| Code | Description | Claims | Beneficiaries | Total Paid |
| 99285 |
|
76,148 |
66,817 |
$27.23M |
| 99284 |
|
47,733 |
42,762 |
$10.60M |
| 99213 |
|
329,842 |
287,215 |
$10.15M |
| 99283 |
|
27,414 |
24,571 |
$4.76M |
| 93005 |
|
61,212 |
50,575 |
$2.55M |
| U0003 |
Cov-19 amp prb hgh thruput |
31,527 |
20,443 |
$2.08M |
| 96413 |
|
10,332 |
6,062 |
$1.97M |
| G0378 |
Hospital observation per hr |
5,934 |
2,292 |
$1.62M |
| 99214 |
|
32,468 |
27,740 |
$1.49M |
| 43239 |
|
4,454 |
3,574 |
$1.30M |
| 80053 |
|
161,996 |
130,900 |
$1.18M |
| 96375 |
|
17,394 |
11,933 |
$959K |
| G0480 |
Drug test def 1-7 classes |
14,668 |
11,527 |
$810K |
| 96374 |
|
25,415 |
21,012 |
$757K |
| 85025 |
|
138,199 |
109,928 |
$720K |
| 70450 |
|
3,851 |
3,314 |
$645K |
| 87635 |
|
16,088 |
14,326 |
$639K |
| 96372 |
|
14,570 |
12,271 |
$635K |
| 36415 |
|
305,101 |
236,653 |
$622K |
| 71046 |
|
13,978 |
12,209 |
$595K |
| 74177 |
|
1,534 |
1,323 |
$588K |
| 96361 |
|
11,216 |
8,355 |
$475K |
| 95810 |
|
525 |
482 |
$420K |
| 71045 |
|
10,824 |
9,384 |
$408K |
| 87536 |
|
7,554 |
6,609 |
$406K |
| 0241U |
|
3,487 |
2,890 |
$363K |
| 97110 |
|
14,851 |
4,369 |
$335K |
| 45380 |
|
1,683 |
1,177 |
$305K |
| 99212 |
|
10,342 |
9,019 |
$296K |
| 83036 |
|
37,979 |
34,197 |
$279K |
| U0005 |
Infec agen detec ampli probe |
15,319 |
9,197 |
$276K |
| 83880 |
|
10,905 |
9,430 |
$267K |
| 31575 |
|
842 |
750 |
$257K |
| 80307 |
|
6,403 |
5,016 |
$251K |
| 95886 |
|
2,447 |
2,203 |
$242K |
| 87491 |
|
7,754 |
6,620 |
$241K |
| 87591 |
|
7,781 |
6,617 |
$240K |
| 80061 |
|
22,507 |
20,552 |
$239K |
| 80050 |
|
6,442 |
5,734 |
$237K |
| 92014 |
|
5,440 |
4,991 |
$230K |
| 84484 |
|
28,656 |
17,756 |
$225K |
| 95911 |
|
556 |
519 |
$222K |
| 82306 |
|
10,046 |
8,741 |
$218K |
| 86360 |
|
6,825 |
6,056 |
$206K |
| 99281 |
|
2,782 |
2,500 |
$201K |
| 77067 |
|
2,346 |
2,194 |
$196K |
| 92012 |
|
3,930 |
3,319 |
$177K |
| 0002A |
|
5,366 |
4,884 |
$171K |
| 73564 |
|
1,756 |
1,433 |
$167K |
| 71260 |
|
742 |
655 |
$165K |
| 86359 |
|
6,935 |
5,951 |
$162K |
| 0001A |
|
5,423 |
5,094 |
$155K |
| 93306 |
|
458 |
429 |
$154K |
| 45385 |
|
951 |
731 |
$144K |
| J0585 |
Injection,onabotulinumtoxina |
431 |
319 |
$143K |
| J1745 |
Infliximab not biosimil 10mg |
44 |
36 |
$125K |
| 83970 |
|
3,685 |
3,233 |
$125K |
| 84443 |
|
9,381 |
8,483 |
$124K |
| 92134 |
|
3,298 |
2,946 |
$115K |
| 95910 |
|
574 |
541 |
$102K |
| 80305 |
|
9,447 |
7,670 |
$101K |
| G0121 |
Colon ca scrn not hi rsk ind |
400 |
328 |
$101K |
| 97803 |
|
9,655 |
8,805 |
$98K |
| 81025 |
|
17,310 |
15,331 |
$97K |
| 73610 |
|
1,741 |
1,507 |
$96K |
| 90674 |
|
6,596 |
6,000 |
$96K |
| 87522 |
Neg quan hep c or qual rna |
2,523 |
2,288 |
$95K |
| 95909 |
|
453 |
398 |
$95K |
| 96365 |
|
843 |
673 |
$93K |
| 96417 |
|
1,305 |
806 |
$92K |
| 86780 |
|
8,101 |
7,040 |
$92K |
| 87389 |
|
4,567 |
4,238 |
$91K |
| 90791 |
|
1,780 |
1,491 |
$91K |
| J9271 |
Inj pembrolizumab |
15 |
12 |
$91K |
| 84425 |
|
4,907 |
4,308 |
$87K |
| 85027 |
|
15,937 |
14,245 |
$80K |
| 83735 |
|
18,855 |
12,778 |
$79K |
| 92133 |
|
2,052 |
1,883 |
$78K |
| G0481 |
Drug test def 8-14 classes |
872 |
659 |
$73K |
| 82607 |
|
5,823 |
5,160 |
$73K |
| 85610 |
|
27,313 |
21,098 |
$72K |
| 83921 |
|
4,121 |
3,588 |
$71K |
| 45378 |
|
281 |
208 |
$70K |
| 90834 |
|
509 |
266 |
$69K |
| 0011A |
|
2,090 |
2,018 |
$68K |
| 90935 |
|
298 |
105 |
$66K |
| 0012A |
|
2,151 |
2,002 |
$66K |
| 73502 |
|
1,013 |
926 |
$66K |
| 82550 |
|
13,942 |
11,811 |
$64K |
| 84207 |
|
4,505 |
3,929 |
$63K |
| 95913 |
|
146 |
138 |
$61K |
| 92083 |
|
2,729 |
2,512 |
$59K |
| 77386 |
|
158 |
13 |
$59K |
| 80048 |
|
8,433 |
7,524 |
$59K |
| 82746 |
|
4,769 |
4,155 |
$58K |
| 73523 |
|
325 |
298 |
$56K |
| 73130 |
|
1,062 |
825 |
$56K |
| 85730 |
|
14,524 |
12,294 |
$52K |
| Q5104 |
Injection, renflexis |
38 |
24 |
$52K |
| 86803 |
|
4,641 |
4,078 |
$52K |
| 84439 |
|
7,137 |
6,173 |
$51K |
| 72125 |
|
301 |
264 |
$50K |
| 83090 |
|
5,680 |
3,912 |
$50K |
| 84252 |
|
4,550 |
3,976 |
$50K |
| 81001 |
|
22,688 |
19,403 |
$49K |
| 82525 |
|
4,751 |
4,147 |
$49K |
| 86141 |
|
4,333 |
3,789 |
$47K |
| 83605 |
|
5,933 |
4,718 |
$46K |
| 95811 |
|
52 |
49 |
$45K |
| 84630 |
|
4,756 |
4,162 |
$45K |
| J2469 |
Palonosetron hcl |
2,070 |
1,132 |
$44K |
| 0004A |
|
1,189 |
1,032 |
$44K |
| 86481 |
|
742 |
672 |
$43K |
| 77336 |
|
440 |
180 |
$42K |
| 82390 |
|
4,571 |
3,980 |
$40K |
| 95912 |
|
120 |
107 |
$40K |
| 96523 |
|
1,365 |
991 |
$39K |
| 73562 |
|
803 |
640 |
$37K |
| 84466 |
|
3,766 |
3,243 |
$37K |
| 11721 |
|
1,007 |
917 |
$37K |
| 70498 |
|
110 |
93 |
$36K |
| 31231 |
|
101 |
91 |
$36K |
| 82728 |
|
3,410 |
2,992 |
$36K |
| J1453 |
Fosaprepitant injection |
356 |
203 |
$34K |
| 72148 |
|
81 |
80 |
$33K |
| 87340 |
|
3,904 |
3,397 |
$32K |
| 91200 |
|
247 |
228 |
$32K |
| 31525 |
|
151 |
135 |
$32K |
| 84600 |
|
2,985 |
2,382 |
$31K |
| 84100 |
|
10,872 |
7,705 |
$31K |
| 96415 |
|
606 |
384 |
$31K |
| 92250 |
|
387 |
374 |
$31K |
| 76705 |
|
294 |
280 |
$30K |
| 93356 |
|
307 |
283 |
$30K |
| 87086 |
|
4,726 |
4,004 |
$30K |
| 96360 |
|
500 |
393 |
$29K |
| 72100 |
|
625 |
581 |
$29K |
| 88175 |
|
1,514 |
1,309 |
$29K |
| 96900 |
|
976 |
231 |
$28K |
| 84481 |
|
2,835 |
2,429 |
$27K |
| 83690 |
|
5,612 |
4,851 |
$27K |
| 20610 |
|
125 |
113 |
$27K |
| 96367 |
|
557 |
368 |
$26K |
| G0433 |
Elisa hiv-1/hiv-2 screen |
3,147 |
2,629 |
$26K |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
3,372 |
2,926 |
$25K |
| J1642 |
Inj heparin sodium per 10 u |
7,756 |
4,721 |
$25K |
| 0031A |
|
896 |
857 |
$25K |
| 87502 |
|
324 |
286 |
$24K |
| 73110 |
|
484 |
378 |
$23K |
| 11056 |
|
658 |
575 |
$23K |
| 87624 |
|
824 |
737 |
$23K |
| 73630 |
|
456 |
378 |
$22K |
| 99211 |
|
1,080 |
917 |
$22K |
| 97802 |
|
1,333 |
1,181 |
$22K |
| 52000 |
|
88 |
79 |
$22K |
| 99215 |
Prolong outpt/office vis |
530 |
461 |
$21K |
| 76536 |
|
183 |
176 |
$20K |
| 87661 |
|
883 |
657 |
$20K |
| 86003 |
|
261 |
187 |
$20K |
| M0243 |
Casirivi and imdevi inj |
78 |
51 |
$20K |
| 29581 |
|
337 |
121 |
$19K |
| 83540 |
|
3,802 |
3,273 |
$18K |
| 97161 |
|
376 |
341 |
$18K |
| 73140 |
|
376 |
304 |
$18K |
| 84134 |
|
3,285 |
2,827 |
$18K |
| 95816 |
|
84 |
79 |
$18K |
| 88305 |
|
10,632 |
9,110 |
$17K |
| Q5103 |
Injection, inflectra |
16 |
12 |
$16K |
| 86706 |
|
1,698 |
1,563 |
$16K |
| 84153 |
|
1,085 |
975 |
$15K |
| 90750 |
|
221 |
208 |
$15K |
| 82962 |
|
6,914 |
4,026 |
$15K |
| 99282 |
|
135 |
114 |
$14K |
| 80375 |
|
1,622 |
1,094 |
$14K |
| 86704 |
|
1,364 |
1,253 |
$14K |
| 97763 |
|
294 |
284 |
$14K |
| 82570 |
|
3,316 |
3,066 |
$13K |
| 80323 |
|
1,502 |
1,006 |
$13K |
| 95908 |
|
89 |
83 |
$13K |
| J1885 |
Ketorolac tromethamine inj |
3,413 |
2,893 |
$13K |
| J1100 |
Dexamethasone sodium phos |
3,586 |
2,046 |
$12K |
| 82947 |
|
4,886 |
3,339 |
$12K |
| 80329 |
|
1,118 |
880 |
$12K |
| J1050 |
Medroxyprogesterone acetate |
595 |
556 |
$12K |
| 97597 |
|
208 |
169 |
$12K |
| 29580 |
|
275 |
118 |
$12K |
| 86708 |
|
1,111 |
1,021 |
$12K |
| 20611 |
|
52 |
25 |
$11K |
| 81003 |
|
7,796 |
6,534 |
$11K |
| 80074 |
|
378 |
341 |
$11K |
| 81002 |
|
3,592 |
2,598 |
$11K |
| 90837 |
|
59 |
26 |
$10K |
| J7050 |
Normal saline solution infus |
632 |
393 |
$10K |
| 70496 |
|
32 |
28 |
$10K |
| G0475 |
Hiv combination assay |
968 |
778 |
$10K |
| 86140 |
|
2,225 |
2,021 |
$10K |
| J2405 |
Ondansetron hcl injection |
3,502 |
2,417 |
$9K |
| 70486 |
|
74 |
64 |
$9K |
| 82043 |
|
2,120 |
1,971 |
$9K |
| J7030 |
Normal saline solution infus |
890 |
742 |
$9K |
| 92229 |
|
378 |
298 |
$9K |
| 86480 |
|
174 |
159 |
$8K |
| 81420 |
|
18 |
14 |
$8K |
| 64721 |
|
27 |
24 |
$8K |
| 90833 |
|
71 |
62 |
$8K |
| 90471 |
|
13,385 |
9,633 |
$8K |
| 70553 |
|
16 |
14 |
$8K |
| 72110 |
|
96 |
87 |
$8K |
| 90715 |
|
294 |
269 |
$7K |
| 11720 |
|
159 |
150 |
$7K |
| 84480 |
|
1,113 |
991 |
$7K |
| 77063 |
|
105 |
102 |
$7K |
| 86850 |
|
1,589 |
1,347 |
$7K |
| 72040 |
|
160 |
141 |
$6K |
| 85651 |
|
1,851 |
1,689 |
$6K |
| 84681 |
|
4,484 |
2,663 |
$6K |
| 0003A |
|
185 |
153 |
$6K |
| 96411 |
|
76 |
52 |
$6K |
| 97530 |
|
400 |
114 |
$6K |
| 93000 |
|
70 |
67 |
$6K |
| 82105 |
|
485 |
434 |
$6K |
| J2920 |
Methylprednisolone injection |
1,720 |
1,435 |
$6K |
| 77065 |
Tomosynthesis, mammo |
82 |
76 |
$6K |
| 96416 |
|
17 |
13 |
$5K |
| 64615 |
|
27 |
26 |
$5K |
| J7120 |
Ringers lactate infusion |
365 |
295 |
$5K |
| 94726 |
|
30 |
29 |
$5K |
| 72141 |
|
12 |
12 |
$5K |
| U0002 |
Covid-19 lab test non-cdc |
171 |
149 |
$5K |
| 90832 |
|
93 |
74 |
$5K |
| 86408 |
|
165 |
137 |
$5K |
| 93923 |
|
77 |
74 |
$5K |
| 0054A |
|
124 |
117 |
$4K |
| 90670 |
|
23 |
18 |
$4K |
| 86762 |
|
278 |
233 |
$4K |
| 87210 |
|
921 |
823 |
$4K |
| 96376 |
|
89 |
81 |
$4K |
| 84702 |
|
420 |
372 |
$4K |
| 93350 |
|
13 |
12 |
$4K |
| 0124A |
|
223 |
153 |
$4K |
| 86900 |
|
1,689 |
1,428 |
$4K |
| 90746 |
|
73 |
71 |
$4K |
| 86901 |
|
1,712 |
1,441 |
$4K |
| 77300 |
|
15 |
15 |
$4K |
| 86357 |
|
219 |
196 |
$4K |
| J3301 |
Triamcinolone acet inj nos |
740 |
672 |
$4K |
| 93017 |
|
17 |
16 |
$4K |
| 86160 |
|
257 |
208 |
$4K |
| 97760 |
|
73 |
66 |
$3K |
| 87804 |
|
173 |
132 |
$3K |
| 90677 |
|
44 |
34 |
$3K |
| 76642 |
|
45 |
37 |
$3K |
| J1170 |
Hydromorphone injection |
1,347 |
884 |
$3K |
| 90651 |
|
15 |
14 |
$3K |
| 95885 |
|
30 |
29 |
$3K |
| J9190 |
Fluorouracil injection |
171 |
48 |
$3K |
| 86235 |
|
61 |
39 |
$3K |
| G0105 |
Colorectal scrn; hi risk ind |
18 |
12 |
$3K |
| 19281 |
|
91 |
51 |
$3K |
| 77073 |
|
25 |
25 |
$3K |
| 83993 |
|
171 |
156 |
$3K |
| 10005 |
|
29 |
13 |
$2K |
| 80320 |
|
816 |
587 |
$2K |
| 80349 |
|
214 |
151 |
$2K |
| 82378 |
|
155 |
119 |
$2K |
| 88112 |
|
107 |
94 |
$2K |
| 80069 |
|
382 |
339 |
$2K |
| 73030 |
|
30 |
26 |
$2K |
| 86355 |
|
131 |
117 |
$2K |
| 72050 |
|
28 |
24 |
$2K |
| 20605 |
|
12 |
12 |
$2K |
| J2270 |
Morphine sulfate injection |
617 |
460 |
$2K |
| J3010 |
Fentanyl citrate injection |
2,586 |
2,016 |
$2K |
| J2250 |
Inj midazolam hydrochloride |
2,945 |
2,337 |
$2K |
| 81596 |
|
49 |
42 |
$2K |
| 72082 |
|
14 |
13 |
$2K |
| 94729 |
|
30 |
29 |
$2K |
| 87088 |
|
228 |
200 |
$2K |
| 76805 |
|
17 |
13 |
$2K |
| 80179 |
|
572 |
303 |
$2K |
| 80143 |
|
570 |
302 |
$1K |
| G0109 |
Diab manage trn ind/group |
46 |
40 |
$1K |
| J1790 |
Droperidol injection |
495 |
388 |
$1K |
| C1713 |
Anchor/screw bn/bn,tis/bn |
29 |
29 |
$1K |
| 0399T |
|
14 |
12 |
$1K |
| 29125 |
|
16 |
16 |
$1K |
| 90734 |
|
14 |
13 |
$1K |
| 73590 |
|
29 |
26 |
$1K |
| 93880 |
|
13 |
12 |
$1K |
| 86225 |
|
126 |
100 |
$1K |
| 90739 |
|
30 |
29 |
$1K |
| 72120 |
|
12 |
12 |
$1K |
| J2704 |
Inj, propofol, 10 mg |
14,953 |
9,237 |
$1K |
| 85007 |
|
596 |
495 |
$1K |
| 96366 |
|
34 |
26 |
$1K |
| 86593 |
|
327 |
301 |
$1K |
| 76830 |
|
12 |
12 |
$1K |
| 87077 |
|
136 |
109 |
$1K |
| 92004 |
|
36 |
30 |
$1K |
| 84156 |
|
420 |
372 |
$1K |
| 86703 |
|
103 |
96 |
$953.85 |
| J1644 |
Inj heparin sodium per 1000u |
247 |
164 |
$920.75 |
| J7040 |
Normal saline solution infus |
48 |
27 |
$914.90 |
| 85384 |
|
186 |
165 |
$910.45 |
| 91320 |
|
28 |
26 |
$884.90 |
| 82785 |
|
69 |
61 |
$869.92 |
| 90632 |
|
14 |
13 |
$845.51 |
| 82150 |
|
158 |
139 |
$824.16 |
| 87102 |
|
134 |
123 |
$790.54 |
| 87480 |
|
42 |
33 |
$748.50 |
| 90472 |
|
315 |
226 |
$741.04 |
| 82180 |
|
92 |
84 |
$729.75 |
| 69210 |
|
20 |
19 |
$696.08 |
| J0640 |
Leucovorin calcium injection |
27 |
12 |
$683.34 |
| 92227 |
|
66 |
59 |
$680.07 |
| 90661 |
|
43 |
39 |
$649.68 |
| J1030 |
Methylprednisolone 40 mg inj |
90 |
86 |
$602.12 |
| 94618 |
|
13 |
12 |
$576.59 |
| 88342 |
|
1,934 |
1,725 |
$575.06 |
| 80353 |
|
52 |
36 |
$570.12 |
| 87660 |
|
39 |
33 |
$561.40 |
| 87510 |
|
39 |
33 |
$561.40 |
| 85660 |
|
109 |
93 |
$560.72 |
| J0665 |
Inj, bupivacaine, nos, 0.5mg |
261 |
178 |
$557.93 |
| C1894 |
Intro/sheath, non-laser |
25 |
24 |
$540.63 |
| 92285 |
|
12 |
12 |
$510.48 |
| 87206 |
|
135 |
123 |
$506.66 |
| 97165 |
|
14 |
12 |
$506.45 |
| 99152 |
|
869 |
578 |
$491.73 |
| 86787 |
|
49 |
39 |
$486.62 |
| 0051A |
|
17 |
13 |
$466.36 |
| J2919 |
Inj, methylpred sod succ 5mg |
208 |
137 |
$463.84 |
| 87186 |
|
46 |
41 |
$433.97 |
| 87516 |
|
13 |
13 |
$428.89 |
| 87081 |
|
28 |
24 |
$421.97 |
| 95249 |
|
15 |
12 |
$420.49 |
| J1200 |
Diphenhydramine hcl injectio |
133 |
100 |
$416.98 |
| 90686 |
|
16 |
12 |
$388.50 |
| 99153 |
Mod sedat endo service >5yrs |
302 |
201 |
$366.20 |
| C1769 |
Guide wire |
14 |
12 |
$355.23 |
| 83010 |
|
28 |
28 |
$336.96 |
| 84590 |
|
31 |
31 |
$325.08 |
| J2003 |
Inj, lidocaine hcl, 1 mg |
162 |
110 |
$302.22 |
| 86038 |
|
29 |
24 |
$295.11 |
| A9585 |
Gadobutrol injection |
15 |
14 |
$283.63 |
| G0463 |
Hospital outpt clinic visit |
11,412 |
9,802 |
$273.60 |
| 97804 |
|
149 |
144 |
$266.94 |
| J0690 |
Cefazolin sodium injection |
555 |
375 |
$244.08 |
| J3475 |
Inj magnesium sulfate |
32 |
25 |
$232.47 |
| 84403 |
|
14 |
13 |
$232.29 |
| C1751 |
Cath, inf, per/cent/midline |
2,820 |
2,403 |
$230.43 |
| 82565 |
|
42 |
40 |
$205.66 |
| 87040 |
|
12 |
12 |
$196.08 |
| 90656 |
|
197 |
111 |
$195.48 |
| 82977 |
|
28 |
28 |
$194.16 |
| 88173 |
|
23 |
13 |
$179.45 |
| 86705 |
|
15 |
15 |
$164.78 |
| 91300 |
|
13,069 |
9,856 |
$146.55 |
| 83615 |
|
30 |
27 |
$144.96 |
| J2060 |
Lorazepam injection |
49 |
38 |
$141.99 |
| 83883 |
|
28 |
28 |
$118.32 |
| 90480 |
|
57 |
39 |
$118.32 |
| J1040 |
Methylprednisolone 80 mg inj |
14 |
13 |
$103.30 |
| J1650 |
Inj enoxaparin sodium |
25 |
13 |
$91.80 |
| 90662 |
|
16 |
14 |
$86.52 |
| J2001 |
Lidocaine injection |
1,246 |
1,038 |
$75.21 |
| Q0163 |
Diphenhydramine hcl 50mg |
159 |
150 |
$56.93 |
| 99443 |
|
40 |
29 |
$54.07 |
| J0330 |
Succinycholine chloride inj |
183 |
106 |
$48.93 |
| J1010 |
Inj, methylpred acetate 1 mg |
17 |
13 |
$47.77 |
| 84550 |
|
16 |
12 |
$45.45 |
| A6258 |
Transparent film >16<=48 in |
159 |
122 |
$41.07 |
| J0696 |
Ceftriaxone sodium injection |
16 |
12 |
$40.49 |
| J1171 |
Inj, hydromorphone, 0.1 mg |
17 |
13 |
$36.80 |
| J7512 |
Prednisone ir or dr oral 1mg |
21 |
18 |
$34.50 |
| Q0162 |
Ondansetron oral |
31 |
27 |
$30.62 |
| A6223 |
Gauze >16<=48 no w/sal w/o b |
1,211 |
1,066 |
$21.67 |
| Q3014 |
Telehealth facility fee |
2,438 |
2,348 |
$16.37 |
| C9803 |
Hopd covid-19 spec collect |
25,490 |
14,761 |
$13.78 |
| E0191 |
Protector heel or elbow |
123 |
115 |
$12.42 |
| J2370 |
Phenylephrine hcl injection |
91 |
57 |
$11.43 |
| J1596 |
Inj, glycopyrrolate, 0.1 mg |
118 |
81 |
$8.76 |
| J2795 |
Ropivacaine hcl injection |
14 |
13 |
$4.79 |
| Q0244 |
Casirivi and imdevi 1200 mg |
71 |
51 |
$0.60 |
| A6222 |
Gauze <=16 in no w/sal w/o b |
47 |
45 |
$0.28 |
| G1004 |
Cdsm ndsc |
208 |
120 |
$0.04 |
| 91312 |
|
308 |
152 |
$0.02 |
| 99001 |
|
14,100 |
8,615 |
$0.00 |
| 82172 |
|
32 |
28 |
$0.00 |
| 88355 |
|
109 |
75 |
$0.00 |
| 90611 |
|
271 |
256 |
$0.00 |
| 99442 |
|
41 |
30 |
$0.00 |
| 80348 |
|
121 |
80 |
$0.00 |
| D1110 |
|
20 |
13 |
$0.00 |
| 91301 |
|
4,735 |
4,047 |
$0.00 |
| 91303 |
|
942 |
856 |
$0.00 |
| J0131 |
Inj, acetaminophen (nos) |
29 |
24 |
$0.00 |
| D0140 |
|
48 |
33 |
$0.00 |
| G0008 |
Admin influenza virus vac |
65 |
63 |
$0.00 |
| 93289 |
|
15 |
13 |
$0.00 |
| J2371 |
Inj phenylephrine hcl 20 mcg |
16 |
14 |
$0.00 |
| 91305 |
|
184 |
172 |
$0.00 |
| C9290 |
Inj, bupivacaine liposome |
14 |
12 |
$0.00 |
| 99441 |
|
33 |
25 |
$0.00 |