
86 |
82 |
$0.00 |
| U0001 |
2019-ncov diagnostic p |
131 |
120 |
$0.00 |
| 91300 |
|
43 |
43 |
$0.00 |
| G8985 |
Carry goal status |
197 |
188 |
$0.00 |
| 82042 |
|
14 |
13 |
$0.00 |
| 83721 |
|
229 |
225 |
$0.00 |
| G8482 |
Flu immunize order/admin |
200 |
184 |
$0.00 |
| 99408 |
|
204 |
203 |
$0.00 |
| 90687 |
|
16 |
16 |
$0.00 |
| 3078F |
|
12 |
12 |
$0.00 |
| 99306 |
Prolong nursin fac eval 15m |
12 |
12 |
$0.00 |
| A4617 |
Mouth piece |
21 |
13 |
$0.00 |
| 94070 |
|
26 |
26 |
$0.00 |
| G8431 |
Pos clin depres scrn f/u doc |
12 |
12 |
$0.00 |
| 90685 |
|
29 |
29 |
$0.00 |
| Q0244 |
Casirivi and imdevi 1200 mg |
14 |
14 |
$0.00 |
| 99473 |
|
30 |
25 |
$0.00 |
| 75580 |
|
14 |
14 |
$0.00 |
| 95957 |
|
12 |
12 |
$0.00 |
| G8938 |
Bmi doc onl fup nt doc |
13 |
12 |
$0.00 |
| 0690T |
|
94 |
94 |
$0.00 |
| 78725 |
|
14 |
12 |
$0.00 |
| G9920 |
Scrning perf and negative |
12 |
12 |
$0.00 |
| 90681 |
|
12 |
12 |
$0.00 |
| 91307 |
|
295 |
277 |
$0.00 |
| G8950 |
Pre-htn or htn doc, f/u indc |
1,090 |
902 |
$0.00 |
| G9903 |
Pt scrn tbco id as non user |
3,129 |
2,982 |
$0.00 |
| 99058 |
|
667 |
632 |
$0.00 |
| G8420 |
Calc bmi norm parameters |
6,880 |
5,759 |
$0.00 |
| G8418 |
Calc bmi blw low param f/u |
2,271 |
1,694 |
$0.00 |
| 91301 |
|
114 |
113 |
$0.00 |
| G8754 |
Dias bp less 90 |
1,542 |
1,409 |
$0.00 |
| 88738 |
|
252 |
252 |
$0.00 |
| 90680 |
|
922 |
921 |
$0.00 |
| 36416 |
|
1,616 |
1,570 |
$0.00 |
| 90677 |
|
253 |
253 |
$0.00 |
| J1642 |
Inj heparin sodium per 10 u |
83 |
37 |
$0.00 |
| 80329 |
|
37 |
36 |
$0.00 |
| 80050 |
|
417 |
417 |
$0.00 |
| 0346T |
|
144 |
144 |
$0.00 |
| 90697 |
|
42 |
42 |
$0.00 |
| 90619 |
|
365 |
365 |
$0.00 |
| G9275 |
Doc of non tobacco user |
762 |
731 |
$0.00 |
| G8419 |
Calc bmi out nrm param nof/u |
94 |
85 |
$0.00 |
| G8883 |
Rev, comm, track, doc biopsy |
125 |
125 |
$0.00 |
| 90647 |
|
658 |
657 |
$0.00 |
| 90698 |
|
545 |
544 |
$0.00 |
| 99070 |
|
17 |
15 |
$0.00 |
| 99172 |
|
227 |
227 |
$0.00 |
| G8430 |
Doc med rsn no medrec |
210 |
175 |
$0.00 |
| S0020 |
Injection, bupivicaine hydro |
128 |
103 |
$0.00 |
| 83014 |
|
182 |
182 |
$0.00 |
| A4556 |
Electrodes, pair |
379 |
357 |
$0.00 |
| 99474 |
|
47 |
38 |
$0.00 |
| 90660 |
|
13 |
13 |
$0.00 |
| 90620 |
|
26 |
24 |
$0.00 |
| 90381 |
|
13 |
13 |
$0.00 |
| 84432 |
|
63 |
63 |
$0.00 |
| 90723 |
|
49 |
49 |
$0.00 |
| 99458 |
|
12 |
12 |
$0.00 |
| G8981 |
Body pos current status |
17 |
17 |
$0.00 |
| S9451 |
Exercise class |
27 |
27 |
$0.00 |
| G8982 |
Body pos goal status |
18 |
18 |
$0.00 |
| 1036F |
|
26 |
26 |
$0.00 |
| G9637 |
Doc >1 dose reduc tech |
44 |
44 |
$0.00 |
| 97550 |
|
47 |
40 |
$0.00 |
| 97750 |
|
16 |
16 |
$0.00 |
| 87632 |
|
37 |
37 |
$0.00 |
| 91306 |
|
16 |
16 |
$0.00 |
| 91303 |
|
28 |
28 |
$0.00 |
| J3490 |
Drugs unclassified injection |
19 |
16 |
$0.00 |
| 3074F |
|
27 |
26 |
$0.00 |
| G8711 |
Pres antibx on/within 3 day |
14 |
14 |
$0.00 |
| 90696 |
|
12 |
12 |
$0.00 |
| 3008F |
|
21 |
20 |
$0.00 |