Medicaid Provider Spending

$1.09 trillion in Medicaid claims data, 2018–2024 · 617K+ providers

RCHP BILLINGS - MISSOULA LLC

NPI: 1346642899 · MISSOULA, MT 59804 · General Acute Care Hospital · NPI assigned 09/16/2014

Billing Flags · Automated signals — not evidence of fraud
Entity Proliferation

Authorized official LAWRENCE, CHARLOTTE controls 20+ related entities in our dataset. Read more

$4.01M
Total Medicaid Paid
833,786
Total Claims
619,960
Beneficiaries
334
Codes Billed
2018-01
First Month
2024-12
Last Month

Provider Details

Authorized OfficialLAWRENCE, CHARLOTTE (SECRETARY)
NPI Enumeration Date09/16/2014

Related Entities

Other providers sharing the same authorized official: LAWRENCE, CHARLOTTE

ProviderCityStateTotal Paid
LAKE CUMBERLAND REGIONAL HOSPITAL LLC SOMERSET KY $77.77M
DANVILLE REGIONAL MEDICAL CENTER, LLC DANVILLE VA $65.11M
PHC-LAS CRUCES INC LAS CRUCES NM $64.77M
GEORGETOWN COMMUNITY HOSPITAL LLC GEORGETOWN KY $44.03M
PINELAKE REGIONAL HOSPITAL LLC MAYFIELD KY $43.34M
RALEIGH GENERAL HOSPITAL LLC BECKLEY WV $36.44M
LOURDES HOSPITAL LLC PASCO WA $33.94M
RCHP-SIERRA VISTA INC SIERRA VISTA AZ $29.77M
CLINCH VALLEY MEDICAL CENTER INC. RICHLANDS VA $26.28M
SPRING VIEW HOSPITAL LLC LEBANON KY $23.35M
HAVASU REGIONAL MEDICAL CENTER LLC LAKE HAVASU CITY AZ $23.19M
LAS CRUCES PHYSICIAN PRACTICES, LLC LAS CRUCES NM $22.78M
MEADOWVIEW REGIONAL MEDICAL CENTER LLC MAYSVILLE KY $22.57M
LOURDES HOSPITAL LLC RICHLAND WA $22.38M
DANVILLE REGIONAL MEDICAL CENTER LLC MARTINSVILLE VA $21.09M
PHC-FORT MOHAVE INC FORT MOHAVE AZ $19.95M
WYTHE COUNTY COMMUNITY HOSPITAL LLC WYTHEVILLE VA $18.30M
DLP CONEMAUGH MEMORIAL MEDICAL CENTER LLC JOHNSTOWN PA $18.22M
BOURBON COMMUNITY HOSPITAL LLC PARIS KY $18.14M
WILLAMETTE VALLEY MEDICAL CENTER LLC MCMINNVILLE OR $17.29M

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2018 132,440 $541K
2019 121,543 $569K
2020 108,000 $414K
2021 128,135 $562K
2022 130,183 $647K
2023 122,466 $670K
2024 91,019 $605K

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
99283 Emergency department visit for the evaluation and management, moderate severity 25,308 22,542 $573K
99284 Emergency department visit for the evaluation and management, high severity 15,976 13,801 $324K
92507 Treatment of speech, language, voice, communication, and/or auditory processing disorder 14,061 4,125 $301K
99285 Emergency department visit for the evaluation and management, high severity with immediate threat to life 9,930 8,247 $276K
97530 Therapeutic activities, direct patient contact, each 15 minutes 21,296 6,691 $249K
74177 Computed tomography, abdomen and pelvis; with contrast material 4,678 4,009 $221K
96413 Chemotherapy administration, intravenous infusion; up to 1 hour, single or initial substance 3,465 1,781 $175K
97110 Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion 23,339 6,489 $161K
70450 Computed tomography, head or brain; without contrast material 3,168 2,746 $74K
99282 Emergency department visit for the evaluation and management, low to moderate severity 2,513 2,327 $66K
43239 Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple 1,115 913 $65K
J3490 Unclassified drugs 15,992 7,897 $60K
96375 Therapeutic injection; each additional sequential IV push 9,864 7,412 $57K
80053 Comprehensive metabolic panel 38,390 31,031 $57K
C1713 Anchor/screw for opposing bone-to-bone or soft tissue-to-bone (implantable) 450 331 $55K
G0378 Hospital observation service, per hour 1,481 1,086 $53K
70553 Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences 982 775 $53K
88305 Level IV - Surgical pathology, gross and microscopic examination 8,060 5,234 $49K
85025 Blood count; complete (CBC), automated, and automated differential WBC count 39,795 31,675 $43K
96374 Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance 13,385 10,963 $43K
96365 Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour 5,348 3,287 $41K
87633 Infectious agent detection by nucleic acid, respiratory virus, 12-25 targets 742 671 $36K
0202U Oncology (prostate), multianalyte, gene expression profiling 754 693 $35K
99281 Emergency department visit for the evaluation and management, self-limited or minor 4,315 3,728 $29K
71046 Radiologic examination, chest; 2 views 3,949 3,635 $27K
70551 Magnetic resonance imaging, brain; without contrast material 311 266 $24K
86140 4,027 3,308 $24K
97112 Therapeutic procedure, each 15 minutes; neuromuscular reeducation of movement, balance, coordination 5,508 1,483 $22K
74018 1,466 1,255 $21K
97161 1,887 1,361 $21K
J2704 Injection, propofol, 10 mg 6,150 4,530 $21K
Q9967 Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml 7,056 6,263 $20K
72148 Magnetic resonance imaging, lumbar spine; without contrast material 1,461 1,361 $18K
45380 Colonoscopy, flexible; with biopsy, single or multiple 217 191 $17K
76700 Ultrasound, abdominal, real time with image documentation; complete 1,447 1,343 $17K
94640 Pressurized or nonpressurized inhalation treatment for acute airway obstruction 2,052 1,448 $16K
87801 Infectious agent detection by nucleic acid; amplified probe, multiple organisms 136 135 $15K
81001 17,966 15,064 $15K
96361 Intravenous infusion, hydration; each additional hour 5,905 4,598 $15K
C9803 Hospital outpatient clinic visit specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source 7,741 6,955 $14K
84703 4,899 4,326 $13K
73721 Magnetic resonance imaging, any joint of lower extremity; without contrast material 651 565 $13K
72125 Computed tomography, cervical spine; without contrast material 370 335 $13K
92523 278 210 $13K
87502 Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets 1,049 993 $12K
82306 Vitamin D; 25 hydroxy, includes fraction(s), if performed 5,669 5,360 $12K
93005 Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report 9,329 7,559 $11K
73610 943 854 $11K
85027 12,351 10,500 $11K
36592 2,043 1,296 $10K
84443 Thyroid stimulating hormone (TSH) 15,772 14,489 $10K
80307 Drug test(s), presumptive, any number of drug classes; immunoassay 4,378 2,716 $10K
87631 303 261 $10K
36415 Collection of venous blood by venipuncture 36,934 30,671 $10K
71045 Radiologic examination, chest; single view 3,884 3,354 $9K
J7050 Infusion, normal saline solution, 250 cc 7,337 3,020 $9K
85651 2,971 2,428 $9K
76705 Ultrasound, abdominal, real time with image documentation; limited 139 122 $9K
87635 Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe 1,182 1,038 $9K
87491 Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe 4,351 4,067 $8K
87798 Infectious agent detection by nucleic acid; not otherwise specified, amplified probe, each organism 812 731 $8K
83690 7,006 5,920 $8K
96366 Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour 1,749 1,123 $8K
87591 Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe 4,310 4,026 $8K
87086 Culture, bacterial; quantitative colony count, urine 8,113 7,295 $8K
76770 586 553 $8K
92526 598 242 $8K
88304 1,367 1,050 $8K
87486 774 698 $7K
73630 1,015 918 $7K
87637 Infectious agent detection by nucleic acid; SARS-CoV-2, influenza, and RSV 1,467 1,310 $7K
87581 774 698 $7K
71275 Computed tomographic angiography, chest, with contrast material 578 482 $7K
99153 Mod sedat endo service >5yrs 1,158 848 $6K
93976 418 385 $6K
96415 381 223 $6K
74176 Computed tomography, abdomen and pelvis; without contrast material 799 735 $6K
87081 2,345 2,126 $6K
87880 Infectious agent antigen detection by immunoassay; Streptococcus, group A 1,683 1,456 $6K
J1885 Injection, ketorolac tromethamine, per 15 mg 9,288 6,585 $6K
82728 3,532 2,998 $6K
36591 2,186 1,039 $6K
73562 1,024 901 $6K
97140 Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) 6,980 2,099 $6K
80048 Basic metabolic panel (calcium, ionized) 8,590 6,952 $5K
U0003 Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, making use of high throughput technologies as described by cms-2020-01-r 359 327 $5K
73110 299 265 $5K
J1100 Injection, dexamethasone sodium phosphate, 1 mg 8,135 5,444 $5K
J2405 Injection, ondansetron hydrochloride, per 1 mg 13,896 10,219 $5K
81025 4,014 3,153 $5K
84439 3,621 3,264 $5K
12001 220 212 $5K
11042 Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm 1,316 679 $5K
97162 948 751 $5K
96372 Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular 6,114 4,881 $5K
73130 436 396 $5K
84484 5,401 4,039 $4K
87186 3,642 3,177 $4K
87070 4,498 4,063 $4K
80076 1,791 1,600 $4K
96360 Intravenous infusion, hydration; initial, 31 minutes to 1 hour 1,559 1,001 $4K
76830 Ultrasound, transvaginal 1,612 1,503 $4K
80061 Lipid panel 7,850 7,489 $4K
J7120 Ringers lactate infusion, up to 1000 cc 11,436 8,420 $4K
A9585 Injection, gadobutrol, 0.1 ml 2,643 2,294 $4K
J0690 Injection, cefazolin sodium, 500 mg 5,505 3,095 $3K
85007 1,197 874 $3K
J1642 Injection, heparin sodium, (heparin lock flush), per 10 units 4,199 1,670 $3K
83540 2,694 2,413 $3K
J8499 Prescription drug, oral, non chemotherapeutic, nos 3,889 2,665 $3K
83550 2,591 2,323 $3K
85379 1,654 1,445 $3K
59025 Fetal non-stress test 3,304 2,207 $3K
83735 5,109 3,992 $3K
87147 2,872 1,775 $2K
73030 489 417 $2K
Q0162 Ondansetron 1 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at the time of chemotherapy treatment, not to exceed a 48 hour dosage regimen 2,563 2,239 $2K
J3010 Injection, fentanyl citrate, 0.1 mg 9,487 6,395 $2K
94060 491 465 $2K
J0171 Injection, adrenalin, epinephrine, 0.1 mg 1,137 673 $2K
96376 1,639 1,281 $2K
80320 867 729 $2K
90471 Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine 1,610 1,399 $2K
87641 4,182 3,135 $2K
99152 2,599 1,967 $2K
83036 Hemoglobin; glycosylated (A1C) 6,592 6,202 $2K
83605 2,114 1,738 $2K
J7060 5% dextrose/water (500 ml = 1 unit) 1,105 716 $2K
87040 1,124 693 $2K
J7030 Infusion, normal saline solution , 1000 cc 6,665 4,758 $2K
72141 385 356 $2K
87077 2,191 1,846 $2K
71260 Computed tomography, thorax, diagnostic; with contrast material 584 494 $2K
97535 Self-care/home management training, each 15 minutes 1,048 425 $2K
88342 788 554 $2K
J2250 Injection, midazolam hydrochloride, per 1 mg 8,667 6,323 $2K
84702 2,260 1,551 $2K
85652 658 541 $2K
82962 5,131 2,331 $2K
85730 1,221 964 $1K
73080 51 51 $1K
82607 1,479 1,378 $1K
73090 43 37 $1K
87651 Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe 334 310 $1K
J7040 Infusion, normal saline solution, sterile (500 ml = 1 unit) 875 799 $1K
72100 376 354 $1K
77012 88 67 $1K
96367 829 384 $1K
J2270 Injection, morphine sulfate, up to 10 mg 1,796 1,480 $1K
J1200 Injection, diphenhydramine hcl, up to 50 mg 3,456 2,586 $1K
94760 714 460 $1K
80143 461 345 $1K
87088 1,161 1,072 $1K
86141 296 276 $1K
97116 2,222 710 $1K
87205 962 865 $1K
J0131 Injection, acetaminophen, not otherwise specified,10 mg 419 336 $992.37
82550 858 746 $984.85
84100 1,044 795 $970.49
85610 4,566 3,187 $949.66
93306 Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete 127 117 $942.65
D1120 Prophylaxis - child 47 46 $895.04
D0120 Periodic oral evaluation - established patient 45 44 $895.04
86850 3,495 2,556 $856.33
12011 26 25 $849.99
88307 528 299 $844.90
90715 302 273 $790.08
82570 2,683 2,436 $787.28
J1170 Injection, hydromorphone, up to 4 mg 6,706 4,492 $780.44
82746 631 589 $762.52
86900 3,962 2,945 $704.67
74019 127 116 $702.95
83880 952 828 $696.08
84480 750 647 $691.72
29125 12 12 $676.03
82670 261 223 $668.12
80305 2,561 2,247 $663.81
84403 128 114 $561.02
86901 3,977 2,952 $559.39
J2060 Injection, lorazepam, 2 mg 1,998 1,684 $557.59
87210 2,028 1,875 $508.48
82077 604 484 $498.51
80179 248 200 $489.10
82565 494 411 $487.55
J0696 Injection, ceftriaxone sodium, per 250 mg 454 294 $461.59
J2710 Injection, neostigmine methylsulfate, up to 0.5 mg 513 341 $453.03
93971 394 365 $452.01
97164 33 25 $410.55
86803 2,908 2,775 $406.29
83615 175 122 $371.44
73140 57 52 $364.51
C1769 Guide wire 141 91 $359.54
97760 626 378 $351.05
86780 2,166 2,063 $339.15
82043 1,364 1,295 $334.87
G0008 Administration of influenza virus vaccine 216 195 $321.61
J2001 Injection, lidocaine hcl for intravenous infusion, 10 mg 368 273 $306.20
97165 138 106 $294.82
J7620 Albuterol, up to 2.5 mg and ipratropium bromide, up to 0.5 mg, fda-approved final product, non-compounded, administered through dme 526 456 $290.12
87636 Infectious agent detection by nucleic acid; SARS-CoV-2 and influenza virus types A and B 218 195 $276.49
97803 20 15 $272.00
83001 203 194 $268.67
90686 691 611 $256.46
A9576 Injection, gadoteridol, (prohance multipack), per ml 429 351 $231.96
G0500 Moderate sedation services provided by the same physician or other qualified health care professional performing a gastrointestinal endoscopic service that sedation supports, requiring the presence of an independent trained observer to assist in the monitoring of the patient's level of consciousness and physiological status; initial 15 minutes of intra-service time; patient age 5 years or older (additional time may be reported with 99153, as appropriate) 607 486 $212.50
86308 115 89 $206.06
76536 15 15 $192.18
82805 131 106 $186.99
G0480 Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not limited to gc/ms (any type, single or tandem) and lc/ms (any type, single or tandem and excluding immunoassays (e.g., ia, eia, elisa, emit, fpia) and enzymatic methods (e.g., alcohol dehydrogenase)), (2) stable isotope or other universally recognized internal standards in all samples (e.g., to control for matrix effects, interferences and variations in signal strength), and (3) method or drug-specific calibration and matrix-matched quality control material (e.g., to control for instrument variations and mass spectral drift); qualitative or quantitative, all sources, includes specimen validity testing, per day; 1-7 drug class(es), including metabolite(s) if performed 2,186 1,673 $186.29
J2550 Injection, promethazine hcl, up to 50 mg 1,919 1,394 $182.58
84146 223 214 $177.61
J7611 Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, concentrated form, 1 mg 213 165 $175.22
G0463 Hospital outpatient clinic visit for assessment and management of a patient 28,171 18,207 $169.98
84156 895 756 $164.44
72170 51 39 $161.82
Q9966 Low osmolar contrast material, 200-299 mg/ml iodine concentration, per ml 1,499 1,233 $161.08
87075 142 127 $153.85
A4216 Sterile water, saline and/or dextrose, diluent/flush, 10 ml 3,065 1,571 $152.43
C8929 Transthoracic echocardiography with contrast, or without contrast followed by with contrast, real-time with image documentation (2d), includes m-mode recording, when performed, complete, with spectral doppler echocardiography, and with color flow doppler echocardiography 1,282 1,127 $143.04
J0665 Injection, bupivicaine, not otherwise specified, 0.5 mg 597 364 $138.34
87340 1,628 1,550 $137.07
0002A 325 323 $134.30
0001A 313 308 $134.30
76642 1,122 895 $126.38
J2371 Injection, phenylephrine hydrochloride, 20 micrograms 120 73 $116.22
J2930 Injection, methylprednisolone sodium succinate, up to 125 mg 67 40 $106.53
94729 120 114 $105.87
86787 657 632 $95.35
84550 82 74 $82.73
80069 1,132 996 $81.92
J0780 Injection, prochlorperazine, up to 10 mg 14 14 $78.21
83970 809 752 $78.02
82977 19 13 $73.94
86592 285 269 $69.09
0012A 69 69 $67.15
J2765 Injection, metoclopramide hcl, up to 10 mg 581 501 $62.92
86762 1,114 1,074 $61.60
77080 12 12 $61.56
84520 29 26 $60.93
87328 15 12 $60.10
87329 15 12 $60.08
U0005 Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, cdc or non-cdc, making use of high throughput technologies, completed within 2 calendar days from date of specimen collection (list separately in addition to either hcpcs code u0003 or u0004) as described by cms-2020-01-r2 15 12 $57.38
80051 29 28 $55.36
88175 Cytopathology, cervical or vaginal, any reporting system; collected in preservative fluid, automated thin layer 4,238 4,012 $50.29
J1790 Injection, droperidol, up to 5 mg 183 139 $39.18
J3475 Injection, magnesium sulfate, per 500 mg 580 393 $38.94
82310 13 12 $38.80
82784 44 15 $35.16
J7512 Prednisone, immediate release or delayed release, oral, 1 mg 322 294 $34.36
86431 141 133 $32.13
84460 14 12 $30.06
86703 3,031 2,886 $24.30
80178 27 25 $16.56
U0002 2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc 2,678 2,360 $14.38
82247 22 12 $9.49
82950 1,197 1,148 $8.97
77067 Screening mammography, bilateral, including computer-aided detection 1,356 1,321 $0.00
62323 380 314 $0.00
G0279 Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066) 326 309 $0.00
45385 Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) 28 27 $0.00
93017 195 137 $0.00
97163 82 66 $0.00
G0260 Injection procedure for sacroiliac joint; provision of anesthetic, steroid and/or other therapeutic agent, with or without arthrography 13 12 $0.00
71250 14 12 $0.00
J3301 Injection, triamcinolone acetonide, not otherwise specified, 10 mg 28 26 $0.00
G8979 Mobility: walking & moving around functional limitation, projected goal status, at therapy episode outset, at reporting intervals, and at discharge or to end reporting 200 166 $0.00
94726 93 88 $0.00
76942 205 167 $0.00
83721 12 12 $0.00
J1171 Injection, hydromorphone, 0.1 mg 97 73 $0.00
85014 55 27 $0.00
77065 Tomosynthesis, mammo 32 27 $0.00
76882 14 13 $0.00
77066 Tomosynthesis, mammo 27 27 $0.00
91300 532 450 $0.00
97129 185 48 $0.00
J0585 Injection, onabotulinumtoxina, 1 unit 15 12 $0.00
90670 15 12 $0.00
85046 16 13 $0.00
87045 12 12 $0.00
84112 123 108 $0.00
G8978 Mobility: walking & moving around functional limitation, current status, at therapy episode outset and at reporting intervals 178 157 $0.00
86200 14 13 $0.00
84145 19 12 $0.00
83003 31 30 $0.00
J2919 Injection, methylprednisolone sodium succinate, 5 mg 37 28 $0.00
73590 13 12 $0.00
J0702 Injection, betamethasone acetate 3 mg and betamethasone sodium phosphate 3 mg 98 78 $0.00
80164 17 13 $0.00
87400 206 89 $0.00
80074 12 12 $0.00
62321 50 42 $0.00
43235 16 13 $0.00
87899 23 12 $0.00
C1894 Introducer/sheath, other than guiding, other than intracardiac electrophysiological, non-laser 20 14 $0.00
J2358 Injection, olanzapine, long-acting, 1 mg 113 105 $0.00
97032 96 26 $0.00
87640 811 734 $0.00
J1010 Injection, methylprednisolone acetate, 1 mg 256 186 $0.00
80055 361 345 $0.00
C8928 Transthoracic echocardiography with contrast, or without contrast followed by with contrast, real-time with image documentation (2d), includes m-mode recording, when performed, during rest and cardiovascular stress test using treadmill, bicycle exercise and/or pharmacologically induced stress, with interpretation and report 74 41 $0.00
77063 Screening digital breast tomosynthesis, bilateral 1,329 1,294 $0.00
85018 49 38 $0.00
J2370 Injection, phenylephrine hcl, up to 1 ml 218 173 $0.00
84153 354 347 $0.00
D1351 Sealant - per tooth 12 12 $0.00
64483 226 188 $0.00
97113 213 60 $0.00
94761 185 86 $0.00
91301 108 108 $0.00
87015 17 16 $0.00
J1040 Injection, methylprednisolone acetate, 80 mg 577 467 $0.00
36416 531 343 $0.00
0241U Neonatal screening for hereditary disorders, genomic sequence analysis panel 317 289 $0.00
J0330 Injection, succinylcholine chloride, up to 20 mg 86 62 $0.00
A9270 Non-covered item or service 1,102 381 $0.00
A9150 Non-prescription drugs 32 24 $0.00
97597 263 178 $0.00
73501 72 65 $0.00
81000 46 40 $0.00
76817 Ultrasound, pregnant uterus, real time with image documentation, transvaginal 58 52 $0.00
H0049 Alcohol and/or drug screening 116 104 $0.00
J3360 Injection, diazepam, up to 5 mg 46 32 $0.00
87624 Infectious agent detection by nucleic acid; human papillomavirus (HPV), high-risk types 29 25 $0.00
J1030 Injection, methylprednisolone acetate, 40 mg 63 50 $0.00
97130 49 12 $0.00
70491 14 13 $0.00
J2003 Injection, lidocaine hydrochloride, 1 mg 55 52 $0.00
0011A 52 51 $0.00
D7140 Extraction, erupted tooth or exposed root 12 12 $0.00
70498 12 12 $0.00
87046 24 12 $0.00
84144 15 15 $0.00
95700 16 15 $0.00