| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99285 |
|
11,673 |
9,629 |
$7.12M |
| 87491 |
|
61,049 |
45,579 |
$5.15M |
| G0378 |
Hospital observation per hr |
4,935 |
3,856 |
$5.09M |
| 87591 |
|
56,490 |
41,896 |
$4.73M |
| 85025 |
|
117,616 |
89,766 |
$4.33M |
| 99284 |
|
14,302 |
12,147 |
$4.13M |
| 87651 |
|
41,510 |
31,270 |
$3.25M |
| 93306 |
|
4,846 |
4,233 |
$3.15M |
| 80048 |
|
58,286 |
44,941 |
$2.58M |
| 80053 |
|
68,890 |
54,575 |
$2.52M |
| 80061 |
|
74,520 |
62,264 |
$2.36M |
| 93005 |
|
24,184 |
19,600 |
$2.32M |
| 82306 |
|
35,964 |
30,128 |
$2.17M |
| 80307 |
|
16,389 |
10,237 |
$1.99M |
| G0480 |
Drug test def 1-7 classes |
14,619 |
9,088 |
$1.89M |
| 84443 |
|
53,203 |
43,567 |
$1.88M |
| 99283 |
|
8,749 |
7,468 |
$1.78M |
| 87481 |
|
8,306 |
5,239 |
$1.65M |
| 82248 |
|
26,137 |
20,260 |
$1.58M |
| J7030 |
Normal saline solution infus |
5,452 |
4,156 |
$1.52M |
| 84484 |
|
11,374 |
7,931 |
$1.50M |
| 87633 |
|
3,190 |
2,720 |
$1.49M |
| 96361 |
|
5,950 |
4,408 |
$1.42M |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
7,575 |
5,949 |
$1.36M |
| 87661 |
|
23,488 |
16,245 |
$1.35M |
| 82948 |
|
6,253 |
3,365 |
$1.31M |
| 87389 |
|
27,299 |
21,366 |
$1.26M |
| 96375 |
|
6,121 |
4,443 |
$1.24M |
| 81514 |
|
3,216 |
3,084 |
$1.23M |
| 83036 |
|
51,702 |
43,654 |
$1.23M |
| 80050 |
|
22,247 |
18,650 |
$1.17M |
| J2405 |
Ondansetron hcl injection |
5,394 |
3,574 |
$1.12M |
| 96374 |
|
7,168 |
5,836 |
$1.12M |
| 83690 |
|
11,703 |
9,617 |
$1.12M |
| 74177 |
|
4,597 |
3,681 |
$1.10M |
| 85027 |
|
41,235 |
33,142 |
$1.09M |
| 71046 |
|
8,935 |
7,488 |
$1.08M |
| 81001 |
|
36,803 |
29,375 |
$1.07M |
| 96372 |
|
5,955 |
3,092 |
$1.01M |
| 83735 |
|
18,617 |
13,234 |
$997K |
| 87801 |
|
8,133 |
5,277 |
$989K |
| 87086 |
|
45,750 |
36,134 |
$931K |
| J3010 |
Fentanyl citrate injection |
2,538 |
1,690 |
$896K |
| 96365 |
|
3,296 |
2,618 |
$872K |
| 87536 |
|
5,265 |
4,049 |
$872K |
| U0003 |
Cov-19 amp prb hgh thruput |
6,386 |
5,679 |
$841K |
| J2250 |
Inj midazolam hydrochloride |
2,974 |
2,153 |
$800K |
| 36415 |
|
92,378 |
70,933 |
$794K |
| 85610 |
|
34,942 |
16,249 |
$778K |
| 86803 |
|
21,873 |
17,611 |
$756K |
| 86780 |
|
24,333 |
18,663 |
$751K |
| J1170 |
Hydromorphone injection |
2,663 |
1,291 |
$742K |
| 83013 |
|
5,089 |
4,071 |
$731K |
| J1885 |
Ketorolac tromethamine inj |
2,994 |
2,089 |
$730K |
| 82728 |
|
23,961 |
20,528 |
$730K |
| J0690 |
Cefazolin sodium injection |
2,123 |
1,026 |
$719K |
| 97110 |
|
14,591 |
4,949 |
$709K |
| 88305 |
|
3,878 |
3,101 |
$662K |
| J2704 |
Inj, propofol, 10 mg |
2,502 |
1,723 |
$651K |
| J2270 |
Morphine sulfate injection |
2,930 |
1,929 |
$641K |
| 87624 |
|
9,414 |
6,516 |
$620K |
| 87637 |
|
2,799 |
2,506 |
$619K |
| J3490 |
Drugs unclassified injection |
2,105 |
1,204 |
$616K |
| J0131 |
Inj, acetaminophen (nos) |
1,668 |
1,054 |
$601K |
| 88175 |
|
12,372 |
8,832 |
$571K |
| 81003 |
|
20,473 |
16,858 |
$569K |
| 82607 |
|
16,150 |
13,751 |
$558K |
| 84100 |
|
9,976 |
7,253 |
$537K |
| 70450 |
|
2,806 |
2,354 |
$512K |
| 97140 |
|
11,024 |
3,722 |
$510K |
| 96376 |
|
2,594 |
1,481 |
$490K |
| 99214 |
|
4,429 |
3,547 |
$486K |
| J1644 |
Inj heparin sodium per 1000u |
1,598 |
770 |
$485K |
| 84703 |
|
5,165 |
4,121 |
$481K |
| G1004 |
Cdsm ndsc |
2,878 |
2,212 |
$475K |
| 87088 |
|
18,261 |
15,279 |
$472K |
| 87340 |
|
16,076 |
12,683 |
$461K |
| 93017 |
|
3,191 |
2,799 |
$440K |
| 84403 |
|
7,920 |
6,433 |
$438K |
| 97530 |
|
5,929 |
2,394 |
$437K |
| 86481 |
|
5,254 |
4,849 |
$429K |
| 86140 |
|
18,005 |
13,961 |
$419K |
| 85651 |
|
21,362 |
16,682 |
$399K |
| 83605 |
|
2,611 |
1,943 |
$380K |
| 87522 |
Neg quan hep c or qual rna |
4,247 |
3,266 |
$379K |
| J1100 |
Dexamethasone sodium phos |
1,478 |
984 |
$374K |
| 71260 |
|
1,232 |
973 |
$367K |
| 99282 |
|
2,522 |
1,910 |
$367K |
| 86003 |
|
2,262 |
1,757 |
$350K |
| 85730 |
|
4,651 |
3,652 |
$350K |
| 84439 |
|
15,527 |
12,803 |
$344K |
| 99213 |
|
3,931 |
3,138 |
$334K |
| 84153 |
|
8,153 |
6,992 |
$327K |
| 87186 |
|
12,261 |
9,905 |
$327K |
| 86900 |
|
4,457 |
3,651 |
$325K |
| 83880 |
|
4,065 |
3,368 |
$323K |
| 86850 |
|
4,309 |
3,513 |
$321K |
| 86706 |
|
10,746 |
8,355 |
$316K |
| 87507 |
|
500 |
330 |
$315K |
| 86901 |
|
4,455 |
3,649 |
$312K |
| 86618 |
|
7,041 |
5,917 |
$305K |
| 83540 |
|
17,667 |
15,065 |
$286K |
| 84460 |
|
20,213 |
16,447 |
$270K |
| 96366 |
|
823 |
552 |
$267K |
| 86360 |
|
2,936 |
2,326 |
$258K |
| 84450 |
|
19,427 |
15,661 |
$257K |
| 96360 |
|
1,742 |
1,469 |
$255K |
| 85379 |
|
2,983 |
2,496 |
$247K |
| 80076 |
|
15,410 |
12,083 |
$246K |
| 83550 |
|
11,483 |
9,875 |
$241K |
| 87529 |
|
1,990 |
1,164 |
$241K |
| 85007 |
|
6,611 |
4,902 |
$234K |
| 83970 |
|
3,466 |
2,976 |
$233K |
| 87077 |
|
10,253 |
8,033 |
$232K |
| 82565 |
|
18,923 |
14,942 |
$227K |
| 83655 |
|
17,067 |
13,321 |
$224K |
| 71045 |
|
1,425 |
1,116 |
$223K |
| J1650 |
Inj enoxaparin sodium |
1,001 |
513 |
$218K |
| 86704 |
|
6,270 |
4,814 |
$212K |
| 82805 |
|
1,527 |
1,161 |
$212K |
| J7040 |
Normal saline solution infus |
1,015 |
775 |
$203K |
| 82670 |
|
3,310 |
2,630 |
$202K |
| 99212 |
|
3,620 |
2,869 |
$202K |
| 86038 |
|
7,093 |
5,520 |
$197K |
| 87510 |
|
4,692 |
2,957 |
$196K |
| 87480 |
|
4,688 |
2,952 |
$196K |
| 97161 |
|
1,809 |
1,513 |
$193K |
| 86762 |
|
5,097 |
4,087 |
$193K |
| U0005 |
Infec agen detec ampli probe |
3,298 |
3,160 |
$192K |
| 84702 |
|
4,527 |
3,115 |
$188K |
| 93797 |
|
2,359 |
481 |
$187K |
| 87798 |
|
881 |
611 |
$185K |
| 87070 |
|
6,881 |
5,789 |
$185K |
| 80074 |
|
1,944 |
1,459 |
$182K |
| 82550 |
|
6,203 |
5,130 |
$181K |
| 93350 |
|
742 |
629 |
$178K |
| 72125 |
|
1,264 |
1,056 |
$177K |
| 71275 |
|
759 |
595 |
$175K |
| 87635 |
|
2,199 |
2,144 |
$172K |
| 86787 |
|
4,970 |
3,958 |
$170K |
| 86359 |
|
2,922 |
2,314 |
$166K |
| 81025 |
|
2,403 |
1,916 |
$166K |
| 82746 |
|
6,055 |
5,163 |
$166K |
| 84270 |
|
3,685 |
2,814 |
$165K |
| 82043 |
|
12,751 |
10,845 |
$163K |
| 87636 |
|
758 |
723 |
$163K |
| 83001 |
|
3,828 |
3,183 |
$161K |
| 87660 |
|
4,678 |
2,949 |
$159K |
| 76705 |
|
891 |
687 |
$158K |
| 88304 |
|
734 |
498 |
$154K |
| 86235 |
|
2,086 |
1,677 |
$147K |
| 84146 |
|
3,394 |
2,731 |
$145K |
| C1769 |
Guide wire |
494 |
315 |
$141K |
| 87081 |
|
1,257 |
832 |
$138K |
| 82652 |
|
1,674 |
1,443 |
$136K |
| 87502 |
|
934 |
676 |
$130K |
| 83516 |
|
3,810 |
2,657 |
$129K |
| 84520 |
|
12,163 |
9,450 |
$125K |
| 86617 |
|
1,745 |
1,236 |
$124K |
| 82784 |
|
4,646 |
3,715 |
$123K |
| 87205 |
|
5,161 |
4,254 |
$123K |
| 97803 |
|
2,271 |
1,859 |
$122K |
| 83002 |
|
2,898 |
2,386 |
$121K |
| 97162 |
|
1,100 |
929 |
$121K |
| 86665 |
|
1,448 |
1,022 |
$121K |
| J2060 |
Lorazepam injection |
875 |
611 |
$118K |
| 78452 |
|
377 |
299 |
$117K |
| 84480 |
|
3,424 |
2,777 |
$115K |
| 93798 |
|
1,450 |
356 |
$114K |
| 80051 |
|
8,422 |
6,252 |
$113K |
| 87505 |
|
544 |
371 |
$110K |
| C9803 |
Hopd covid-19 spec collect |
501 |
390 |
$109K |
| 97804 |
|
1,090 |
645 |
$105K |
| 86160 |
|
2,069 |
1,742 |
$104K |
| 73560 |
|
805 |
650 |
$104K |
| 86708 |
|
2,771 |
1,948 |
$100K |
| 97112 |
|
1,518 |
680 |
$98K |
| 94640 |
|
1,317 |
615 |
$97K |
| J1200 |
Diphenhydramine hcl injectio |
596 |
412 |
$96K |
| 87040 |
|
745 |
421 |
$96K |
| 87902 |
|
263 |
208 |
$95K |
| 83721 |
|
4,106 |
3,243 |
$94K |
| 84550 |
|
5,309 |
4,392 |
$94K |
| 87147 |
|
2,165 |
1,199 |
$92K |
| A9502 |
Tc99m tetrofosmin |
371 |
278 |
$91K |
| 71250 |
|
396 |
319 |
$91K |
| 85014 |
|
4,707 |
3,726 |
$90K |
| 85018 |
|
4,726 |
3,732 |
$90K |
| 83020 |
|
2,370 |
1,796 |
$88K |
| 93975 |
|
332 |
269 |
$82K |
| 82570 |
|
5,369 |
3,785 |
$81K |
| 82947 |
|
7,914 |
6,271 |
$81K |
| 86735 |
|
2,557 |
2,005 |
$78K |
| 86765 |
|
2,611 |
2,046 |
$78K |
| J1815 |
Insulin injection |
148 |
70 |
$77K |
| 99153 |
Mod sedat endo service >5yrs |
397 |
318 |
$76K |
| G0328 |
Fecal blood scrn immunoassay |
2,628 |
2,164 |
$75K |
| Q9957 |
Inj perflutren lip micros,ml |
415 |
351 |
$75K |
| 86696 |
|
1,401 |
845 |
$74K |
| 84425 |
|
3,280 |
2,763 |
$73K |
| 0241U |
|
401 |
356 |
$73K |
| 82310 |
|
4,312 |
3,296 |
$72K |
| 86039 |
|
2,822 |
2,216 |
$71K |
| 86431 |
|
4,660 |
3,743 |
$71K |
| 76811 |
|
370 |
253 |
$70K |
| 84134 |
|
2,140 |
1,561 |
$70K |
| 96367 |
|
128 |
99 |
$68K |
| A9575 |
Inj gadoterate meglumi 0.1ml |
338 |
243 |
$67K |
| 82040 |
|
6,138 |
4,612 |
$67K |
| 87650 |
|
1,687 |
1,639 |
$66K |
| 80164 |
|
1,962 |
1,413 |
$66K |
| 86480 |
|
1,172 |
661 |
$65K |
| 86225 |
|
2,035 |
1,726 |
$64K |
| 99152 |
|
341 |
267 |
$64K |
| 84481 |
|
3,306 |
2,813 |
$63K |
| 88342 |
|
392 |
268 |
$63K |
| 93971 |
|
805 |
624 |
$61K |
| 86200 |
|
2,374 |
1,918 |
$61K |
| 86695 |
|
1,248 |
745 |
$59K |
| 77067 |
|
447 |
388 |
$56K |
| 86592 |
|
2,892 |
2,302 |
$56K |
| 87641 |
|
1,154 |
931 |
$56K |
| 87640 |
|
1,144 |
943 |
$56K |
| 82140 |
|
1,242 |
914 |
$54K |
| 83615 |
|
2,719 |
2,084 |
$54K |
| 93296 |
|
741 |
726 |
$54K |
| 86664 |
|
1,398 |
1,018 |
$54K |
| J0696 |
Ceftriaxone sodium injection |
337 |
233 |
$53K |
| 84466 |
|
1,818 |
1,595 |
$52K |
| S9433 |
Medical food oral 100% nutr |
863 |
200 |
$52K |
| 70498 |
|
179 |
140 |
$51K |
| 82105 |
|
1,339 |
1,131 |
$49K |
| 70496 |
|
164 |
129 |
$48K |
| 70551 |
|
93 |
73 |
$48K |
| 86663 |
|
1,398 |
1,018 |
$47K |
| 82627 |
|
950 |
765 |
$47K |
| 82150 |
|
2,819 |
2,289 |
$47K |
| 86376 |
|
1,340 |
1,090 |
$47K |
| 83993 |
|
1,247 |
1,049 |
$45K |
| 86364 |
|
2,198 |
2,115 |
$44K |
| 82465 |
|
3,865 |
2,932 |
$44K |
| 77080 |
|
475 |
353 |
$43K |
| 73630 |
|
358 |
288 |
$43K |
| 43239 |
|
102 |
84 |
$43K |
| 84156 |
|
4,055 |
3,343 |
$42K |
| 82533 |
|
1,024 |
840 |
$42K |
| 87653 |
|
615 |
414 |
$40K |
| J2543 |
Piperacillin/tazobactam |
20 |
12 |
$40K |
| 88141 |
|
1,431 |
642 |
$39K |
| 97535 |
|
1,001 |
667 |
$39K |
| 84207 |
|
619 |
560 |
$38K |
| 85060 |
|
1,658 |
1,142 |
$38K |
| 84402 |
|
646 |
558 |
$38K |
| 83718 |
|
2,050 |
1,482 |
$37K |
| 84075 |
|
2,463 |
1,760 |
$36K |
| 76816 |
|
545 |
307 |
$36K |
| 80197 |
|
2,480 |
1,435 |
$36K |
| J7512 |
Prednisone ir or dr oral 1mg |
609 |
325 |
$35K |
| 83525 |
|
1,311 |
977 |
$34K |
| 86308 |
|
1,243 |
911 |
$33K |
| J2785 |
Regadenoson injection |
153 |
113 |
$32K |
| 82950 |
|
2,609 |
2,129 |
$31K |
| 93225 |
|
356 |
315 |
$31K |
| 86800 |
|
861 |
657 |
$31K |
| 73030 |
|
409 |
311 |
$30K |
| 82977 |
|
1,829 |
1,453 |
$30K |
| U0002 |
Covid-19 lab test non-cdc |
75 |
65 |
$30K |
| 84436 |
|
1,916 |
1,407 |
$29K |
| 74176 |
|
194 |
163 |
$29K |
| 76805 |
|
249 |
184 |
$29K |
| 88112 |
|
245 |
219 |
$29K |
| 85045 |
|
2,026 |
1,558 |
$27K |
| 82247 |
|
2,208 |
1,405 |
$27K |
| 84132 |
|
2,361 |
1,870 |
$26K |
| 73130 |
|
243 |
183 |
$26K |
| 86705 |
|
805 |
584 |
$26K |
| 87015 |
|
494 |
440 |
$26K |
| 73610 |
|
189 |
149 |
$25K |
| 82785 |
|
519 |
508 |
$25K |
| 76813 |
|
194 |
113 |
$24K |
| 87517 |
|
278 |
202 |
$23K |
| 84155 |
|
1,709 |
1,260 |
$23K |
| 80069 |
|
2,048 |
1,410 |
$23K |
| 88341 |
|
106 |
61 |
$22K |
| 70553 |
|
13 |
12 |
$22K |
| J3475 |
Inj magnesium sulfate |
62 |
45 |
$22K |
| 80178 |
|
1,322 |
995 |
$22K |
| 97166 |
|
119 |
94 |
$21K |
| 87338 |
|
825 |
674 |
$21K |
| J2001 |
Lidocaine injection |
45 |
38 |
$21K |
| 84165 |
|
915 |
764 |
$21K |
| G2066 |
Inter devc remote 30d |
474 |
468 |
$20K |
| G0463 |
Hospital outpt clinic visit |
4,375 |
3,889 |
$19K |
| 86666 |
|
335 |
260 |
$19K |
| 84478 |
|
1,184 |
798 |
$19K |
| 84295 |
|
799 |
593 |
$18K |
| 90471 |
|
270 |
231 |
$18K |
| 83520 |
|
550 |
315 |
$17K |
| 99203 |
|
121 |
119 |
$17K |
| 86147 |
|
126 |
100 |
$16K |
| 86753 |
|
353 |
285 |
$16K |
| 97802 |
|
134 |
118 |
$16K |
| 93299 |
|
261 |
206 |
$15K |
| 72100 |
|
124 |
114 |
$14K |
| 86593 |
|
569 |
492 |
$14K |
| G0424 |
Pulmonary rehab w exer |
399 |
40 |
$14K |
| 76830 |
|
83 |
55 |
$14K |
| 86256 |
|
538 |
242 |
$13K |
| 83498 |
|
219 |
173 |
$13K |
| 87901 |
|
33 |
13 |
$13K |
| 82747 |
|
298 |
283 |
$13K |
| 77063 |
|
298 |
283 |
$12K |
| 99412 |
|
340 |
120 |
$12K |
| 93246 |
|
238 |
232 |
$12K |
| 73502 |
|
214 |
167 |
$11K |
| 84300 |
|
304 |
192 |
$10K |
| 87184 |
|
352 |
275 |
$10K |
| M0239 |
Bamlanivimab-xxxx infusion |
63 |
62 |
$10K |
| 87493 |
|
166 |
112 |
$9K |
| 84590 |
|
298 |
283 |
$9K |
| 94060 |
|
72 |
64 |
$8K |
| 97165 |
|
38 |
26 |
$8K |
| J0780 |
Prochlorperazine injection |
86 |
51 |
$8K |
| 87799 |
|
148 |
112 |
$8K |
| 73590 |
|
50 |
41 |
$8K |
| G0483 |
Drug test def 22+ classes |
26 |
25 |
$8K |
| 86709 |
|
262 |
180 |
$8K |
| J1642 |
Inj heparin sodium per 10 u |
21 |
12 |
$8K |
| J1071 |
Inj testosterone cypionate |
1,244 |
529 |
$7K |
| 99204 |
|
39 |
39 |
$7K |
| J2765 |
Metoclopramide hcl injection |
70 |
51 |
$7K |
| 83921 |
|
257 |
198 |
$7K |
| 86141 |
|
303 |
201 |
$7K |
| G0008 |
Admin influenza virus vac |
191 |
167 |
$7K |
| 84305 |
|
153 |
137 |
$6K |
| 86258 |
|
148 |
131 |
$6K |
| 87207 |
|
246 |
238 |
$6K |
| 86146 |
|
62 |
43 |
$6K |
| ATP08 |
|
1,991 |
1,346 |
$6K |
| 87625 |
|
89 |
40 |
$6K |
| 84252 |
|
110 |
110 |
$6K |
| 93298 |
|
69 |
68 |
$6K |
| 82274 |
|
223 |
216 |
$6K |
| 93325 |
|
28 |
25 |
$5K |
| 84630 |
|
168 |
156 |
$5K |
| 76856 |
|
44 |
29 |
$5K |
| 99215 |
Prolong outpt/office vis |
26 |
26 |
$5K |
| 82951 |
|
151 |
107 |
$4K |
| 82330 |
|
197 |
186 |
$4K |
| 86677 |
|
144 |
44 |
$4K |
| 94729 |
|
64 |
53 |
$4K |
| 99281 |
|
27 |
14 |
$4K |
| G8979 |
Mobility goal status |
86 |
64 |
$4K |
| G8978 |
Mobility current status |
81 |
60 |
$4K |
| 83090 |
|
128 |
107 |
$4K |
| 94727 |
|
55 |
42 |
$4K |
| 87140 |
|
232 |
230 |
$3K |
| G8980 |
Mobility d/c status |
49 |
43 |
$3K |
| 87804 |
|
162 |
127 |
$3K |
| 74246 |
|
32 |
15 |
$3K |
| 86255 |
|
124 |
48 |
$3K |
| 0002A |
|
95 |
94 |
$3K |
| 82525 |
|
98 |
94 |
$3K |
| J1630 |
Haloperidol injection |
17 |
13 |
$3K |
| J2930 |
Methylprednisolone injection |
34 |
26 |
$3K |
| 90715 |
|
29 |
26 |
$3K |
| C9113 |
Inj pantoprazole sodium, via |
24 |
14 |
$3K |
| 0001A |
|
109 |
105 |
$2K |
| 86231 |
|
104 |
99 |
$2K |
| 84154 |
|
22 |
14 |
$2K |
| 93280 |
|
173 |
140 |
$2K |
| 93320 |
|
12 |
12 |
$2K |
| 80177 |
|
67 |
39 |
$2K |
| 72170 |
|
16 |
12 |
$2K |
| 82374 |
|
15 |
12 |
$2K |
| 73110 |
|
34 |
28 |
$2K |
| 93270 |
|
14 |
14 |
$1K |
| 87430 |
|
62 |
46 |
$1K |
| 82952 |
|
151 |
107 |
$1K |
| 83519 |
|
43 |
29 |
$1K |
| 90662 |
|
55 |
46 |
$1K |
| 86694 |
|
38 |
37 |
$1K |
| C1894 |
Intro/sheath, non-laser |
14 |
12 |
$1K |
| G0239 |
Oth resp proc, group |
65 |
12 |
$1K |
| 86334 |
|
41 |
39 |
$1K |
| 82010 |
|
22 |
12 |
$1K |
| G1011 |
Cdsm qualified nos |
21 |
15 |
$950.68 |
| 93880 |
|
13 |
13 |
$846.54 |
| 85612 |
|
26 |
25 |
$809.73 |
| 85613 |
|
26 |
25 |
$803.14 |
| 86769 |
|
12 |
12 |
$796.65 |
| 86355 |
|
14 |
13 |
$726.67 |
| 86357 |
|
14 |
13 |
$725.47 |
| 93290 |
|
17 |
12 |
$723.03 |
| 99211 |
|
29 |
28 |
$711.64 |
| 99201 |
|
12 |
12 |
$660.36 |
| 0012A |
|
17 |
17 |
$590.75 |
| 87206 |
|
62 |
43 |
$588.77 |
| 82340 |
|
39 |
39 |
$576.88 |
| 84133 |
|
28 |
26 |
$570.82 |
| 80305 |
|
30 |
12 |
$549.92 |
| 86328 |
|
12 |
12 |
$501.21 |
| 82435 |
|
40 |
37 |
$486.49 |
| 93010 |
|
67 |
65 |
$472.88 |
| ATP15 |
|
55 |
52 |
$447.54 |
| 86381 |
|
13 |
13 |
$444.05 |
| 87075 |
|
21 |
12 |
$429.22 |
| 85240 |
|
12 |
12 |
$427.36 |
| 82103 |
|
13 |
12 |
$426.22 |
| 74018 |
|
15 |
13 |
$409.70 |
| 82397 |
|
13 |
13 |
$397.75 |
| 83695 |
|
12 |
12 |
$347.35 |
| 0011A |
|
17 |
17 |
$341.36 |
| 82390 |
|
13 |
13 |
$339.55 |
| 82180 |
|
13 |
13 |
$306.78 |
| 86036 |
|
16 |
16 |
$299.78 |
| 93282 |
|
12 |
12 |
$296.39 |
| 87102 |
|
18 |
13 |
$172.20 |
| 82436 |
|
14 |
12 |
$140.61 |
| ATP14 |
|
78 |
50 |
$120.93 |
| G0103 |
Psa screening |
139 |
139 |
$37.28 |
| ATP10 |
|
27 |
14 |
$17.92 |
| 0250 |
|
1,844 |
659 |
$0.00 |