| Code | Description | Claims | Beneficiaries | Total Paid |
| 99284 |
|
48,979 |
44,958 |
$6.88M |
| 99283 |
|
53,754 |
50,031 |
$5.19M |
| 99285 |
|
25,110 |
22,864 |
$4.87M |
| 99213 |
|
136,192 |
124,481 |
$4.33M |
| 99214 |
|
92,711 |
83,385 |
$4.24M |
| J9271 |
Inj pembrolizumab |
507 |
325 |
$2.64M |
| 99211 |
|
99,684 |
88,466 |
$2.53M |
| 99215 |
Prolong outpt/office vis |
47,909 |
43,411 |
$2.13M |
| 20610 |
|
6,750 |
5,432 |
$1.63M |
| J1745 |
Infliximab not biosimil 10mg |
419 |
345 |
$1.49M |
| 96413 |
|
10,373 |
6,464 |
$1.09M |
| 80053 |
|
136,119 |
109,913 |
$1.04M |
| 74177 |
|
2,990 |
2,723 |
$919K |
| 87635 |
|
23,733 |
20,598 |
$884K |
| 96372 |
|
43,663 |
35,311 |
$754K |
| 85025 |
|
128,580 |
104,949 |
$714K |
| 99282 |
|
9,336 |
8,798 |
$598K |
| 31575 |
|
2,135 |
1,901 |
$587K |
| 80050 |
|
14,684 |
13,176 |
$564K |
| 80307 |
|
11,506 |
9,949 |
$526K |
| 71260 |
|
2,473 |
2,243 |
$489K |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
6,058 |
5,398 |
$484K |
| 93005 |
|
30,063 |
27,149 |
$471K |
| 87502 |
|
5,587 |
5,220 |
$463K |
| 87591 |
|
15,963 |
12,318 |
$441K |
| 87491 |
|
15,837 |
12,289 |
$436K |
| 87536 |
|
7,928 |
6,630 |
$434K |
| 71046 |
|
11,668 |
10,743 |
$418K |
| 36415 |
|
190,242 |
155,352 |
$417K |
| 80061 |
|
38,188 |
34,324 |
$399K |
| 87636 |
|
3,215 |
3,079 |
$393K |
| 87651 |
|
13,640 |
11,843 |
$381K |
| 82306 |
|
18,543 |
16,072 |
$378K |
| 0241U |
|
3,915 |
3,132 |
$363K |
| 96375 |
|
11,808 |
7,745 |
$344K |
| 0240U |
|
3,892 |
2,979 |
$331K |
| 83036 |
|
40,892 |
36,343 |
$295K |
| 92014 |
|
10,260 |
8,281 |
$283K |
| 70450 |
|
1,579 |
1,436 |
$268K |
| 71045 |
|
9,566 |
8,695 |
$249K |
| G0480 |
Drug test def 1-7 classes |
4,603 |
3,419 |
$242K |
| 73564 |
|
4,290 |
3,114 |
$239K |
| 77067 |
|
3,713 |
3,523 |
$228K |
| 84443 |
|
17,993 |
15,765 |
$221K |
| 81025 |
|
34,613 |
30,012 |
$212K |
| J3490 |
Drugs unclassified injection |
44,657 |
17,665 |
$202K |
| 87389 |
|
10,806 |
9,188 |
$201K |
| 96374 |
|
11,327 |
9,070 |
$194K |
| 81001 |
|
81,019 |
69,995 |
$184K |
| 93306 |
|
978 |
908 |
$177K |
| J2469 |
Palonosetron hcl |
1,442 |
790 |
$173K |
| J2505 |
Injection, pegfilgrastim 6mg |
54 |
39 |
$173K |
| 52000 |
|
642 |
604 |
$172K |
| 80074 |
|
5,499 |
4,602 |
$172K |
| 93458 |
|
127 |
111 |
$165K |
| 90686 |
|
5,934 |
5,329 |
$161K |
| 87637 |
|
1,292 |
1,221 |
$149K |
| G0378 |
Hospital observation per hr |
1,496 |
558 |
$149K |
| 96361 |
|
8,099 |
5,799 |
$147K |
| 99212 |
|
5,183 |
4,731 |
$146K |
| 96365 |
|
2,449 |
1,449 |
$141K |
| 51700 |
|
974 |
498 |
$139K |
| 86780 |
|
13,651 |
10,996 |
$136K |
| 96417 |
|
2,704 |
1,767 |
$135K |
| J0585 |
Injection,onabotulinumtoxina |
1,066 |
552 |
$129K |
| 84484 |
|
15,097 |
12,566 |
$119K |
| 87804 |
|
9,890 |
5,624 |
$118K |
| J1885 |
Ketorolac tromethamine inj |
24,391 |
21,998 |
$108K |
| J0185 |
Inj., aprepitant, 1 mg |
407 |
248 |
$98K |
| 67028 |
|
407 |
320 |
$95K |
| J1050 |
Medroxyprogesterone acetate |
4,117 |
2,529 |
$94K |
| 84439 |
|
13,951 |
11,774 |
$92K |
| 92557 |
|
1,865 |
1,716 |
$89K |
| 86361 |
|
5,177 |
4,385 |
$89K |
| 90651 |
|
513 |
483 |
$86K |
| 74178 |
|
240 |
219 |
$85K |
| 96367 |
|
3,364 |
1,962 |
$84K |
| J0897 |
Denosumab injection |
86 |
81 |
$84K |
| 87880 |
|
5,619 |
5,168 |
$76K |
| 96415 |
|
3,290 |
2,326 |
$75K |
| 74176 |
|
236 |
224 |
$71K |
| 83880 |
|
2,996 |
2,619 |
$68K |
| 66984 |
|
179 |
147 |
$67K |
| 43239 |
|
238 |
202 |
$65K |
| 96360 |
|
1,917 |
1,446 |
$65K |
| 83735 |
|
14,923 |
11,201 |
$65K |
| 87624 |
|
2,423 |
2,163 |
$62K |
| 87088 |
|
9,955 |
8,909 |
$62K |
| J3301 |
Triamcinolone acet inj nos |
6,071 |
5,662 |
$58K |
| 77063 |
|
1,824 |
1,723 |
$58K |
| 87522 |
Neg quan hep c or qual rna |
1,645 |
1,422 |
$58K |
| 92133 |
|
3,323 |
2,462 |
$57K |
| 96523 |
|
3,330 |
2,507 |
$54K |
| 99281 |
|
1,602 |
1,492 |
$54K |
| 86803 |
|
5,135 |
4,241 |
$54K |
| 99202 |
|
2,017 |
1,936 |
$53K |
| 74019 |
|
1,480 |
1,355 |
$52K |
| 41899 |
|
76 |
70 |
$52K |
| 92134 |
|
3,906 |
2,962 |
$51K |
| 80048 |
|
7,412 |
6,646 |
$49K |
| 92567 |
|
2,679 |
2,443 |
$49K |
| 76705 |
|
634 |
590 |
$48K |
| 83690 |
|
8,720 |
7,689 |
$44K |
| 87811 |
|
1,558 |
1,432 |
$44K |
| 90750 |
|
456 |
412 |
$43K |
| J1950 |
Leuprolide acetate /3.75 mg |
26 |
25 |
$43K |
| 92250 |
|
3,127 |
2,642 |
$43K |
| 88174 |
|
2,583 |
2,341 |
$40K |
| 99203 |
|
1,443 |
1,345 |
$40K |
| 73130 |
|
1,299 |
1,018 |
$39K |
| 76856 |
|
432 |
396 |
$39K |
| 82728 |
|
3,992 |
3,346 |
$38K |
| 76830 |
|
403 |
377 |
$38K |
| 73610 |
|
1,362 |
1,085 |
$38K |
| 83970 |
|
1,200 |
1,143 |
$37K |
| 86480 |
|
915 |
715 |
$37K |
| 90715 |
|
620 |
579 |
$37K |
| 87661 |
|
1,239 |
1,105 |
$36K |
| 99205 |
Prolong outpt/office vis |
945 |
879 |
$35K |
| 45385 |
|
136 |
111 |
$34K |
| 78306 |
|
261 |
241 |
$34K |
| 99201 |
|
1,313 |
1,264 |
$33K |
| J1100 |
Dexamethasone sodium phos |
9,586 |
6,588 |
$32K |
| 51798 |
|
1,263 |
1,136 |
$32K |
| 96416 |
|
337 |
211 |
$32K |
| C1713 |
Anchor/screw bn/bn,tis/bn |
600 |
537 |
$32K |
| 92012 |
|
1,234 |
1,041 |
$31K |
| 86481 |
|
545 |
499 |
$31K |
| 64615 |
|
365 |
357 |
$30K |
| 82570 |
|
7,260 |
6,612 |
$29K |
| J7030 |
Normal saline solution infus |
2,242 |
2,044 |
$28K |
| 92083 |
|
1,468 |
1,090 |
$28K |
| 82553 |
|
3,796 |
3,300 |
$28K |
| 20611 |
|
93 |
77 |
$28K |
| 87210 |
|
7,009 |
6,084 |
$28K |
| 93017 |
|
293 |
268 |
$27K |
| J7321 |
Hyalgan supartz visco-3 dose |
179 |
74 |
$27K |
| J8499 |
Oral prescrip drug non chemo |
5,935 |
3,352 |
$26K |
| 82043 |
|
6,041 |
5,267 |
$26K |
| 73030 |
|
791 |
695 |
$26K |
| J0640 |
Leucovorin calcium injection |
336 |
187 |
$25K |
| 83550 |
|
4,089 |
3,409 |
$25K |
| J1642 |
Inj heparin sodium per 10 u |
6,349 |
4,583 |
$25K |
| 88305 |
|
3,864 |
2,684 |
$24K |
| 84153 |
|
1,909 |
1,648 |
$24K |
| 73110 |
|
783 |
629 |
$23K |
| 87340 |
|
2,941 |
2,494 |
$23K |
| J2916 |
Na ferric gluconate complex |
216 |
77 |
$22K |
| 87081 |
|
3,941 |
3,583 |
$22K |
| G0108 |
Diab manage trn per indiv |
924 |
736 |
$22K |
| 78452 |
|
58 |
51 |
$21K |
| J7120 |
Ringers lactate infusion |
7,591 |
5,707 |
$21K |
| 82607 |
|
1,842 |
1,577 |
$21K |
| 82550 |
|
4,785 |
4,134 |
$20K |
| 76801 |
|
204 |
187 |
$19K |
| 82378 |
|
1,454 |
1,151 |
$18K |
| 73630 |
|
590 |
463 |
$18K |
| 83540 |
|
4,127 |
3,446 |
$18K |
| J2405 |
Ondansetron hcl injection |
9,585 |
7,337 |
$17K |
| J1200 |
Diphenhydramine hcl injectio |
5,265 |
3,412 |
$17K |
| 86360 |
|
544 |
460 |
$17K |
| J1453 |
Fosaprepitant injection |
125 |
90 |
$16K |
| 82077 |
|
1,587 |
1,359 |
$16K |
| 80179 |
|
1,535 |
1,287 |
$16K |
| 86850 |
|
2,110 |
1,499 |
$15K |
| 81002 |
|
6,136 |
4,994 |
$15K |
| J7050 |
Normal saline solution infus |
1,251 |
887 |
$15K |
| 85027 |
|
2,969 |
2,441 |
$15K |
| 80320 |
|
2,878 |
2,019 |
$15K |
| 90734 |
|
137 |
124 |
$15K |
| 86160 |
|
1,340 |
959 |
$14K |
| 99204 |
|
364 |
330 |
$14K |
| 86359 |
|
542 |
460 |
$14K |
| J9190 |
Fluorouracil injection |
447 |
237 |
$13K |
| 86762 |
|
998 |
896 |
$13K |
| 85610 |
|
4,451 |
3,594 |
$12K |
| 69210 |
|
384 |
341 |
$12K |
| 96411 |
|
299 |
196 |
$12K |
| 92593 |
|
744 |
673 |
$11K |
| 86787 |
|
1,074 |
944 |
$11K |
| 92652 |
|
119 |
96 |
$11K |
| 76805 |
|
180 |
167 |
$11K |
| Q0138 |
Ferumoxytol, non-esrd |
16 |
12 |
$10K |
| 87902 |
|
50 |
39 |
$10K |
| 87449 |
|
770 |
725 |
$10K |
| 58100 |
|
245 |
214 |
$10K |
| 87086 |
|
1,628 |
1,486 |
$10K |
| 92587 |
|
240 |
215 |
$10K |
| A9502 |
Tc99m tetrofosmin |
61 |
52 |
$9K |
| 86140 |
|
2,558 |
2,214 |
$9K |
| 96402 |
|
510 |
406 |
$9K |
| J2930 |
Methylprednisolone injection |
680 |
566 |
$8K |
| J1644 |
Inj heparin sodium per 1000u |
2,326 |
1,392 |
$8K |
| 84156 |
|
3,019 |
2,679 |
$8K |
| 94640 |
|
643 |
528 |
$8K |
| J2785 |
Regadenoson injection |
62 |
51 |
$8K |
| 76811 |
|
95 |
77 |
$7K |
| 72100 |
|
211 |
198 |
$7K |
| 96368 |
|
853 |
480 |
$7K |
| 90838 |
|
323 |
271 |
$7K |
| 86706 |
|
819 |
703 |
$6K |
| 84481 |
|
711 |
612 |
$6K |
| 29580 |
|
63 |
12 |
$6K |
| 82962 |
|
2,403 |
1,857 |
$6K |
| 87400 |
|
1,008 |
449 |
$6K |
| 84100 |
|
1,841 |
1,514 |
$6K |
| 11719 |
|
259 |
230 |
$6K |
| 82274 |
|
357 |
349 |
$6K |
| 81003 |
|
2,967 |
2,482 |
$6K |
| 86708 |
|
605 |
534 |
$6K |
| 80143 |
|
549 |
461 |
$5K |
| 71270 |
|
36 |
29 |
$5K |
| 20526 |
|
27 |
27 |
$5K |
| 83615 |
|
1,142 |
925 |
$5K |
| 90677 |
|
163 |
110 |
$4K |
| 76775 |
|
80 |
78 |
$4K |
| 85660 |
|
882 |
783 |
$4K |
| 82150 |
|
774 |
725 |
$4K |
| 85651 |
|
1,477 |
1,260 |
$4K |
| 99396 |
|
1,206 |
1,021 |
$4K |
| A9503 |
Tc99m medronate |
222 |
199 |
$4K |
| 83605 |
|
574 |
403 |
$4K |
| J2704 |
Inj, propofol, 10 mg |
7,775 |
6,057 |
$4K |
| 97530 |
|
174 |
114 |
$4K |
| 57456 |
|
12 |
12 |
$4K |
| 95816 |
|
45 |
41 |
$4K |
| 58558 |
|
13 |
12 |
$4K |
| 80329 |
|
1,099 |
439 |
$4K |
| 86900 |
|
1,908 |
1,545 |
$4K |
| 88108 |
|
238 |
215 |
$4K |
| 96366 |
|
192 |
98 |
$4K |
| 86901 |
|
1,907 |
1,544 |
$4K |
| 31525 |
|
13 |
13 |
$4K |
| 85379 |
|
518 |
435 |
$4K |
| 86235 |
|
154 |
84 |
$4K |
| 71250 |
|
21 |
21 |
$3K |
| 95812 |
|
33 |
29 |
$3K |
| 82746 |
|
333 |
267 |
$3K |
| J7324 |
Orthovisc inj per dose |
210 |
103 |
$3K |
| 83655 |
|
292 |
256 |
$3K |
| J9263 |
Oxaliplatin |
17 |
12 |
$3K |
| 55700 |
|
12 |
12 |
$3K |
| 31576 |
|
15 |
12 |
$3K |
| 57454 |
|
17 |
12 |
$3K |
| 85730 |
|
769 |
694 |
$3K |
| 86225 |
|
266 |
245 |
$3K |
| 86704 |
|
346 |
284 |
$3K |
| 73562 |
|
88 |
78 |
$3K |
| 85652 |
|
1,360 |
1,222 |
$3K |
| J2001 |
Lidocaine injection |
4,869 |
4,014 |
$3K |
| 99291 |
|
13 |
12 |
$3K |
| 91200 |
|
319 |
275 |
$3K |
| 86300 |
|
224 |
117 |
$3K |
| 82784 |
|
314 |
214 |
$2K |
| J2250 |
Inj midazolam hydrochloride |
4,593 |
3,850 |
$2K |
| 85007 |
|
1,709 |
1,301 |
$2K |
| 86334 |
|
192 |
170 |
$2K |
| J3010 |
Fentanyl citrate injection |
4,766 |
4,090 |
$2K |
| J9267 |
Paclitaxel injection |
51 |
25 |
$2K |
| J0702 |
Betamethasone acet&sod phosp |
72 |
67 |
$2K |
| 83521 |
|
205 |
137 |
$2K |
| 87807 |
|
190 |
172 |
$2K |
| J2270 |
Morphine sulfate injection |
590 |
447 |
$2K |
| 88307 |
|
122 |
84 |
$2K |
| J7040 |
Normal saline solution infus |
350 |
207 |
$2K |
| 87625 |
|
96 |
64 |
$2K |
| 90636 |
|
217 |
94 |
$2K |
| A9577 |
Inj multihance |
43 |
39 |
$2K |
| 84702 |
|
275 |
211 |
$2K |
| 83516 |
|
118 |
93 |
$2K |
| 87077 |
|
359 |
284 |
$2K |
| 86592 |
|
696 |
509 |
$2K |
| 90656 |
|
850 |
658 |
$2K |
| 84165 |
|
287 |
244 |
$2K |
| C1894 |
Intro/sheath, non-laser |
128 |
115 |
$2K |
| 90670 |
|
13 |
12 |
$2K |
| A9150 |
Misc/exper non-prescript dru |
1,162 |
761 |
$2K |
| J1650 |
Inj enoxaparin sodium |
58 |
27 |
$2K |
| 76642 |
|
33 |
33 |
$2K |
| 99442 |
|
455 |
441 |
$2K |
| 83883 |
|
297 |
190 |
$2K |
| 59025 |
|
102 |
56 |
$1K |
| J0500 |
Dicyclomine injection |
28 |
26 |
$1K |
| 87481 |
|
50 |
42 |
$1K |
| C1769 |
Guide wire |
139 |
127 |
$1K |
| 87511 |
|
50 |
42 |
$1K |
| 92558 |
|
26 |
24 |
$1K |
| 96401 |
|
74 |
57 |
$1K |
| 83010 |
|
130 |
116 |
$1K |
| 81005 |
|
1,369 |
1,151 |
$1K |
| 96376 |
|
100 |
30 |
$1K |
| 92020 |
|
87 |
78 |
$1K |
| 76816 |
|
13 |
12 |
$1K |
| 72040 |
|
41 |
41 |
$1K |
| 84550 |
|
373 |
339 |
$1K |
| 90471 |
|
827 |
711 |
$1K |
| 92015 |
|
95 |
85 |
$1K |
| 99443 |
|
261 |
243 |
$947.93 |
| 82565 |
|
289 |
273 |
$936.92 |
| C1887 |
Catheter, guiding |
73 |
71 |
$928.09 |
| 11055 |
|
31 |
25 |
$887.92 |
| 77080 |
|
13 |
13 |
$850.90 |
| 85018 |
|
335 |
288 |
$839.12 |
| 84703 |
|
152 |
122 |
$812.16 |
| 17000 |
|
28 |
27 |
$680.68 |
| J8597 |
Antiemetic drug oral nos |
28 |
25 |
$611.20 |
| 17110 |
|
13 |
13 |
$605.85 |
| 86769 |
|
28 |
17 |
$591.75 |
| 80069 |
|
107 |
92 |
$587.70 |
| U0002 |
Covid-19 lab test non-cdc |
24 |
16 |
$568.20 |
| 90739 |
|
26 |
26 |
$543.06 |
| 86705 |
|
62 |
56 |
$541.42 |
| 92025 |
|
13 |
13 |
$540.30 |
| 94761 |
|
127 |
99 |
$530.65 |
| J2060 |
Lorazepam injection |
116 |
100 |
$510.16 |
| 73140 |
|
16 |
13 |
$485.90 |
| A9578 |
Inj multihance multipack |
12 |
12 |
$483.56 |
| 81511 |
|
38 |
36 |
$481.36 |
| 77065 |
Tomosynthesis, mammo |
15 |
14 |
$476.88 |
| 76001 |
|
46 |
43 |
$475.53 |
| J0690 |
Cefazolin sodium injection |
2,827 |
2,116 |
$466.34 |
| 86200 |
|
39 |
36 |
$451.73 |
| 87186 |
|
98 |
75 |
$451.09 |
| J2795 |
Ropivacaine hcl injection |
422 |
387 |
$443.10 |
| J7060 |
5% dextrose/water |
39 |
16 |
$440.30 |
| 96377 |
|
34 |
25 |
$427.78 |
| V5266 |
Battery for hearing device |
115 |
105 |
$423.50 |
| 82977 |
|
66 |
57 |
$418.40 |
| 92592 |
|
27 |
25 |
$409.14 |
| 86800 |
|
30 |
28 |
$397.75 |
| 86431 |
|
96 |
53 |
$393.50 |
| 84154 |
|
32 |
28 |
$386.19 |
| 92136 |
|
93 |
79 |
$366.93 |
| 86376 |
|
30 |
28 |
$363.75 |
| 86038 |
|
40 |
31 |
$358.62 |
| 82747 |
|
24 |
24 |
$353.00 |
| 84436 |
|
113 |
106 |
$340.76 |
| 93976 |
|
27 |
25 |
$335.46 |
| 92082 |
|
35 |
33 |
$330.93 |
| 86141 |
|
41 |
26 |
$310.80 |
| 99391 |
|
84 |
65 |
$268.98 |
| 84630 |
|
40 |
27 |
$257.97 |
| 86256 |
|
27 |
25 |
$253.05 |
| 86039 |
|
28 |
26 |
$245.52 |
| Q9969 |
Non-heu tc-99m add-on/dose |
240 |
220 |
$238.50 |
| Q2039 |
Influenza virus vaccine, nos |
14 |
12 |
$220.06 |
| 92227 |
|
109 |
97 |
$216.92 |
| J2305 |
Inj, nitroglycerin, 5 mg |
63 |
51 |
$211.91 |
| 76514 |
|
14 |
14 |
$208.32 |
| 84160 |
|
65 |
59 |
$200.88 |
| 84146 |
|
13 |
12 |
$197.62 |
| J0696 |
Ceftriaxone sodium injection |
47 |
38 |
$196.82 |
| A9698 |
Non-rad contrast materialnoc |
118 |
111 |
$186.76 |
| J2003 |
Inj, lidocaine hcl, 1 mg |
172 |
133 |
$184.06 |
| 77061 |
|
13 |
12 |
$169.38 |
| 90662 |
|
34 |
24 |
$168.07 |
| 82042 |
|
55 |
43 |
$167.00 |
| J2765 |
Metoclopramide hcl injection |
52 |
48 |
$145.40 |
| 99152 |
|
167 |
129 |
$139.06 |
| 87040 |
|
13 |
12 |
$134.16 |
| Q0091 |
Obtaining screen pap smear |
13 |
13 |
$132.77 |
| 86707 |
|
12 |
12 |
$127.27 |
| 87350 |
|
12 |
12 |
$126.83 |
| 99441 |
|
76 |
74 |
$126.00 |
| J1170 |
Hydromorphone injection |
58 |
40 |
$124.98 |
| 86430 |
|
17 |
12 |
$122.78 |
| 85045 |
|
41 |
37 |
$116.64 |
| 86593 |
|
28 |
26 |
$110.99 |
| 99153 |
Mod sedat endo service >5yrs |
29 |
25 |
$102.17 |
| G0463 |
Hospital outpt clinic visit |
28,316 |
23,470 |
$92.65 |
| 87184 |
|
12 |
12 |
$89.76 |
| 82950 |
|
20 |
12 |
$82.25 |
| 76000 |
|
13 |
12 |
$79.18 |
| 86580 |
|
14 |
12 |
$63.10 |
| J0330 |
Succinycholine chloride inj |
17 |
14 |
$52.63 |
| 82947 |
|
16 |
14 |
$47.16 |
| V5275 |
Ear impression |
13 |
12 |
$38.55 |
| 99459 |
|
36 |
27 |
$35.99 |
| 84460 |
|
78 |
57 |
$33.07 |
| 82247 |
|
78 |
57 |
$28.82 |
| 84132 |
|
65 |
52 |
$25.80 |
| J2550 |
Promethazine hcl injection |
258 |
227 |
$24.75 |
| J2175 |
Meperidine hydrochl /100 mg |
244 |
212 |
$22.54 |
| J0595 |
Butorphanol tartrate 1 mg |
13 |
12 |
$13.42 |
| J0665 |
Inj, bupivacaine, nos, 0.5mg |
149 |
102 |
$6.38 |
| J0171 |
Adrenalin epinephrine inject |
265 |
216 |
$6.38 |
| J2371 |
Inj phenylephrine hcl 20 mcg |
14 |
12 |
$6.38 |
| 94760 |
|
20 |
15 |
$1.85 |
| 02404 |
|
27 |
26 |
$0.00 |
| C1780 |
Lens, intraocular (new tech) |
170 |
142 |
$0.00 |
| 01810 |
|
12 |
12 |
$0.00 |
| 87631 |
|
786 |
724 |
$0.00 |
| G0101 |
Ca screen;pelvic/breast exam |
71 |
69 |
$0.00 |
| 82172 |
|
81 |
59 |
$0.00 |
| 90653 |
|
13 |
12 |
$0.00 |
| 00811 |
|
103 |
93 |
$0.00 |
| J9035 |
Bevacizumab injection |
32 |
24 |
$0.00 |
| J2710 |
Neostigmine methylslfte inj |
30 |
24 |
$0.00 |
| 76942 |
|
48 |
47 |
$0.00 |
| 88312 |
|
133 |
110 |
$0.00 |
| 00731 |
|
28 |
28 |
$0.00 |
| 90472 |
|
16 |
13 |
$0.00 |
| 02414 |
|
12 |
12 |
$0.00 |
| Q2038 |
Fluzone vacc, 3 yrs & >, im |
12 |
12 |
$0.00 |
| A9270 |
Non-covered item or service |
604 |
309 |
$0.00 |
| 64415 |
|
34 |
25 |
$0.00 |
| A4648 |
Implantable tissue marker |
17 |
12 |
$0.00 |
| 3008F |
|
28 |
28 |
$0.00 |
| 76872 |
|
12 |
12 |
$0.00 |
| G0008 |
Admin influenza virus vac |
106 |
103 |
$0.00 |
| 91305 |
|
15 |
12 |
$0.00 |
| J7999 |
Compounded drug, noc |
103 |
46 |
$0.00 |
| 1031F |
|
19 |
19 |
$0.00 |
| V2632 |
Post chmbr intraocular lens |
59 |
31 |
$0.00 |
| 98967 |
|
24 |
24 |
$0.00 |