| Code | Description | Claims | Beneficiaries | Total Paid |
| G0463 |
Hospital outpt clinic visit |
454,667 |
406,053 |
$44.86M |
| 99283 |
|
73,887 |
50,573 |
$8.17M |
| 99284 |
|
52,996 |
40,454 |
$7.23M |
| 99214 |
|
169,260 |
159,216 |
$6.31M |
| 99213 |
|
180,901 |
170,387 |
$5.00M |
| 99285 |
|
20,982 |
18,436 |
$4.61M |
| 66984 |
|
3,661 |
1,221 |
$3.21M |
| 90834 |
|
27,271 |
16,605 |
$2.31M |
| T1013 |
Sign lang/oral interpreter |
44,127 |
37,873 |
$1.88M |
| 96374 |
|
10,646 |
9,814 |
$1.41M |
| 92014 |
|
20,825 |
13,522 |
$1.27M |
| 90837 |
|
12,234 |
7,321 |
$1.16M |
| 99232 |
|
32,509 |
9,025 |
$1.11M |
| 96413 |
|
3,431 |
1,924 |
$1.07M |
| 90792 |
|
8,520 |
5,079 |
$964K |
| 90853 |
|
15,977 |
4,697 |
$920K |
| 99391 |
|
13,335 |
7,229 |
$918K |
| 90460 |
|
17,283 |
16,557 |
$757K |
| 99392 |
|
9,807 |
5,722 |
$754K |
| 20610 |
|
6,273 |
3,237 |
$748K |
| J0585 |
Injection,onabotulinumtoxina |
2,503 |
1,194 |
$733K |
| 95913 |
|
2,613 |
1,277 |
$685K |
| 96372 |
|
34,142 |
28,852 |
$617K |
| 96361 |
|
9,916 |
8,307 |
$522K |
| 87637 |
|
4,116 |
4,023 |
$503K |
| 99282 |
|
7,625 |
6,429 |
$499K |
| 92004 |
|
8,113 |
5,971 |
$497K |
| 93306 |
|
3,264 |
2,752 |
$480K |
| 90791 |
|
4,057 |
2,867 |
$446K |
| 0241U |
|
3,311 |
3,164 |
$401K |
| 99393 |
|
4,714 |
3,156 |
$363K |
| 95811 |
|
972 |
546 |
$361K |
| U0004 |
Cov-19 test non-cdc hgh thru |
5,447 |
5,121 |
$353K |
| 74177 |
|
4,754 |
4,444 |
$351K |
| 62323 |
|
1,314 |
685 |
$329K |
| 94060 |
|
2,760 |
1,489 |
$314K |
| 87635 |
|
7,822 |
7,370 |
$314K |
| 96110 |
|
3,541 |
2,078 |
$312K |
| 71046 |
|
19,308 |
17,957 |
$311K |
| 45378 |
|
697 |
359 |
$300K |
| 99231 |
|
13,576 |
4,379 |
$292K |
| 99203 |
|
5,050 |
4,846 |
$285K |
| 76811 |
|
2,652 |
2,472 |
$261K |
| 80061 |
|
19,663 |
18,554 |
$261K |
| 70450 |
|
6,475 |
6,048 |
$257K |
| 77067 |
|
5,154 |
4,803 |
$243K |
| 64615 |
|
2,339 |
1,216 |
$237K |
| 69436 |
|
369 |
180 |
$236K |
| 99204 |
|
2,901 |
2,797 |
$220K |
| 88305 |
|
5,443 |
5,024 |
$212K |
| 99394 |
|
2,198 |
1,612 |
$193K |
| 90686 |
|
14,943 |
14,157 |
$177K |
| 96375 |
|
4,590 |
3,374 |
$171K |
| 95911 |
|
648 |
314 |
$151K |
| U0003 |
Cov-19 amp prb hgh thruput |
2,098 |
2,054 |
$148K |
| 87491 |
|
5,229 |
4,983 |
$147K |
| 77063 |
|
5,156 |
4,805 |
$144K |
| 73630 |
|
11,747 |
10,523 |
$141K |
| 36415 |
|
165,097 |
141,081 |
$135K |
| 99212 |
|
8,796 |
8,133 |
$133K |
| 11042 |
|
609 |
313 |
$130K |
| 20553 |
|
926 |
363 |
$129K |
| 90471 |
|
10,496 |
9,966 |
$126K |
| J0897 |
Denosumab injection |
250 |
231 |
$108K |
| 43239 |
|
319 |
167 |
$105K |
| 95810 |
|
265 |
145 |
$104K |
| 90832 |
|
4,598 |
3,514 |
$101K |
| 99460 |
|
1,749 |
1,461 |
$99K |
| 99233 |
Prolong inpt eval add15 m |
2,122 |
961 |
$99K |
| 80050 |
|
1,854 |
1,789 |
$94K |
| 92507 |
|
1,565 |
498 |
$94K |
| 95886 |
|
4,369 |
2,013 |
$91K |
| 87880 |
|
7,759 |
7,450 |
$88K |
| 87591 |
|
5,231 |
4,984 |
$86K |
| 99202 |
|
1,911 |
1,835 |
$86K |
| 99239 |
|
1,264 |
1,102 |
$85K |
| 96365 |
|
515 |
336 |
$81K |
| 99215 |
Prolong outpt/office vis |
1,444 |
1,328 |
$80K |
| 78452 |
|
130 |
118 |
$79K |
| 94726 |
|
2,703 |
1,456 |
$74K |
| 97110 |
|
3,056 |
1,270 |
$70K |
| 96360 |
|
447 |
429 |
$68K |
| J2794 |
Inj risperdal consta, 0.5 mg |
330 |
185 |
$68K |
| 73610 |
|
5,283 |
4,826 |
$63K |
| 67028 |
|
272 |
102 |
$63K |
| 76705 |
|
2,183 |
2,037 |
$60K |
| 93010 |
|
8,697 |
7,128 |
$60K |
| 80053 |
|
51,176 |
45,670 |
$60K |
| 0002A |
|
1,608 |
1,579 |
$59K |
| 20552 |
|
635 |
277 |
$59K |
| 74176 |
|
891 |
823 |
$57K |
| 71045 |
|
6,102 |
4,714 |
$55K |
| 92134 |
|
6,005 |
3,157 |
$55K |
| 66821 |
|
282 |
126 |
$54K |
| 0001A |
|
1,687 |
1,620 |
$53K |
| 98929 |
|
2,257 |
990 |
$50K |
| 85025 |
|
77,599 |
64,696 |
$50K |
| V2020 |
Vision svcs frames purchases |
2,216 |
1,975 |
$49K |
| G0279 |
Tomosynthesis, mammo |
1,904 |
1,665 |
$46K |
| 74019 |
|
3,581 |
3,363 |
$45K |
| 91320 |
|
762 |
740 |
$44K |
| 71260 |
|
500 |
465 |
$43K |
| 92083 |
|
1,899 |
1,138 |
$42K |
| 73562 |
|
3,566 |
3,336 |
$42K |
| 97140 |
|
1,262 |
528 |
$40K |
| 86481 |
|
797 |
770 |
$39K |
| 80307 |
|
10,796 |
9,716 |
$38K |
| 71275 |
|
782 |
734 |
$38K |
| J1439 |
Inj ferric carboxymaltos 1mg |
82 |
48 |
$38K |
| 92557 |
|
377 |
359 |
$37K |
| 90833 |
|
1,348 |
723 |
$36K |
| 99238 |
|
808 |
715 |
$36K |
| 90716 |
|
630 |
600 |
$35K |
| 99223 |
Prolong inpt eval add15 m |
312 |
298 |
$34K |
| 83036 |
|
23,007 |
21,862 |
$34K |
| 84443 |
|
8,849 |
8,389 |
$34K |
| 86780 |
|
1,878 |
1,745 |
$34K |
| D7140 |
|
339 |
191 |
$34K |
| C9803 |
Hopd covid-19 spec collect |
1,973 |
1,786 |
$34K |
| 80048 |
|
33,895 |
28,910 |
$32K |
| 90847 |
|
293 |
125 |
$32K |
| 99396 |
|
340 |
177 |
$31K |
| 76816 |
|
1,004 |
911 |
$31K |
| 77065 |
Tomosynthesis, mammo |
845 |
748 |
$30K |
| 92133 |
|
4,078 |
2,368 |
$27K |
| 45385 |
|
51 |
26 |
$27K |
| 97597 |
|
372 |
134 |
$27K |
| 92136 |
|
2,192 |
1,135 |
$26K |
| 73130 |
|
2,385 |
2,194 |
$25K |
| 0124A |
|
1,077 |
914 |
$25K |
| 90480 |
|
1,036 |
1,000 |
$24K |
| 99220 |
|
235 |
221 |
$24K |
| D0140 |
|
503 |
500 |
$24K |
| 76830 |
|
700 |
670 |
$24K |
| 73030 |
|
2,543 |
2,372 |
$24K |
| 76801 |
|
350 |
316 |
$23K |
| 72125 |
|
514 |
490 |
$23K |
| J0178 |
Aflibercept injection |
16 |
13 |
$23K |
| 72100 |
|
2,016 |
1,933 |
$23K |
| S0280 |
Medical home, initial plan |
1,160 |
1,043 |
$22K |
| 87631 |
|
2,035 |
1,965 |
$22K |
| 92012 |
|
326 |
238 |
$22K |
| 65855 |
|
117 |
49 |
$22K |
| 76642 |
|
621 |
567 |
$19K |
| 99222 |
|
238 |
220 |
$19K |
| 69210 |
|
1,154 |
579 |
$19K |
| 11721 |
|
658 |
614 |
$19K |
| 95800 |
|
315 |
274 |
$18K |
| 86900 |
|
3,121 |
2,865 |
$18K |
| 82306 |
|
1,534 |
1,446 |
$18K |
| 97161 |
|
306 |
283 |
$17K |
| 99217 |
|
331 |
318 |
$16K |
| 0003A |
|
573 |
510 |
$15K |
| 64493 |
|
30 |
13 |
$14K |
| J1885 |
Ketorolac tromethamine inj |
12,996 |
11,509 |
$14K |
| 73110 |
|
1,226 |
1,124 |
$14K |
| G0378 |
Hospital observation per hr |
1,518 |
1,178 |
$14K |
| 90651 |
|
391 |
382 |
$14K |
| 83655 |
|
1,588 |
1,560 |
$13K |
| 87070 |
|
1,722 |
1,657 |
$13K |
| 99219 |
|
180 |
169 |
$13K |
| 72148 |
|
229 |
224 |
$13K |
| 95819 |
|
101 |
50 |
$13K |
| 76856 |
|
427 |
409 |
$13K |
| U0002 |
Covid-19 lab test non-cdc |
293 |
271 |
$13K |
| 90677 |
|
159 |
156 |
$12K |
| 87426 |
|
374 |
342 |
$12K |
| 81001 |
|
7,396 |
7,038 |
$11K |
| 70553 |
|
116 |
112 |
$11K |
| 94729 |
|
3,659 |
1,979 |
$11K |
| D0220 |
|
591 |
586 |
$11K |
| 90750 |
|
129 |
119 |
$11K |
| 84439 |
|
3,370 |
3,188 |
$10K |
| 95813 |
|
83 |
43 |
$10K |
| 93971 |
|
374 |
321 |
$10K |
| 74018 |
|
1,085 |
898 |
$10K |
| 29405 |
|
51 |
27 |
$10K |
| 99188 |
|
788 |
756 |
$9K |
| U0001 |
2019-ncov diagnostic p |
282 |
238 |
$9K |
| 87804 |
|
878 |
832 |
$9K |
| D0210 |
|
84 |
84 |
$8K |
| D0460 |
|
399 |
398 |
$8K |
| 86592 |
|
181 |
164 |
$8K |
| 99395 |
|
89 |
63 |
$8K |
| 64483 |
|
26 |
12 |
$8K |
| 87633 |
|
16 |
16 |
$7K |
| 87661 |
|
1,409 |
1,358 |
$7K |
| 96136 |
|
458 |
241 |
$7K |
| 90656 |
|
1,519 |
1,492 |
$7K |
| D0150 |
|
138 |
138 |
$7K |
| 98960 |
|
217 |
211 |
$7K |
| D1206 |
|
250 |
248 |
$7K |
| 0072A |
|
218 |
195 |
$7K |
| 95115 |
|
202 |
110 |
$6K |
| 99225 |
|
224 |
130 |
$6K |
| 73721 |
|
109 |
108 |
$6K |
| 85060 |
|
372 |
337 |
$6K |
| 77066 |
Tomosynthesis, mammo |
104 |
97 |
$6K |
| 93970 |
|
72 |
46 |
$6K |
| 86480 |
|
86 |
74 |
$5K |
| 96417 |
|
124 |
72 |
$5K |
| 52000 |
|
22 |
12 |
$5K |
| 92567 |
|
1,159 |
1,085 |
$5K |
| 99462 |
|
153 |
111 |
$5K |
| 88304 |
|
394 |
371 |
$5K |
| 96367 |
|
124 |
90 |
$5K |
| 81025 |
|
9,581 |
9,112 |
$5K |
| 88342 |
|
212 |
193 |
$4K |
| 0071A |
|
157 |
138 |
$4K |
| 90746 |
|
86 |
84 |
$4K |
| 99443 |
|
594 |
544 |
$4K |
| 93017 |
|
97 |
90 |
$4K |
| 93005 |
|
13,658 |
12,224 |
$4K |
| 99442 |
|
550 |
508 |
$4K |
| 90632 |
|
127 |
126 |
$4K |
| 90678 |
|
13 |
12 |
$4K |
| 87389 |
|
1,937 |
1,810 |
$4K |
| 70486 |
|
67 |
64 |
$4K |
| 76817 |
|
105 |
91 |
$3K |
| 94640 |
|
1,125 |
1,021 |
$3K |
| 92587 |
|
12 |
12 |
$3K |
| 71250 |
|
75 |
72 |
$3K |
| V2103 |
Spherocylindr 4.00d/12-2.00d |
139 |
120 |
$3K |
| 76805 |
|
74 |
70 |
$3K |
| 73140 |
|
345 |
322 |
$3K |
| 0111A |
|
108 |
79 |
$3K |
| 54150 |
|
36 |
28 |
$3K |
| 90670 |
|
3,028 |
2,938 |
$3K |
| J1050 |
Medroxyprogesterone acetate |
1,025 |
998 |
$3K |
| 80074 |
|
425 |
413 |
$3K |
| 72141 |
|
46 |
40 |
$3K |
| D2392 |
|
18 |
17 |
$3K |
| 76775 |
|
118 |
109 |
$2K |
| 95974 |
|
34 |
16 |
$2K |
| 00142 |
|
50 |
40 |
$2K |
| 59025 |
|
26 |
13 |
$2K |
| 99205 |
Prolong outpt/office vis |
31 |
30 |
$2K |
| 99483 |
Prolong outpt/office vis |
50 |
24 |
$2K |
| D0120 |
|
68 |
68 |
$2K |
| 71271 |
|
43 |
42 |
$2K |
| 88307 |
|
30 |
26 |
$2K |
| 92002 |
|
37 |
36 |
$2K |
| 77002 |
|
207 |
180 |
$2K |
| 87086 |
|
2,055 |
1,868 |
$2K |
| 96127 |
|
607 |
408 |
$2K |
| 95976 |
|
47 |
25 |
$2K |
| 73080 |
|
148 |
141 |
$2K |
| 85610 |
|
4,575 |
4,055 |
$2K |
| J1040 |
Methylprednisolone 80 mg inj |
3,242 |
2,928 |
$2K |
| 94010 |
|
205 |
193 |
$2K |
| 93225 |
|
16 |
15 |
$2K |
| 87210 |
|
284 |
276 |
$1K |
| 90710 |
|
397 |
382 |
$1K |
| 0112A |
|
37 |
33 |
$1K |
| 96130 |
|
110 |
55 |
$1K |
| V2756 |
Eye glass case |
1,325 |
1,169 |
$1K |
| 92235 |
|
23 |
12 |
$1K |
| 82043 |
|
2,721 |
2,557 |
$1K |
| 76536 |
|
35 |
30 |
$1K |
| 90836 |
|
29 |
15 |
$1K |
| 82950 |
|
140 |
136 |
$1K |
| 92020 |
|
261 |
171 |
$1K |
| 0004A |
|
55 |
53 |
$1K |
| D1110 |
|
15 |
15 |
$1K |
| 72040 |
|
97 |
95 |
$1K |
| 90734 |
|
119 |
112 |
$971.50 |
| 90715 |
|
1,066 |
1,008 |
$932.59 |
| D1120 |
|
19 |
19 |
$921.31 |
| J2795 |
Ropivacaine hcl injection |
4,779 |
3,951 |
$899.32 |
| 82728 |
|
1,295 |
1,206 |
$890.94 |
| 88142 |
|
303 |
284 |
$851.44 |
| S0201 |
Partial hospitalization serv |
133 |
70 |
$826.28 |
| 87428 |
|
31 |
26 |
$811.51 |
| 73564 |
|
97 |
85 |
$800.36 |
| 84460 |
|
2,842 |
2,681 |
$780.21 |
| 90662 |
|
150 |
124 |
$755.61 |
| 93227 |
|
29 |
28 |
$753.82 |
| 73501 |
|
27 |
27 |
$749.53 |
| 82570 |
|
2,648 |
2,486 |
$749.32 |
| 64494 |
|
30 |
13 |
$738.77 |
| 84450 |
|
2,527 |
2,383 |
$689.42 |
| G0008 |
Admin influenza virus vac |
739 |
633 |
$681.92 |
| 71101 |
|
54 |
51 |
$678.49 |
| 85046 |
|
689 |
665 |
$650.34 |
| 76514 |
|
272 |
151 |
$644.69 |
| 93018 |
|
42 |
42 |
$633.24 |
| 73502 |
|
60 |
53 |
$624.30 |
| 90707 |
|
55 |
55 |
$606.00 |
| 83550 |
|
1,294 |
1,208 |
$590.35 |
| 84702 |
|
346 |
293 |
$577.17 |
| 81003 |
|
10,100 |
9,538 |
$566.45 |
| G2211 |
Complex e/m visit add on |
138 |
133 |
$554.20 |
| 96103 |
|
317 |
177 |
$548.11 |
| 96366 |
|
38 |
24 |
$540.91 |
| 99201 |
|
27 |
27 |
$522.66 |
| 85004 |
|
146 |
116 |
$495.27 |
| 83540 |
|
1,303 |
1,215 |
$468.51 |
| 99308 |
|
92 |
78 |
$433.68 |
| 90671 |
|
853 |
844 |
$432.95 |
| 0012A |
|
55 |
54 |
$431.55 |
| 99418 |
Prolong nursin fac eval 15m |
12 |
12 |
$425.62 |
| 96131 |
|
26 |
13 |
$417.68 |
| 51798 |
|
206 |
185 |
$412.62 |
| 85027 |
|
1,317 |
1,188 |
$405.10 |
| 82105 |
|
239 |
215 |
$402.59 |
| J1010 |
Inj, methylpred acetate 1 mg |
425 |
397 |
$396.22 |
| G0297 |
Ldct for lung ca screen |
12 |
12 |
$382.30 |
| 99309 |
|
16 |
13 |
$375.25 |
| 96380 |
|
36 |
34 |
$354.24 |
| 82677 |
|
155 |
133 |
$340.32 |
| J1453 |
Fosaprepitant injection |
20 |
12 |
$338.65 |
| 87340 |
|
445 |
416 |
$336.10 |
| 88175 |
|
43 |
39 |
$333.23 |
| 87328 |
|
42 |
41 |
$306.15 |
| 90620 |
|
14 |
14 |
$304.48 |
| 87077 |
|
91 |
87 |
$295.53 |
| 98928 |
|
21 |
12 |
$294.39 |
| D0274 |
|
12 |
12 |
$290.94 |
| 85018 |
|
1,859 |
1,787 |
$289.26 |
| 87653 |
|
74 |
72 |
$283.04 |
| 86706 |
|
420 |
410 |
$274.08 |
| 87329 |
|
42 |
41 |
$265.42 |
| 83880 |
|
165 |
158 |
$262.60 |
| 84484 |
|
8,126 |
5,737 |
$232.99 |
| 90723 |
|
1,838 |
1,792 |
$230.64 |
| 93000 |
|
16 |
15 |
$229.25 |
| 82652 |
|
16 |
12 |
$225.75 |
| 83735 |
|
792 |
665 |
$220.40 |
| 86336 |
|
155 |
133 |
$219.36 |
| G0480 |
Drug test def 1-7 classes |
192 |
178 |
$217.02 |
| 85048 |
|
149 |
118 |
$200.04 |
| 99173 |
|
54 |
38 |
$192.07 |
| 82077 |
|
4,241 |
3,971 |
$183.15 |
| 87624 |
|
24 |
24 |
$183.01 |
| D0330 |
|
28 |
28 |
$181.76 |
| 77085 |
|
16 |
15 |
$175.34 |
| 87150 |
|
52 |
50 |
$171.02 |
| 76937 |
|
17 |
12 |
$164.49 |
| J0689 |
Inj cefazolin sodium, baxter |
327 |
278 |
$160.66 |
| 99307 |
|
30 |
27 |
$156.48 |
| J1030 |
Methylprednisolone 40 mg inj |
620 |
564 |
$146.40 |
| 90619 |
|
33 |
33 |
$146.04 |
| 73560 |
|
24 |
18 |
$145.12 |
| 99441 |
|
12 |
12 |
$127.33 |
| 86803 |
|
314 |
297 |
$123.37 |
| 73565 |
|
17 |
16 |
$119.86 |
| 86850 |
|
2,317 |
2,120 |
$114.12 |
| 73590 |
|
14 |
14 |
$111.93 |
| 92250 |
|
25 |
13 |
$110.39 |
| 72072 |
|
13 |
12 |
$107.23 |
| 83690 |
|
4,372 |
4,143 |
$104.30 |
| G0400 |
Home sleep test/type 4 porta |
189 |
187 |
$101.63 |
| 83020 |
|
12 |
12 |
$99.52 |
| 96401 |
|
71 |
64 |
$94.79 |
| 95012 |
|
191 |
170 |
$89.17 |
| 84163 |
|
68 |
58 |
$88.30 |
| 0011A |
|
31 |
29 |
$86.06 |
| 85014 |
|
1,581 |
1,519 |
$85.82 |
| 82607 |
|
42 |
39 |
$85.34 |
| 80069 |
|
26 |
24 |
$75.27 |
| 80179 |
|
1,218 |
1,154 |
$71.89 |
| 80143 |
|
1,206 |
1,140 |
$71.89 |
| 86308 |
|
365 |
347 |
$67.17 |
| J2405 |
Ondansetron hcl injection |
1,594 |
814 |
$64.83 |
| G0179 |
Md recertification hha pt |
40 |
36 |
$53.74 |
| 36410 |
|
17 |
12 |
$43.72 |
| 86140 |
|
2,311 |
2,186 |
$42.16 |
| 86901 |
|
3,121 |
2,865 |
$41.41 |
| 83970 |
|
124 |
113 |
$40.00 |
| 85730 |
|
998 |
955 |
$34.45 |
| 87081 |
|
101 |
99 |
$32.95 |
| 82075 |
|
45 |
40 |
$29.07 |
| 86704 |
|
159 |
155 |
$28.84 |
| J0690 |
Cefazolin sodium injection |
538 |
410 |
$22.46 |
| J0696 |
Ceftriaxone sodium injection |
39 |
39 |
$18.00 |
| 82746 |
|
13 |
12 |
$14.25 |
| 86762 |
|
561 |
498 |
$13.94 |
| 82150 |
|
105 |
101 |
$11.60 |
| J0702 |
Betamethasone acet&sod phosp |
113 |
109 |
$11.40 |
| 84100 |
|
95 |
58 |
$11.12 |
| 82550 |
|
295 |
269 |
$6.30 |
| J2270 |
Morphine sulfate injection |
323 |
247 |
$5.10 |
| 90472 |
|
661 |
630 |
$5.09 |
| Q9969 |
Non-heu tc-99m add-on/dose |
75 |
71 |
$4.00 |
| 85652 |
|
25 |
25 |
$2.57 |
| J3301 |
Triamcinolone acet inj nos |
40 |
39 |
$1.59 |
| 90713 |
|
961 |
925 |
$0.40 |
| 0502F |
|
3,597 |
3,086 |
$0.00 |
| 90461 |
|
6,971 |
6,748 |
$0.00 |
| 91300 |
|
4,490 |
4,206 |
$0.00 |
| 90648 |
|
2,767 |
2,707 |
$0.00 |
| 90633 |
|
1,521 |
1,459 |
$0.00 |
| J1631 |
Haloperidol decanoate inj |
193 |
143 |
$0.00 |
| 90685 |
|
84 |
78 |
$0.00 |
| 80076 |
|
136 |
129 |
$0.00 |
| 90700 |
|
176 |
173 |
$0.00 |
| 91311 |
|
193 |
186 |
$0.00 |
| 91312 |
|
278 |
272 |
$0.00 |
| 86709 |
|
108 |
104 |
$0.00 |
| 91321 |
|
36 |
36 |
$0.00 |
| 90380 |
|
26 |
24 |
$0.00 |
| 93226 |
|
16 |
15 |
$0.00 |
| 84145 |
|
31 |
28 |
$0.00 |
| J1200 |
Diphenhydramine hcl injectio |
34 |
31 |
$0.00 |
| 82565 |
|
15 |
12 |
$0.00 |
| 87186 |
|
31 |
30 |
$0.00 |
| V2632 |
Post chmbr intraocular lens |
2,294 |
1,397 |
$0.00 |
| 83605 |
|
210 |
186 |
$0.00 |
| 90680 |
|
2,637 |
2,582 |
$0.00 |
| J1100 |
Dexamethasone sodium phos |
290 |
194 |
$0.00 |
| 94761 |
|
416 |
199 |
$0.00 |
| J2001 |
Lidocaine injection |
87 |
45 |
$0.00 |
| 0500F |
|
76 |
70 |
$0.00 |
| 90744 |
|
59 |
56 |
$0.00 |
| 91307 |
|
77 |
75 |
$0.00 |
| A9500 |
Tc99m sestamibi |
83 |
77 |
$0.00 |
| J2785 |
Regadenoson injection |
14 |
12 |
$0.00 |
| 90698 |
|
149 |
146 |
$0.00 |
| 86141 |
|
13 |
12 |
$0.00 |
| 90688 |
|
162 |
158 |
$0.00 |
| 0503F |
|
54 |
54 |
$0.00 |
| L8699 |
Prosthetic implant nos |
145 |
138 |
$0.00 |
| 85660 |
|
13 |
12 |
$0.00 |
| 82962 |
|
79 |
52 |
$0.00 |
| J3010 |
Fentanyl citrate injection |
49 |
36 |
$0.00 |
| 96376 |
|
37 |
24 |
$0.00 |
| 99024 |
|
15 |
15 |
$0.00 |
| 85379 |
|
13 |
12 |
$0.00 |
| 90696 |
|
12 |
12 |
$0.00 |
| 90381 |
|
25 |
24 |
$0.00 |
| J2060 |
Lorazepam injection |
15 |
12 |
$0.00 |