| Code | Description | Claims | Beneficiaries | Total Paid |
| 0450 |
|
130,142 |
113,500 |
$6.25M |
| 99283 |
|
85,455 |
76,220 |
$4.22M |
| 70450 |
|
17,957 |
17,267 |
$2.66M |
| 74177 |
|
11,023 |
10,683 |
$2.06M |
| 11042 |
|
7,118 |
3,580 |
$1.56M |
| 80053 |
|
103,067 |
91,282 |
$1.47M |
| 96374 |
|
26,431 |
24,957 |
$1.45M |
| 0241U |
|
11,476 |
11,110 |
$1.45M |
| 93005 |
|
49,802 |
45,427 |
$1.34M |
| 85025 |
|
123,339 |
106,949 |
$1.26M |
| 74176 |
|
12,931 |
12,550 |
$1.20M |
| 96372 |
|
41,465 |
34,637 |
$1.10M |
| 80307 |
|
17,957 |
16,136 |
$978K |
| Z7502 |
|
22,435 |
22,138 |
$844K |
| 99285 |
|
7,541 |
7,037 |
$777K |
| 96375 |
|
21,507 |
18,041 |
$756K |
| 15275 |
|
647 |
263 |
$740K |
| 84484 |
|
51,660 |
37,913 |
$737K |
| 72125 |
|
3,896 |
3,815 |
$708K |
| 96365 |
|
9,222 |
8,818 |
$630K |
| 71275 |
|
3,519 |
3,421 |
$583K |
| 99499 |
|
6,859 |
5,742 |
$564K |
| 84702 |
|
34,857 |
32,159 |
$552K |
| 76705 |
|
10,498 |
10,145 |
$544K |
| 71046 |
|
28,751 |
27,505 |
$527K |
| 96361 |
|
17,047 |
15,426 |
$508K |
| 0206 |
|
52 |
43 |
$393K |
| 11043 |
|
954 |
650 |
$357K |
| 0360 |
|
2,514 |
2,340 |
$354K |
| 93306 |
|
2,596 |
2,545 |
$352K |
| 96360 |
|
6,012 |
5,844 |
$346K |
| 93975 |
|
1,770 |
1,719 |
$343K |
| 83690 |
|
37,146 |
34,615 |
$342K |
| 71045 |
|
35,870 |
33,843 |
$340K |
| 93971 |
|
3,670 |
3,566 |
$340K |
| 72131 |
|
1,977 |
1,947 |
$327K |
| U0003 |
Cov-19 amp prb hgh thruput |
4,350 |
4,211 |
$323K |
| 83880 |
|
15,545 |
14,585 |
$321K |
| 92507 |
|
4,830 |
1,907 |
$290K |
| 94640 |
|
15,009 |
12,094 |
$290K |
| 81001 |
|
61,206 |
57,189 |
$278K |
| 99284 |
|
3,772 |
3,533 |
$275K |
| 76856 |
|
4,462 |
4,334 |
$275K |
| G0378 |
Hospital observation per hr |
5,637 |
3,106 |
$271K |
| 70551 |
|
747 |
734 |
$260K |
| 99070 |
|
138,718 |
60,524 |
$255K |
| Q4133 |
Grafix stravix prime pl sqcm |
363 |
150 |
$245K |
| 87636 |
|
1,882 |
1,872 |
$243K |
| 76801 |
|
4,696 |
4,194 |
$237K |
| 80048 |
|
20,760 |
17,600 |
$229K |
| 76817 |
|
4,023 |
3,640 |
$207K |
| 87040 |
|
12,626 |
8,536 |
$204K |
| 70496 |
|
1,493 |
1,454 |
$203K |
| 49083 |
|
1,848 |
779 |
$195K |
| 93970 |
|
1,217 |
1,183 |
$194K |
| 83605 |
|
12,320 |
9,745 |
$185K |
| 76830 |
|
3,072 |
3,000 |
$180K |
| 96366 |
|
3,765 |
3,220 |
$179K |
| 70486 |
|
1,180 |
1,151 |
$177K |
| 87651 |
|
3,660 |
3,614 |
$173K |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
13,896 |
13,343 |
$171K |
| 0761 |
|
5,073 |
3,125 |
$168K |
| 97530 |
|
4,038 |
1,654 |
$167K |
| Z9725 |
|
3,718 |
3,683 |
$160K |
| 93458 |
|
103 |
103 |
$159K |
| 87635 |
|
3,415 |
3,330 |
$159K |
| 78452 |
|
712 |
691 |
$156K |
| 70498 |
|
1,549 |
1,510 |
$152K |
| J3490 |
Drugs unclassified injection |
81,348 |
39,623 |
$145K |
| 11044 |
|
127 |
84 |
$130K |
| 85379 |
|
9,679 |
9,299 |
$130K |
| 87631 |
|
2,647 |
2,622 |
$129K |
| 84443 |
|
6,225 |
5,945 |
$128K |
| 71260 |
|
569 |
557 |
$125K |
| 83735 |
|
15,494 |
12,755 |
$124K |
| 0710 |
|
4,515 |
4,248 |
$124K |
| 76815 |
|
2,062 |
1,935 |
$116K |
| 85610 |
|
21,903 |
20,285 |
$115K |
| 87086 |
|
14,381 |
13,717 |
$114K |
| 87804 |
|
8,365 |
7,659 |
$112K |
| 85730 |
|
15,961 |
14,773 |
$110K |
| 0240U |
|
906 |
896 |
$109K |
| A9500 |
Tc99m sestamibi |
604 |
580 |
$107K |
| 84703 |
|
10,099 |
9,656 |
$103K |
| 73630 |
|
4,610 |
4,421 |
$100K |
| 90715 |
|
2,924 |
2,883 |
$97K |
| 73130 |
|
4,183 |
3,979 |
$97K |
| 76770 |
|
1,423 |
1,400 |
$95K |
| 73610 |
|
3,906 |
3,776 |
$91K |
| 73562 |
|
4,108 |
3,927 |
$86K |
| 97110 |
|
3,932 |
1,124 |
$81K |
| 73030 |
|
3,339 |
3,180 |
$80K |
| 74018 |
|
4,814 |
4,655 |
$80K |
| 0762 |
|
1,450 |
613 |
$77K |
| 88305 |
|
2,986 |
2,876 |
$76K |
| P9016 |
Rbc leukocytes reduced |
374 |
326 |
$76K |
| G0463 |
Hospital outpt clinic visit |
4,113 |
2,717 |
$74K |
| J3010 |
Fentanyl citrate injection |
13,076 |
11,187 |
$72K |
| 82948 |
|
13,992 |
6,563 |
$71K |
| 82962 |
|
10,266 |
5,684 |
$67K |
| 84439 |
|
5,980 |
5,650 |
$67K |
| 86901 |
|
10,660 |
9,807 |
$66K |
| 73110 |
|
2,801 |
2,668 |
$65K |
| 93454 |
|
39 |
39 |
$64K |
| 72100 |
|
2,338 |
2,303 |
$60K |
| 70491 |
|
275 |
266 |
$56K |
| 99238 |
|
1,871 |
1,864 |
$56K |
| 96367 |
|
1,544 |
1,448 |
$54K |
| 99152 |
|
1,689 |
1,617 |
$53K |
| 87186 |
|
3,969 |
3,757 |
$51K |
| 87591 |
|
3,191 |
3,101 |
$51K |
| 87491 |
|
3,173 |
3,088 |
$50K |
| 76870 |
|
935 |
885 |
$49K |
| 86141 |
|
5,754 |
5,478 |
$49K |
| 96376 |
|
2,324 |
1,260 |
$48K |
| 86850 |
|
5,392 |
5,160 |
$48K |
| Z7610 |
|
10,050 |
6,185 |
$47K |
| 73080 |
|
1,844 |
1,787 |
$45K |
| 76816 |
|
988 |
933 |
$44K |
| 86900 |
|
10,613 |
9,803 |
$44K |
| 73502 |
|
1,552 |
1,472 |
$42K |
| J0131 |
Inj, acetaminophen (nos) |
1,078 |
1,032 |
$41K |
| 86923 |
|
274 |
266 |
$41K |
| 82805 |
|
1,095 |
1,028 |
$40K |
| 93017 |
|
717 |
693 |
$39K |
| 85027 |
|
4,995 |
3,960 |
$38K |
| J2785 |
Regadenoson injection |
332 |
317 |
$37K |
| 73590 |
|
2,100 |
2,010 |
$37K |
| 15271 |
|
30 |
13 |
$37K |
| J1100 |
Dexamethasone sodium phos |
15,486 |
14,678 |
$36K |
| 73090 |
|
1,864 |
1,785 |
$35K |
| J1885 |
Ketorolac tromethamine inj |
21,507 |
20,225 |
$35K |
| 71250 |
|
192 |
191 |
$35K |
| 87077 |
|
4,595 |
4,329 |
$34K |
| 72040 |
|
1,365 |
1,337 |
$33K |
| 83036 |
|
2,950 |
2,837 |
$32K |
| 74021 |
|
1,360 |
1,317 |
$32K |
| 81025 |
|
4,411 |
4,327 |
$31K |
| 99217 |
|
390 |
386 |
$31K |
| J2270 |
Morphine sulfate injection |
14,459 |
11,361 |
$31K |
| 82550 |
|
3,728 |
3,493 |
$31K |
| 80061 |
|
2,517 |
2,415 |
$30K |
| 88304 |
|
2,355 |
2,263 |
$29K |
| J2405 |
Ondansetron hcl injection |
25,970 |
22,132 |
$28K |
| 81003 |
|
9,402 |
8,565 |
$28K |
| 72128 |
|
227 |
225 |
$28K |
| 66984 |
|
121 |
121 |
$28K |
| 59025 |
|
1,367 |
665 |
$27K |
| 82728 |
|
1,692 |
1,579 |
$27K |
| J0696 |
Ceftriaxone sodium injection |
11,089 |
9,420 |
$26K |
| 82803 |
|
927 |
888 |
$25K |
| 71101 |
|
619 |
603 |
$24K |
| 76937 |
|
1,574 |
1,428 |
$23K |
| V2632 |
Post chmbr intraocular lens |
216 |
203 |
$23K |
| 87070 |
|
2,240 |
1,999 |
$22K |
| 36415 |
|
7,460 |
5,199 |
$22K |
| 47562 |
|
68 |
64 |
$22K |
| 99281 |
|
594 |
538 |
$21K |
| 12001 |
|
1,127 |
1,116 |
$21K |
| P9047 |
Albumin (human), 25%, 50ml |
346 |
144 |
$21K |
| 87210 |
|
3,308 |
3,166 |
$20K |
| 87430 |
|
1,406 |
1,351 |
$17K |
| 80076 |
|
1,701 |
1,608 |
$17K |
| 82010 |
|
1,567 |
1,465 |
$17K |
| 99221 |
|
153 |
93 |
$17K |
| 82140 |
|
1,167 |
1,044 |
$16K |
| J1815 |
Insulin injection |
5,312 |
2,591 |
$16K |
| J2250 |
Inj midazolam hydrochloride |
8,512 |
7,865 |
$16K |
| 87081 |
|
2,083 |
2,006 |
$16K |
| V5008 |
Hearing screening |
364 |
351 |
$15K |
| J2710 |
Neostigmine methylslfte inj |
1,796 |
1,765 |
$15K |
| J2930 |
Methylprednisolone injection |
3,394 |
3,089 |
$14K |
| 10060 |
|
813 |
774 |
$14K |
| 87807 |
|
2,030 |
1,920 |
$14K |
| J1650 |
Inj enoxaparin sodium |
5,085 |
2,642 |
$14K |
| J7030 |
Normal saline solution infus |
3,599 |
3,188 |
$14K |
| S0164 |
Injection pantroprazole |
3,020 |
2,138 |
$14K |
| 83615 |
|
1,762 |
1,659 |
$14K |
| 87205 |
|
2,719 |
2,392 |
$14K |
| J1170 |
Hydromorphone injection |
6,515 |
4,808 |
$13K |
| 76700 |
|
201 |
176 |
$13K |
| 99291 |
|
39 |
38 |
$13K |
| J2704 |
Inj, propofol, 10 mg |
5,991 |
5,562 |
$13K |
| 0250 |
|
4,103 |
2,448 |
$12K |
| 99199 |
|
294 |
277 |
$12K |
| 84100 |
|
2,599 |
2,163 |
$12K |
| J2765 |
Metoclopramide hcl injection |
7,324 |
6,909 |
$12K |
| 90471 |
|
3,151 |
3,047 |
$12K |
| J0702 |
Betamethasone acet&sod phosp |
736 |
614 |
$12K |
| J0690 |
Cefazolin sodium injection |
5,084 |
4,223 |
$12K |
| 12011 |
|
581 |
576 |
$12K |
| 73060 |
|
672 |
646 |
$12K |
| 59425 |
|
192 |
162 |
$11K |
| 29515 |
|
1,231 |
1,202 |
$11K |
| 29125 |
|
1,646 |
1,608 |
$11K |
| 92523 |
|
146 |
143 |
$11K |
| J2001 |
Lidocaine injection |
3,433 |
3,045 |
$10K |
| 99153 |
Mod sedat endo service >5yrs |
991 |
950 |
$10K |
| A4216 |
Sterile water/saline, 10 ml |
636 |
461 |
$10K |
| J1644 |
Inj heparin sodium per 1000u |
5,010 |
2,922 |
$10K |
| Q0144 |
Azithromycin dihydrate, oral |
1,071 |
1,008 |
$10K |
| 76999 |
|
102 |
102 |
$9K |
| 87075 |
|
939 |
815 |
$9K |
| 73552 |
|
471 |
440 |
$9K |
| 97533 |
|
486 |
225 |
$9K |
| J1953 |
Levetiracetam injection |
983 |
761 |
$9K |
| 88342 |
|
348 |
338 |
$9K |
| J2543 |
Piperacillin/tazobactam |
2,418 |
1,639 |
$8K |
| 0361 |
|
66 |
63 |
$8K |
| 0272 |
|
671 |
592 |
$8K |
| S0020 |
Injection, bupivicaine hydro |
1,642 |
1,513 |
$7K |
| J1200 |
Diphenhydramine hcl injectio |
5,789 |
5,268 |
$7K |
| 85652 |
|
2,263 |
2,194 |
$7K |
| 84550 |
|
1,222 |
1,071 |
$7K |
| 87147 |
|
1,306 |
1,189 |
$7K |
| J0500 |
Dicyclomine injection |
302 |
289 |
$7K |
| 71020 |
|
266 |
238 |
$7K |
| 76819 |
|
143 |
125 |
$7K |
| J3370 |
Vancomycin hcl injection |
1,121 |
805 |
$6K |
| 82731 |
|
148 |
144 |
$6K |
| 73140 |
|
401 |
380 |
$6K |
| 82570 |
|
1,051 |
866 |
$6K |
| G0480 |
Drug test def 1-7 classes |
89 |
79 |
$5K |
| J0330 |
Succinycholine chloride inj |
1,303 |
1,276 |
$5K |
| 94664 |
|
754 |
376 |
$5K |
| 70360 |
|
328 |
314 |
$5K |
| 72070 |
|
190 |
185 |
$5K |
| 96368 |
|
248 |
241 |
$5K |
| J0360 |
Hydralazine hcl injection |
1,590 |
1,222 |
$5K |
| 94799 |
|
175 |
163 |
$5K |
| Q0163 |
Diphenhydramine hcl 50mg |
1,858 |
1,771 |
$5K |
| Z6410 |
|
540 |
461 |
$5K |
| M0243 |
Casirivi and imdevi inj |
17 |
17 |
$4K |
| 72170 |
|
249 |
246 |
$4K |
| 74019 |
|
189 |
171 |
$4K |
| 12002 |
|
250 |
246 |
$4K |
| 0270 |
|
1,859 |
1,111 |
$4K |
| J7120 |
Ringers lactate infusion |
488 |
476 |
$4K |
| Z6500 |
|
27 |
27 |
$4K |
| 87637 |
|
26 |
26 |
$4K |
| G0500 |
Mod sedat endo service >5yrs |
110 |
110 |
$4K |
| 97161 |
|
115 |
113 |
$4K |
| J2060 |
Lorazepam injection |
3,623 |
2,846 |
$4K |
| 97116 |
|
280 |
212 |
$3K |
| J7050 |
Normal saline solution infus |
2,353 |
1,287 |
$3K |
| 29505 |
|
345 |
341 |
$3K |
| 85018 |
|
1,071 |
942 |
$3K |
| J3475 |
Inj magnesium sulfate |
1,021 |
890 |
$3K |
| 36600 |
|
253 |
236 |
$3K |
| J2175 |
Meperidine hydrochl /100 mg |
589 |
422 |
$3K |
| 97535 |
|
326 |
170 |
$3K |
| J0561 |
Penicillin g benzathine inj |
80 |
74 |
$3K |
| J2919 |
Inj, methylpred sod succ 5mg |
616 |
537 |
$3K |
| J1940 |
Furosemide injection |
1,788 |
1,055 |
$3K |
| C1769 |
Guide wire |
156 |
154 |
$2K |
| 43239 |
|
99 |
99 |
$2K |
| 45380 |
|
91 |
80 |
$2K |
| 85049 |
|
992 |
967 |
$2K |
| 72072 |
|
72 |
71 |
$2K |
| 71010 |
|
139 |
137 |
$2K |
| J0171 |
Adrenalin epinephrine inject |
637 |
574 |
$2K |
| J3105 |
Terbutaline sulfate inj |
679 |
527 |
$2K |
| J0456 |
Azithromycin |
827 |
556 |
$2K |
| J2795 |
Ropivacaine hcl injection |
432 |
311 |
$2K |
| 86308 |
|
280 |
274 |
$2K |
| J1836 |
Inj, metronidazole, 10 mg |
237 |
158 |
$2K |
| 84156 |
|
710 |
586 |
$2K |
| 82077 |
|
45 |
43 |
$2K |
| 94760 |
|
456 |
275 |
$2K |
| 84132 |
|
337 |
319 |
$2K |
| S0077 |
Injection, clindamycin phosp |
192 |
172 |
$2K |
| 97140 |
|
77 |
29 |
$1K |
| J8540 |
Oral dexamethasone |
1,056 |
987 |
$1K |
| 58558 |
|
12 |
12 |
$1K |
| 85384 |
|
111 |
105 |
$1K |
| 74022 |
|
28 |
28 |
$1K |
| 87880 |
|
94 |
93 |
$1K |
| 94729 |
|
28 |
28 |
$1K |
| J7512 |
Prednisone ir or dr oral 1mg |
2,807 |
2,573 |
$1K |
| 0353U |
|
25 |
25 |
$1K |
| 94726 |
|
28 |
28 |
$1K |
| 29105 |
|
132 |
127 |
$1K |
| J0780 |
Prochlorperazine injection |
310 |
300 |
$1K |
| 51702 |
|
83 |
74 |
$1K |
| 82330 |
|
58 |
57 |
$996.86 |
| 87389 |
|
65 |
64 |
$980.53 |
| 76805 |
|
12 |
12 |
$974.05 |
| 88307 |
|
26 |
26 |
$955.36 |
| 86920 |
|
14 |
12 |
$952.90 |
| 74000 |
|
58 |
42 |
$935.54 |
| 97799 |
|
92 |
12 |
$918.87 |
| J3480 |
Inj potassium chloride |
624 |
452 |
$870.03 |
| 42820 |
|
16 |
14 |
$865.16 |
| J0694 |
Cefoxitin sodium injection |
132 |
101 |
$861.23 |
| A4217 |
Sterile water/saline, 500 ml |
152 |
134 |
$855.90 |
| 74020 |
|
28 |
26 |
$849.52 |
| 80074 |
|
12 |
12 |
$797.42 |
| J0688 |
Inj cefazolin sodium, hikma |
664 |
635 |
$756.34 |
| J0665 |
Inj, bupivacaine, nos, 0.5mg |
684 |
627 |
$740.66 |
| 99213 |
|
27 |
14 |
$735.95 |
| J7510 |
Prednisolone oral per 5 mg |
955 |
936 |
$709.59 |
| 0637 |
|
452 |
238 |
$698.86 |
| S0028 |
Injection, famotidine, 20 mg |
572 |
509 |
$660.32 |
| J2790 |
Rho d immune globulin inj |
12 |
12 |
$658.20 |
| U0005 |
Infec agen detec ampli probe |
210 |
202 |
$643.95 |
| A0429 |
Bls-emergency |
20 |
18 |
$595.20 |
| 93990 |
|
14 |
12 |
$583.40 |
| 82150 |
|
72 |
68 |
$574.45 |
| 82248 |
|
84 |
77 |
$562.55 |
| J2359 |
Inj. olanzapine, 0.5mg |
35 |
25 |
$561.50 |
| J2370 |
Phenylephrine hcl injection |
255 |
248 |
$544.18 |
| G1004 |
Cdsm ndsc |
2,675 |
2,096 |
$535.00 |
| 0391 |
|
18 |
17 |
$488.38 |
| J0692 |
Cefepime hcl for injection |
130 |
93 |
$479.54 |
| J1596 |
Inj, glycopyrrolate, 0.1 mg |
254 |
254 |
$451.70 |
| J0134 |
Inj acetaminophen -fresenius |
158 |
158 |
$447.19 |
| A9540 |
Tc99m maa |
16 |
16 |
$444.84 |
| 84145 |
|
25 |
25 |
$439.34 |
| 0258 |
|
710 |
584 |
$427.91 |
| 0636 |
|
147 |
76 |
$423.64 |
| 82272 |
|
345 |
329 |
$422.44 |
| J2470 |
Inj pantoprazole sodium 40mg |
257 |
159 |
$386.41 |
| 99156 |
|
17 |
14 |
$381.66 |
| J0595 |
Butorphanol tartrate 1 mg |
65 |
58 |
$360.66 |
| 90384 |
|
13 |
13 |
$358.01 |
| J2920 |
Methylprednisolone injection |
99 |
72 |
$342.33 |
| 88302 |
|
34 |
24 |
$335.58 |
| Z6400 |
|
27 |
27 |
$294.35 |
| Q0162 |
Ondansetron oral |
1,645 |
1,614 |
$285.56 |
| 84295 |
|
45 |
44 |
$267.51 |
| 11045 |
|
188 |
120 |
$247.55 |
| 83550 |
|
30 |
28 |
$220.95 |
| 73000 |
|
12 |
12 |
$219.67 |
| J3411 |
Thiamine hcl 100 mg |
95 |
66 |
$217.68 |
| 82553 |
|
15 |
14 |
$216.62 |
| J2272 |
Inj, morphine (fresenius) |
123 |
111 |
$212.14 |
| J7613 |
Albuterol non-comp unit |
2,331 |
1,898 |
$205.13 |
| 73120 |
|
13 |
13 |
$203.19 |
| 82947 |
|
42 |
41 |
$202.80 |
| 73660 |
|
13 |
13 |
$202.13 |
| 83540 |
|
31 |
29 |
$187.75 |
| 82247 |
|
26 |
24 |
$178.23 |
| 94200 |
|
13 |
13 |
$169.32 |
| 36410 |
|
59 |
57 |
$168.98 |
| 0410 |
|
33 |
28 |
$146.17 |
| 82270 |
|
44 |
42 |
$140.13 |
| 86592 |
|
26 |
26 |
$130.58 |
| C9113 |
Inj pantoprazole sodium, via |
65 |
46 |
$130.30 |
| 82607 |
|
14 |
13 |
$115.85 |
| J0736 |
Inj, clindamycin phosp 300mg |
38 |
36 |
$111.07 |
| 29130 |
|
15 |
15 |
$84.00 |
| 87340 |
|
12 |
12 |
$82.17 |
| J2550 |
Promethazine hcl injection |
30 |
27 |
$63.82 |
| 83986 |
|
13 |
12 |
$59.36 |
| J7040 |
Normal saline solution infus |
41 |
39 |
$59.27 |
| Q4051 |
Splint supplies misc |
190 |
98 |
$49.61 |
| J1956 |
Levofloxacin injection |
70 |
48 |
$47.94 |
| J1921 |
Inj labetalol hcl hikma, 5mg |
20 |
16 |
$45.88 |
| J2371 |
Inj phenylephrine hcl 20 mcg |
61 |
61 |
$28.25 |
| J1171 |
Inj, hydromorphone, 0.1 mg |
114 |
95 |
$28.02 |
| J1630 |
Haloperidol injection |
26 |
25 |
$19.64 |
| J1920 |
Inj, labetalol hcl, 5mg |
75 |
59 |
$18.04 |
| J2004 |
Inj, lidocaine w epinephrine |
17 |
16 |
$14.93 |
| C1887 |
Catheter, guiding |
32 |
32 |
$0.00 |
| 0460 |
|
32 |
29 |
$0.00 |
| 0730 |
|
64 |
57 |
$0.00 |
| C1894 |
Intro/sheath, non-laser |
69 |
67 |
$0.00 |
| 0300 |
|
82 |
72 |
$0.00 |
| 84112 |
|
20 |
20 |
$0.00 |
| 76818 |
|
55 |
47 |
$0.00 |
| C1729 |
Cath, drainage |
58 |
26 |
$0.00 |
| 0301 |
|
82 |
72 |
$0.00 |
| 94762 |
|
50 |
29 |
$0.00 |
| 0305 |
|
27 |
24 |
$0.00 |
| 0306 |
|
46 |
40 |
$0.00 |
| 80050 |
|
260 |
106 |
$0.00 |
| A9270 |
Non-covered item or service |
321 |
79 |
$0.00 |
| 0324 |
|
78 |
68 |
$0.00 |
| P9612 |
Catheterize for urine spec |
32 |
26 |
$0.00 |
| 36416 |
|
24 |
17 |
$0.00 |