| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99285 |
|
106,972 |
100,138 |
$37.16M |
| 99284 |
|
42,647 |
41,543 |
$8.29M |
| G0463 |
Hospital outpt clinic visit |
90,360 |
81,911 |
$5.48M |
| 96374 |
|
62,220 |
53,769 |
$5.21M |
| G0378 |
Hospital observation per hr |
25,890 |
23,262 |
$5.04M |
| 99283 |
|
26,883 |
26,057 |
$3.69M |
| 82306 |
|
199,167 |
198,360 |
$3.20M |
| 47562 |
|
1,035 |
1,032 |
$2.84M |
| 80061 |
|
260,578 |
259,402 |
$2.61M |
| 84443 |
|
262,078 |
259,310 |
$2.50M |
| 93458 |
|
1,667 |
1,658 |
$2.42M |
| 74177 |
|
16,885 |
16,622 |
$2.12M |
| 80053 |
|
363,062 |
347,002 |
$1.97M |
| 87491 |
|
91,211 |
89,681 |
$1.78M |
| 87591 |
|
90,491 |
88,977 |
$1.76M |
| 58558 |
|
1,209 |
1,201 |
$1.65M |
| 71046 |
|
32,096 |
31,523 |
$1.62M |
| 70450 |
|
18,368 |
17,970 |
$1.55M |
| 85025 |
|
447,082 |
412,706 |
$1.49M |
| U0003 |
Cov-19 amp prb hgh thruput |
28,880 |
27,090 |
$1.40M |
| 59025 |
|
15,688 |
7,128 |
$1.40M |
| 96365 |
|
16,995 |
15,227 |
$1.29M |
| 71045 |
|
29,164 |
28,004 |
$1.27M |
| 78452 |
|
3,611 |
3,591 |
$1.26M |
| 77067 |
|
25,266 |
25,209 |
$1.24M |
| 43239 |
|
3,424 |
3,414 |
$1.23M |
| 83036 |
|
214,623 |
213,570 |
$1.21M |
| 99291 |
|
1,994 |
1,964 |
$1.20M |
| 82947 |
|
35,066 |
27,476 |
$1.13M |
| 82607 |
|
137,680 |
137,042 |
$1.12M |
| 76700 |
|
14,473 |
14,418 |
$1.11M |
| 99282 |
|
11,484 |
11,286 |
$1.09M |
| 93975 |
|
10,257 |
10,030 |
$1.08M |
| 96375 |
|
47,965 |
39,115 |
$1.08M |
| 96413 |
|
6,417 |
3,941 |
$1.05M |
| 92507 |
|
25,704 |
9,605 |
$1.04M |
| 87633 |
|
4,745 |
4,707 |
$988K |
| 76856 |
|
20,194 |
19,999 |
$971K |
| 93306 |
|
6,222 |
6,189 |
$965K |
| 96361 |
|
23,529 |
19,173 |
$949K |
| 95810 |
|
1,888 |
1,883 |
$942K |
| 70553 |
|
4,289 |
4,276 |
$896K |
| 76830 |
|
14,732 |
14,575 |
$878K |
| 74176 |
|
8,726 |
8,601 |
$874K |
| 19083 |
|
1,092 |
1,087 |
$864K |
| 97530 |
|
24,325 |
8,766 |
$805K |
| 87389 |
|
59,078 |
58,844 |
$805K |
| 45380 |
|
1,452 |
1,449 |
$788K |
| 95811 |
|
1,581 |
1,573 |
$788K |
| 80307 |
|
26,615 |
25,587 |
$709K |
| 76811 |
|
6,031 |
6,015 |
$683K |
| 84439 |
|
129,563 |
128,265 |
$678K |
| 76816 |
|
13,633 |
12,355 |
$657K |
| 87636 |
|
7,090 |
6,933 |
$644K |
| 76801 |
|
10,149 |
9,598 |
$606K |
| 83013 |
|
15,154 |
15,114 |
$602K |
| 76805 |
|
9,881 |
9,811 |
$596K |
| 86003 |
|
7,343 |
7,254 |
$537K |
| 76770 |
|
9,304 |
9,200 |
$524K |
| G0480 |
Drug test def 1-7 classes |
20,544 |
18,209 |
$505K |
| 87661 |
|
25,780 |
25,388 |
$502K |
| 80074 |
|
18,751 |
18,637 |
$497K |
| 82728 |
|
61,685 |
61,012 |
$492K |
| 72148 |
|
5,201 |
5,191 |
$492K |
| 82746 |
|
57,220 |
56,992 |
$488K |
| 96360 |
|
5,472 |
5,234 |
$482K |
| 84466 |
|
59,769 |
59,271 |
$445K |
| 87631 |
|
11,063 |
10,837 |
$436K |
| 87624 |
|
20,328 |
20,276 |
$430K |
| 73721 |
|
3,184 |
3,128 |
$429K |
| 76705 |
|
7,112 |
6,918 |
$417K |
| 86900 |
|
28,928 |
27,594 |
$416K |
| 87086 |
|
94,078 |
90,445 |
$412K |
| 76642 |
|
10,238 |
10,149 |
$412K |
| 87480 |
|
37,459 |
36,717 |
$409K |
| 86803 |
|
47,606 |
47,484 |
$409K |
| 72141 |
|
3,069 |
3,063 |
$408K |
| 87660 |
|
36,805 |
36,056 |
$399K |
| 71260 |
|
3,712 |
3,694 |
$393K |
| 87637 |
|
5,703 |
5,625 |
$387K |
| 45385 |
|
788 |
786 |
$385K |
| 80048 |
|
90,892 |
79,775 |
$382K |
| 88175 |
|
22,205 |
22,176 |
$381K |
| 87510 |
|
35,727 |
35,028 |
$380K |
| 71275 |
|
6,179 |
6,122 |
$374K |
| 36415 |
|
298,071 |
270,838 |
$373K |
| 96366 |
|
9,836 |
6,826 |
$332K |
| 77066 |
Tomosynthesis, mammo |
5,461 |
5,441 |
$323K |
| 96372 |
|
30,991 |
22,657 |
$319K |
| 76536 |
|
5,732 |
5,713 |
$294K |
| 84403 |
|
19,108 |
18,956 |
$293K |
| 86769 |
|
11,787 |
11,760 |
$289K |
| 78815 |
|
355 |
355 |
$287K |
| 90670 |
|
5,939 |
5,925 |
$285K |
| 83540 |
|
72,437 |
71,848 |
$277K |
| 90460 |
|
10,297 |
10,284 |
$273K |
| 93798 |
|
4,196 |
827 |
$272K |
| U0005 |
Infec agen detec ampli probe |
16,367 |
15,869 |
$271K |
| 73221 |
|
1,828 |
1,809 |
$265K |
| 86480 |
|
7,195 |
7,145 |
$264K |
| 97161 |
|
2,984 |
2,949 |
$260K |
| 93970 |
|
2,859 |
2,828 |
$258K |
| 74178 |
|
1,383 |
1,381 |
$254K |
| 74174 |
|
1,735 |
1,724 |
$254K |
| 84702 |
|
61,316 |
54,918 |
$250K |
| G0103 |
Psa screening |
20,290 |
20,259 |
$244K |
| 72110 |
|
6,165 |
6,150 |
$240K |
| U0002 |
Covid-19 lab test non-cdc |
6,878 |
6,619 |
$236K |
| 77065 |
Tomosynthesis, mammo |
5,164 |
4,800 |
$235K |
| 70551 |
|
2,143 |
2,139 |
$235K |
| 99281 |
|
3,921 |
3,825 |
$233K |
| 84481 |
|
22,481 |
22,281 |
$223K |
| 87502 |
|
6,734 |
6,666 |
$206K |
| 77334 |
|
652 |
373 |
$206K |
| 74183 |
|
1,006 |
1,004 |
$206K |
| 70486 |
|
4,862 |
4,842 |
$201K |
| 87651 |
|
9,062 |
8,922 |
$200K |
| 83970 |
|
8,602 |
8,324 |
$194K |
| J2505 |
Injection, pegfilgrastim 6mg |
126 |
99 |
$194K |
| 85027 |
|
64,553 |
60,312 |
$193K |
| 70491 |
|
1,805 |
1,779 |
$193K |
| 87653 |
|
9,940 |
9,828 |
$189K |
| 77386 |
|
578 |
53 |
$188K |
| 87635 |
|
5,482 |
5,298 |
$180K |
| 77063 |
|
13,924 |
13,920 |
$179K |
| 97112 |
|
10,564 |
4,063 |
$176K |
| 93971 |
|
3,997 |
3,939 |
$175K |
| 86780 |
|
20,161 |
19,975 |
$175K |
| 77336 |
|
2,526 |
1,139 |
$174K |
| 83735 |
|
93,480 |
79,985 |
$171K |
| G0121 |
Colon ca scrn not hi rsk ind |
374 |
374 |
$165K |
| 78226 |
|
1,028 |
1,027 |
$161K |
| 73564 |
|
4,938 |
4,700 |
$157K |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
25,833 |
24,982 |
$154K |
| 86696 |
|
13,931 |
13,840 |
$153K |
| 87340 |
|
27,116 |
26,973 |
$153K |
| 96367 |
|
5,377 |
3,982 |
$150K |
| 88305 |
|
17,690 |
17,148 |
$148K |
| 72131 |
|
3,097 |
3,073 |
$148K |
| 82043 |
|
41,968 |
41,729 |
$142K |
| 88184 |
|
1,895 |
1,881 |
$142K |
| 45378 |
|
360 |
360 |
$136K |
| 87536 |
|
2,939 |
2,918 |
$136K |
| 83001 |
|
12,217 |
12,152 |
$134K |
| 77412 |
|
1,030 |
110 |
$131K |
| 90471 |
|
13,408 |
13,239 |
$128K |
| 86038 |
|
18,478 |
18,368 |
$127K |
| 87070 |
|
27,618 |
27,277 |
$127K |
| 97110 |
|
7,728 |
3,376 |
$125K |
| 71250 |
|
2,256 |
2,249 |
$124K |
| 74018 |
|
4,465 |
4,362 |
$120K |
| 87077 |
|
25,220 |
24,742 |
$119K |
| 77080 |
|
1,941 |
1,939 |
$117K |
| 73130 |
|
5,908 |
5,741 |
$117K |
| 87186 |
|
23,650 |
23,179 |
$117K |
| 84146 |
|
10,406 |
10,317 |
$117K |
| 58661 |
|
42 |
42 |
$116K |
| 83655 |
|
16,474 |
16,435 |
$115K |
| 96415 |
|
2,342 |
1,805 |
$112K |
| 83002 |
|
10,108 |
10,057 |
$111K |
| 74022 |
|
2,769 |
2,734 |
$111K |
| 72197 |
|
559 |
559 |
$110K |
| 82670 |
|
6,480 |
6,450 |
$109K |
| 82652 |
|
5,203 |
5,188 |
$108K |
| 93351 |
|
405 |
404 |
$108K |
| 86235 |
|
3,295 |
3,266 |
$107K |
| 80081 |
|
2,806 |
2,801 |
$103K |
| 73030 |
|
5,581 |
5,408 |
$102K |
| 73630 |
|
6,032 |
5,824 |
$102K |
| 76881 |
|
1,698 |
1,657 |
$101K |
| 36430 |
|
1,011 |
826 |
$101K |
| 92523 |
|
953 |
947 |
$100K |
| 81001 |
|
78,625 |
75,816 |
$99K |
| 77072 |
|
1,724 |
1,723 |
$99K |
| 84153 |
|
9,012 |
8,965 |
$97K |
| 86695 |
|
12,676 |
12,594 |
$97K |
| 84402 |
|
6,880 |
6,831 |
$96K |
| 30520 |
|
119 |
118 |
$96K |
| 82627 |
|
7,137 |
7,098 |
$95K |
| 86762 |
|
11,579 |
11,529 |
$93K |
| 72082 |
|
1,677 |
1,673 |
$93K |
| 97165 |
|
2,616 |
2,576 |
$91K |
| 97162 |
|
1,525 |
1,496 |
$90K |
| 71271 |
|
1,511 |
1,511 |
$87K |
| 72125 |
|
6,323 |
6,237 |
$87K |
| 82105 |
|
9,330 |
9,260 |
$85K |
| G0279 |
Tomosynthesis, mammo |
7,023 |
7,014 |
$85K |
| 84550 |
|
34,336 |
33,687 |
$84K |
| 86147 |
|
2,024 |
1,987 |
$83K |
| 83021 |
|
8,279 |
8,252 |
$82K |
| 86706 |
|
13,629 |
13,594 |
$82K |
| 73610 |
|
4,104 |
4,006 |
$80K |
| 93005 |
|
48,103 |
44,410 |
$75K |
| 82785 |
|
7,610 |
6,919 |
$71K |
| J1453 |
Fosaprepitant injection |
1,478 |
946 |
$71K |
| 87634 |
|
1,885 |
1,872 |
$71K |
| 93925 |
|
623 |
621 |
$70K |
| 97140 |
|
4,973 |
2,080 |
$70K |
| 86787 |
|
9,586 |
9,552 |
$70K |
| 87522 |
Neg quan hep c or qual rna |
2,991 |
2,939 |
$69K |
| 93017 |
|
4,058 |
4,035 |
$69K |
| 72050 |
|
1,433 |
1,432 |
$69K |
| 77300 |
|
336 |
312 |
$69K |
| 90472 |
|
4,181 |
4,161 |
$67K |
| 10005 |
|
203 |
203 |
$67K |
| 72052 |
|
1,254 |
1,254 |
$67K |
| 93880 |
|
965 |
958 |
$67K |
| P9016 |
Rbc leukocytes reduced |
723 |
579 |
$64K |
| 83880 |
|
12,531 |
11,855 |
$63K |
| 72100 |
|
1,731 |
1,726 |
$62K |
| 86140 |
|
22,676 |
21,566 |
$61K |
| 99395 |
|
891 |
888 |
$60K |
| 81003 |
|
60,781 |
59,195 |
$60K |
| G0390 |
Trauma respons w/hosp criti |
388 |
378 |
$59K |
| J0585 |
Injection,onabotulinumtoxina |
114 |
113 |
$56K |
| 73502 |
|
2,671 |
2,635 |
$56K |
| 90651 |
|
763 |
761 |
$55K |
| 86850 |
|
26,590 |
25,407 |
$55K |
| 90716 |
|
1,885 |
1,882 |
$54K |
| 84144 |
|
4,250 |
4,119 |
$54K |
| 86376 |
|
6,216 |
6,182 |
$53K |
| 86592 |
|
22,063 |
21,859 |
$53K |
| 96417 |
|
1,352 |
936 |
$53K |
| 82784 |
|
6,195 |
6,140 |
$52K |
| 97116 |
|
4,710 |
2,256 |
$52K |
| 85610 |
|
66,150 |
59,377 |
$52K |
| 73110 |
|
2,624 |
2,551 |
$51K |
| 86431 |
|
15,150 |
15,096 |
$49K |
| 85652 |
|
33,903 |
32,836 |
$49K |
| 97166 |
|
1,164 |
1,153 |
$48K |
| 90686 |
|
4,645 |
4,636 |
$47K |
| G0145 |
Scr c/v cyto,thinlayer,rescr |
2,845 |
2,840 |
$46K |
| 88185 |
|
657 |
594 |
$46K |
| 80051 |
|
17,062 |
15,294 |
$45K |
| 87529 |
|
1,929 |
1,920 |
$44K |
| 96523 |
|
1,911 |
1,748 |
$44K |
| 86870 |
|
520 |
507 |
$44K |
| 84425 |
|
3,644 |
3,639 |
$44K |
| 86146 |
|
1,377 |
1,349 |
$44K |
| 31253 |
|
14 |
14 |
$42K |
| 86225 |
|
5,224 |
5,194 |
$41K |
| 86360 |
|
1,675 |
1,662 |
$41K |
| 70496 |
|
878 |
875 |
$40K |
| 83525 |
|
5,962 |
5,912 |
$40K |
| 82550 |
|
14,033 |
13,428 |
$40K |
| 83516 |
|
5,604 |
5,576 |
$40K |
| 74019 |
|
642 |
636 |
$40K |
| 76819 |
|
673 |
397 |
$39K |
| 80076 |
|
16,209 |
15,461 |
$39K |
| 99195 |
|
690 |
533 |
$39K |
| 82565 |
|
31,526 |
27,666 |
$38K |
| 44970 |
|
12 |
12 |
$38K |
| 95806 |
|
471 |
470 |
$38K |
| 82533 |
|
3,965 |
3,866 |
$38K |
| 82248 |
|
21,685 |
19,707 |
$38K |
| 73562 |
|
2,253 |
2,122 |
$37K |
| 99396 |
|
540 |
536 |
$37K |
| 86200 |
|
4,816 |
4,792 |
$36K |
| 85730 |
|
48,093 |
45,460 |
$36K |
| 76870 |
|
2,008 |
1,992 |
$34K |
| 86800 |
|
3,816 |
3,713 |
$34K |
| 72040 |
|
1,392 |
1,373 |
$34K |
| 86160 |
|
2,605 |
2,578 |
$34K |
| 72072 |
|
953 |
948 |
$34K |
| 84478 |
|
973 |
888 |
$33K |
| 88112 |
|
2,059 |
2,017 |
$33K |
| 82378 |
|
3,204 |
3,025 |
$32K |
| 82570 |
|
11,967 |
11,241 |
$32K |
| 76882 |
|
892 |
862 |
$32K |
| 84460 |
|
13,863 |
13,256 |
$31K |
| 94640 |
|
13,732 |
7,093 |
$31K |
| 84450 |
|
13,947 |
13,307 |
$31K |
| 87880 |
|
5,658 |
5,595 |
$30K |
| 30140 |
|
160 |
159 |
$30K |
| 90732 |
|
360 |
358 |
$30K |
| 87427 |
|
2,413 |
2,358 |
$30K |
| 87632 |
|
333 |
332 |
$29K |
| 81329 |
|
619 |
615 |
$29K |
| 10060 |
|
409 |
406 |
$29K |
| 88342 |
|
2,081 |
2,047 |
$28K |
| 84100 |
|
18,649 |
15,936 |
$28K |
| 73523 |
|
474 |
473 |
$28K |
| 73700 |
|
551 |
544 |
$28K |
| 82950 |
|
10,184 |
10,130 |
$28K |
| 73080 |
|
1,532 |
1,513 |
$27K |
| 73560 |
|
1,586 |
1,530 |
$27K |
| J2469 |
Palonosetron hcl |
1,449 |
903 |
$27K |
| 73590 |
|
2,213 |
2,133 |
$27K |
| 84445 |
|
865 |
859 |
$26K |
| 72070 |
|
718 |
718 |
$26K |
| 83690 |
|
36,829 |
34,918 |
$26K |
| 83615 |
|
10,165 |
9,533 |
$25K |
| 84520 |
|
25,290 |
23,273 |
$24K |
| 87046 |
|
2,422 |
2,395 |
$24K |
| 76815 |
|
552 |
505 |
$24K |
| 86039 |
|
3,810 |
3,767 |
$24K |
| 76818 |
|
393 |
239 |
$24K |
| 82274 |
|
2,215 |
2,209 |
$23K |
| 78227 |
|
126 |
126 |
$23K |
| 73090 |
|
1,690 |
1,651 |
$22K |
| 88307 |
|
1,614 |
1,579 |
$22K |
| 82024 |
|
986 |
972 |
$22K |
| 86359 |
|
983 |
981 |
$21K |
| 84156 |
|
11,776 |
10,552 |
$21K |
| 86704 |
|
3,007 |
2,995 |
$20K |
| 86765 |
|
2,592 |
2,580 |
$20K |
| 85046 |
|
6,035 |
5,865 |
$20K |
| 86735 |
|
2,523 |
2,513 |
$20K |
| 82247 |
|
8,772 |
6,937 |
$19K |
| C1769 |
Guide wire |
4,010 |
3,871 |
$19K |
| 88304 |
|
4,245 |
4,210 |
$19K |
| 82150 |
|
6,477 |
6,349 |
$19K |
| 94726 |
|
344 |
343 |
$18K |
| 76825 |
|
65 |
63 |
$18K |
| 82677 |
|
1,452 |
1,445 |
$18K |
| 71101 |
|
663 |
659 |
$18K |
| 96411 |
|
498 |
317 |
$18K |
| J1745 |
Infliximab not biosimil 10mg |
13 |
13 |
$18K |
| 82951 |
|
2,360 |
2,355 |
$18K |
| 86255 |
|
2,156 |
2,137 |
$17K |
| 72170 |
|
2,012 |
1,992 |
$17K |
| A9577 |
Inj multihance |
5,028 |
4,969 |
$17K |
| 88142 |
|
1,221 |
1,220 |
$16K |
| 70360 |
|
551 |
547 |
$16K |
| 87147 |
|
4,864 |
4,827 |
$16K |
| 84165 |
|
2,818 |
2,800 |
$15K |
| 86304 |
|
1,391 |
1,337 |
$15K |
| 86901 |
|
27,587 |
26,324 |
$15K |
| 84134 |
|
1,957 |
1,881 |
$15K |
| 99385 |
|
244 |
242 |
$15K |
| 86665 |
|
820 |
797 |
$15K |
| 80069 |
|
3,109 |
2,890 |
$14K |
| G8978 |
Mobility current status |
178 |
171 |
$14K |
| 95816 |
|
308 |
305 |
$14K |
| 64642 |
|
54 |
53 |
$13K |
| G0379 |
Direct refer hospital observ |
24 |
24 |
$13K |
| 57522 |
|
12 |
12 |
$13K |
| 72146 |
|
117 |
117 |
$13K |
| 86336 |
|
1,575 |
1,565 |
$12K |
| 70498 |
|
862 |
862 |
$12K |
| 19081 |
|
12 |
12 |
$12K |
| 82330 |
|
4,043 |
3,629 |
$12K |
| 87045 |
|
2,417 |
2,393 |
$12K |
| 81401 |
|
237 |
237 |
$12K |
| 82977 |
|
2,866 |
2,845 |
$12K |
| 86708 |
|
1,769 |
1,764 |
$12K |
| 74160 |
|
112 |
112 |
$12K |
| 76820 |
|
3,242 |
1,794 |
$11K |
| 83993 |
|
945 |
942 |
$11K |
| 84432 |
|
1,252 |
1,249 |
$11K |
| 86694 |
|
1,703 |
1,696 |
$11K |
| 86256 |
|
1,129 |
1,110 |
$11K |
| 85379 |
|
6,538 |
6,404 |
$11K |
| 82465 |
|
3,149 |
3,138 |
$11K |
| 87081 |
|
7,553 |
7,468 |
$11K |
| G0472 |
Hep c screen high risk/other |
442 |
442 |
$11K |
| 87209 |
|
1,189 |
1,177 |
$10K |
| 36591 |
|
2,258 |
1,561 |
$10K |
| 84630 |
|
1,394 |
1,393 |
$10K |
| 84305 |
|
843 |
836 |
$10K |
| 82157 |
|
741 |
735 |
$10K |
| 77301 |
|
13 |
12 |
$10K |
| 80164 |
|
1,901 |
1,778 |
$10K |
| 87449 |
|
1,698 |
1,672 |
$10K |
| 87205 |
|
6,233 |
6,058 |
$10K |
| 81270 |
|
175 |
175 |
$9K |
| 76813 |
|
663 |
660 |
$9K |
| 76885 |
|
204 |
204 |
$9K |
| 87324 |
|
1,635 |
1,612 |
$9K |
| 83498 |
|
933 |
925 |
$9K |
| 87428 |
|
324 |
320 |
$9K |
| 80050 |
|
3,000 |
2,978 |
$9K |
| 82270 |
|
466 |
460 |
$9K |
| G0475 |
Hiv combination assay |
712 |
712 |
$9K |
| 76817 |
|
4,603 |
4,255 |
$9K |
| 81025 |
|
9,950 |
9,712 |
$9K |
| 86141 |
|
1,156 |
1,133 |
$9K |
| 86334 |
|
755 |
750 |
$8K |
| 96416 |
|
45 |
26 |
$8K |
| 83921 |
|
793 |
786 |
$8K |
| 87075 |
|
2,697 |
2,632 |
$8K |
| 90734 |
|
453 |
451 |
$8K |
| 84484 |
|
41,413 |
32,323 |
$8K |
| 73552 |
|
949 |
930 |
$8K |
| 82040 |
|
3,325 |
3,282 |
$7K |
| 83090 |
|
714 |
707 |
$7K |
| 70487 |
|
82 |
82 |
$7K |
| M0243 |
Casirivi and imdevi inj |
28 |
28 |
$7K |
| G0328 |
Fecal blood scrn immunoassay |
948 |
946 |
$7K |
| 86301 |
|
622 |
602 |
$7K |
| 31267 |
|
16 |
16 |
$7K |
| 12001 |
|
1,200 |
1,192 |
$7K |
| 87400 |
|
3,334 |
3,242 |
$7K |
| 87329 |
|
873 |
866 |
$6K |
| 82525 |
|
921 |
918 |
$6K |
| 84681 |
|
632 |
619 |
$6K |
| 88341 |
|
898 |
861 |
$6K |
| 73600 |
|
498 |
464 |
$6K |
| 87328 |
|
724 |
719 |
$6K |
| 90688 |
|
340 |
339 |
$6K |
| 72128 |
|
284 |
278 |
$6K |
| 85613 |
|
1,153 |
1,143 |
$6K |
| 85597 |
|
531 |
521 |
$6K |
| 87517 |
|
211 |
210 |
$6K |
| G0297 |
Ldct for lung ca screen |
131 |
131 |
$6K |
| 72158 |
|
51 |
51 |
$6K |
| 85018 |
|
5,808 |
5,359 |
$6K |
| 82374 |
|
4,420 |
3,811 |
$5K |
| J1750 |
Inj iron dextran |
64 |
27 |
$5K |
| 82671 |
|
253 |
253 |
$5K |
| 64483 |
|
14 |
14 |
$5K |
| 80197 |
|
641 |
496 |
$5K |
| Q9966 |
Locm 200-299mg/ml iodine,1ml |
2,880 |
2,832 |
$5K |
| 87177 |
|
1,187 |
1,175 |
$5K |
| 87902 |
|
87 |
87 |
$5K |
| 83010 |
|
959 |
948 |
$5K |
| 82088 |
|
214 |
207 |
$5K |
| 82952 |
|
2,113 |
2,111 |
$5K |
| 86364 |
|
608 |
608 |
$5K |
| 73100 |
|
428 |
412 |
$5K |
| 85045 |
|
2,984 |
2,931 |
$5K |
| 82310 |
|
2,399 |
2,195 |
$5K |
| 70480 |
|
79 |
79 |
$5K |
| 84480 |
|
470 |
461 |
$5K |
| 77338 |
|
32 |
26 |
$5K |
| 74247 |
|
48 |
48 |
$4K |
| 83630 |
|
526 |
524 |
$4K |
| 85660 |
|
1,404 |
1,403 |
$4K |
| 82140 |
|
1,453 |
1,298 |
$4K |
| 88312 |
|
312 |
307 |
$4K |
| 86664 |
|
492 |
488 |
$4K |
| 86923 |
|
894 |
818 |
$4K |
| 86300 |
|
315 |
292 |
$4K |
| 73060 |
|
571 |
552 |
$4K |
| 0241U |
|
1,333 |
1,320 |
$4K |
| 83014 |
|
989 |
988 |
$4K |
| 82164 |
|
582 |
577 |
$4K |
| 73120 |
|
192 |
185 |
$4K |
| 70544 |
|
13 |
13 |
$4K |
| 86663 |
|
440 |
437 |
$4K |
| 12011 |
|
648 |
644 |
$4K |
| 84075 |
|
1,428 |
1,387 |
$4K |
| 86618 |
|
383 |
375 |
$4K |
| 90677 |
|
13 |
13 |
$3K |
| 58301 |
|
31 |
28 |
$3K |
| 12002 |
|
709 |
706 |
$3K |
| 80305 |
|
6,365 |
5,983 |
$3K |
| 90474 |
|
1,057 |
1,048 |
$3K |
| 86709 |
|
635 |
632 |
$3K |
| 82962 |
|
15,276 |
8,970 |
$3K |
| 87798 |
|
154 |
151 |
$3K |
| 29125 |
|
111 |
107 |
$3K |
| 80177 |
|
1,004 |
939 |
$3K |
| 84132 |
|
7,101 |
6,271 |
$3K |
| 90671 |
|
12 |
12 |
$3K |
| 85306 |
|
350 |
344 |
$3K |
| 87641 |
|
231 |
228 |
$3K |
| 77280 |
|
44 |
40 |
$3K |
| 62270 |
|
12 |
12 |
$3K |
| 82626 |
|
189 |
189 |
$3K |
| 86308 |
|
2,181 |
2,154 |
$3K |
| 87640 |
|
220 |
219 |
$3K |
| 82672 |
|
278 |
277 |
$3K |
| 87040 |
|
5,720 |
5,094 |
$3K |
| 94761 |
|
3,169 |
2,979 |
$3K |
| 77290 |
|
13 |
13 |
$3K |
| 81002 |
|
1,331 |
1,091 |
$3K |
| 0072A |
|
69 |
69 |
$3K |
| 84155 |
|
1,522 |
1,497 |
$2K |
| 84207 |
|
159 |
159 |
$2K |
| 90746 |
|
37 |
37 |
$2K |
| 82731 |
|
100 |
98 |
$2K |
| 86920 |
|
420 |
399 |
$2K |
| 90656 |
|
111 |
106 |
$2K |
| 85245 |
|
180 |
173 |
$2K |
| 83521 |
|
134 |
123 |
$2K |
| 99495 |
|
40 |
37 |
$2K |
| 0071A |
|
60 |
59 |
$2K |
| 86812 |
|
140 |
140 |
$2K |
| 81514 |
|
14 |
14 |
$2K |
| 78014 |
|
12 |
12 |
$2K |
| 85303 |
|
287 |
284 |
$2K |
| 82668 |
|
189 |
189 |
$2K |
| C1713 |
Anchor/screw bn/bn,tis/bn |
437 |
430 |
$2K |
| 86060 |
|
465 |
463 |
$2K |
| 75574 |
|
25 |
25 |
$2K |
| 84244 |
|
168 |
163 |
$2K |
| G0008 |
Admin influenza virus vac |
232 |
230 |
$2K |
| 29515 |
|
43 |
43 |
$2K |
| 94060 |
|
12 |
12 |
$2K |
| 85014 |
|
2,846 |
2,461 |
$2K |
| 82575 |
|
373 |
365 |
$2K |
| 86340 |
|
192 |
192 |
$2K |
| C1889 |
Implant/insert device, noc |
905 |
889 |
$2K |
| 74740 |
|
15 |
15 |
$2K |
| 0124A |
|
63 |
63 |
$2K |
| 84436 |
|
387 |
383 |
$2K |
| 91322 |
|
12 |
12 |
$2K |
| 74230 |
|
24 |
24 |
$2K |
| 99386 |
|
27 |
27 |
$2K |
| 76981 |
|
129 |
129 |
$2K |
| G0108 |
Diab manage trn per indiv |
28 |
28 |
$2K |
| 92611 |
|
37 |
37 |
$2K |
| 76775 |
|
151 |
150 |
$2K |
| 83721 |
|
241 |
239 |
$2K |
| 84166 |
|
166 |
164 |
$2K |
| 87184 |
|
577 |
573 |
$2K |
| 86705 |
|
211 |
210 |
$1K |
| 93978 |
|
13 |
13 |
$1K |
| 87106 |
|
218 |
216 |
$1K |
| 64400 |
|
12 |
12 |
$1K |
| 80178 |
|
481 |
448 |
$1K |
| 86593 |
|
547 |
542 |
$1K |
| J2270 |
Morphine sulfate injection |
17,111 |
11,169 |
$1K |
| 82390 |
|
214 |
214 |
$1K |
| C1758 |
Catheter, ureteral |
311 |
297 |
$1K |
| 87338 |
|
195 |
195 |
$1K |
| 93922 |
|
274 |
273 |
$1K |
| 82172 |
|
91 |
89 |
$1K |
| 86777 |
|
146 |
146 |
$1K |
| 83605 |
|
9,569 |
8,421 |
$1K |
| 87535 |
|
53 |
53 |
$1K |
| 74170 |
|
13 |
13 |
$1K |
| 84154 |
|
116 |
116 |
$1K |
| 90480 |
|
26 |
26 |
$1K |
| C1725 |
Cath, translumin non-laser |
160 |
157 |
$1K |
| 80202 |
|
301 |
160 |
$1K |
| 90461 |
|
3,522 |
3,521 |
$1K |
| 99214 |
|
13 |
13 |
$998.32 |
| 88262 |
|
81 |
81 |
$995.54 |
| 85055 |
|
58 |
48 |
$974.68 |
| 88173 |
|
404 |
397 |
$942.39 |
| 85240 |
|
97 |
96 |
$922.08 |
| 93976 |
|
16 |
15 |
$919.34 |
| 73620 |
|
126 |
120 |
$916.52 |
| 74420 |
|
279 |
272 |
$908.79 |
| Q9969 |
Non-heu tc-99m add-on/dose |
84 |
82 |
$886.71 |
| 84238 |
|
40 |
40 |
$859.30 |
| 97168 |
|
27 |
27 |
$853.35 |
| 85384 |
|
633 |
598 |
$845.85 |
| 85300 |
|
132 |
129 |
$812.28 |
| 99203 |
|
13 |
13 |
$789.26 |
| 84145 |
|
1,741 |
1,699 |
$788.97 |
| 82805 |
|
883 |
833 |
$751.35 |
| 80185 |
|
208 |
190 |
$743.50 |
| 87181 |
|
269 |
256 |
$736.50 |
| 85461 |
|
434 |
425 |
$690.29 |
| J2405 |
Ondansetron hcl injection |
46,245 |
37,498 |
$681.49 |
| 84295 |
|
4,522 |
3,906 |
$663.30 |
| 99406 |
|
43 |
43 |
$631.51 |
| 73070 |
|
87 |
82 |
$622.56 |
| 89051 |
|
350 |
346 |
$621.00 |
| 93225 |
|
13 |
13 |
$603.24 |
| 96376 |
|
18,055 |
10,481 |
$574.76 |
| 87015 |
|
506 |
467 |
$566.95 |
| 82239 |
|
61 |
51 |
$545.56 |
| 82435 |
|
4,132 |
3,520 |
$539.43 |
| 74150 |
|
14 |
13 |
$539.16 |
| 72114 |
|
12 |
12 |
$538.48 |
| 90658 |
|
33 |
33 |
$536.58 |
| 87420 |
|
926 |
909 |
$522.47 |
| 72220 |
|
49 |
49 |
$506.05 |
| 83520 |
|
656 |
648 |
$502.23 |
| 82103 |
|
66 |
66 |
$501.13 |
| J1885 |
Ketorolac tromethamine inj |
39,181 |
33,373 |
$469.70 |
| 81241 |
|
14 |
13 |
$465.13 |
| 87102 |
|
235 |
229 |
$464.08 |
| 83718 |
|
89 |
89 |
$462.56 |
| 0003A |
|
13 |
13 |
$461.03 |
| 86922 |
|
92 |
76 |
$441.47 |
| 82010 |
|
2,136 |
1,908 |
$431.02 |
| 84703 |
|
234 |
229 |
$414.10 |
| 94760 |
|
7,975 |
6,114 |
$398.27 |
| 86005 |
|
73 |
73 |
$393.51 |
| 85246 |
|
41 |
41 |
$379.43 |
| 83695 |
|
40 |
40 |
$360.87 |
| 87252 |
|
27 |
27 |
$358.71 |
| 87116 |
|
168 |
151 |
$358.06 |
| 87088 |
|
152 |
151 |
$357.27 |
| 83835 |
|
28 |
28 |
$326.58 |
| J2250 |
Inj midazolam hydrochloride |
24,185 |
23,002 |
$324.60 |
| 85244 |
|
26 |
26 |
$321.99 |
| 76821 |
|
413 |
228 |
$301.39 |
| 90681 |
|
556 |
550 |
$295.20 |
| 70160 |
|
13 |
13 |
$292.08 |
| 73521 |
|
16 |
16 |
$289.45 |
| 87430 |
|
3,671 |
3,619 |
$278.86 |
| 87206 |
|
207 |
186 |
$256.49 |
| 88302 |
|
76 |
76 |
$254.10 |
| 82077 |
|
665 |
612 |
$249.43 |
| 97535 |
|
149 |
110 |
$244.40 |
| 86258 |
|
15 |
14 |
$216.86 |
| 87804 |
|
71 |
71 |
$215.55 |
| 58300 |
|
12 |
12 |
$212.37 |
| 90473 |
|
68 |
68 |
$206.13 |
| 96127 |
|
44 |
44 |
$188.10 |
| 86341 |
|
15 |
14 |
$177.36 |
| 86580 |
|
29 |
27 |
$177.19 |
| 90723 |
|
3,829 |
3,824 |
$175.00 |
| 86880 |
|
12 |
12 |
$168.01 |
| 94010 |
|
25 |
25 |
$164.57 |
| C1729 |
Cath, drainage |
57 |
55 |
$160.00 |
| A4648 |
Implantable tissue marker |
1,381 |
1,370 |
$160.00 |
| 80159 |
|
17 |
12 |
$157.11 |
| 90715 |
|
5,464 |
5,428 |
$156.90 |
| 71100 |
|
12 |
12 |
$144.99 |
| G0123 |
Screen cerv/vag thin layer |
14 |
14 |
$144.04 |
| 36600 |
|
12 |
12 |
$136.55 |
| 93308 |
|
14 |
14 |
$130.30 |
| 85347 |
|
1,730 |
1,376 |
$127.33 |
| 82542 |
|
175 |
173 |
$126.42 |
| A9502 |
Tc99m tetrofosmin |
2,497 |
2,483 |
$126.00 |
| 88313 |
|
12 |
12 |
$114.72 |
| 87350 |
|
15 |
15 |
$110.29 |
| 86645 |
|
12 |
12 |
$109.80 |
| 87341 |
|
27 |
25 |
$107.35 |
| 84163 |
|
21 |
21 |
$106.29 |
| Q0091 |
Obtaining screen pap smear |
12 |
12 |
$105.33 |
| 86707 |
|
14 |
14 |
$103.35 |
| 85048 |
|
57 |
56 |
$97.90 |
| 92610 |
|
13 |
13 |
$97.82 |
| 86644 |
|
12 |
12 |
$93.74 |
| 93010 |
|
19 |
16 |
$90.25 |
| 82044 |
|
63 |
63 |
$80.99 |
| 83625 |
|
14 |
14 |
$79.47 |
| J1200 |
Diphenhydramine hcl injectio |
16,397 |
13,574 |
$77.20 |
| 96040 |
|
304 |
303 |
$71.67 |
| 85041 |
|
30 |
30 |
$60.81 |
| J1756 |
Iron sucrose injection |
9,966 |
4,401 |
$59.04 |
| 76827 |
|
40 |
39 |
$57.30 |
| 87185 |
|
58 |
58 |
$49.60 |
| J1644 |
Inj heparin sodium per 1000u |
18,974 |
8,326 |
$48.64 |
| 88311 |
|
56 |
56 |
$48.43 |
| 83930 |
|
13 |
13 |
$41.71 |
| 87076 |
|
13 |
12 |
$41.56 |
| 85007 |
|
27 |
24 |
$39.12 |
| 89050 |
|
50 |
49 |
$29.86 |
| J2710 |
Neostigmine methylslfte inj |
2,408 |
2,363 |
$18.37 |
| 85732 |
|
13 |
13 |
$15.37 |
| J7042 |
5% dextrose/normal saline |
1,538 |
1,021 |
$15.34 |
| J0665 |
Inj, bupivacaine, nos, 0.5mg |
828 |
814 |
$15.20 |
| 86703 |
|
26 |
26 |
$14.41 |
| 82945 |
|
65 |
65 |
$13.53 |
| J3370 |
Vancomycin hcl injection |
4,020 |
2,157 |
$12.62 |
| J2060 |
Lorazepam injection |
7,994 |
5,450 |
$11.12 |
| J2920 |
Methylprednisolone injection |
1,337 |
654 |
$10.85 |
| J1805 |
Inj, esmolol hcl, 10mg |
191 |
189 |
$10.78 |
| 84300 |
|
13 |
12 |
$10.23 |
| J7120 |
Ringers lactate infusion |
30,462 |
25,842 |
$10.01 |
| J7060 |
5% dextrose/water |
12,524 |
7,511 |
$9.49 |
| 99177 |
|
184 |
184 |
$8.92 |
| J0696 |
Ceftriaxone sodium injection |
11,560 |
8,866 |
$8.71 |
| J1836 |
Inj, metronidazole, 10 mg |
561 |
351 |
$8.71 |
| 84157 |
|
63 |
63 |
$8.48 |
| J3475 |
Inj magnesium sulfate |
7,655 |
6,123 |
$8.34 |
| J1940 |
Furosemide injection |
959 |
559 |
$7.79 |
| 96368 |
|
774 |
575 |
$7.28 |
| J0736 |
Inj, clindamycin phosp 300mg |
80 |
71 |
$6.24 |
| C1894 |
Intro/sheath, non-laser |
3,307 |
3,254 |
$4.75 |
| J1920 |
Inj, labetalol hcl, 5mg |
223 |
210 |
$4.03 |
| C9113 |
Inj pantoprazole sodium, via |
3,571 |
1,841 |
$3.13 |
| J3010 |
Fentanyl citrate injection |
27,318 |
22,877 |
$2.84 |
| J7030 |
Normal saline solution infus |
3,004 |
2,604 |
$2.57 |
| J1100 |
Dexamethasone sodium phos |
26,487 |
23,487 |
$1.95 |
| J0690 |
Cefazolin sodium injection |
10,609 |
9,117 |
$1.23 |
| J7999 |
Compounded drug, noc |
182 |
169 |
$1.19 |
| J1170 |
Hydromorphone injection |
6,664 |
4,689 |
$1.01 |
| J2765 |
Metoclopramide hcl injection |
7,415 |
6,534 |
$0.78 |
| J2704 |
Inj, propofol, 10 mg |
25,926 |
22,924 |
$0.68 |
| J2930 |
Methylprednisolone injection |
3,553 |
2,793 |
$0.37 |
| J0595 |
Butorphanol tartrate 1 mg |
29 |
28 |
$0.33 |
| 36416 |
|
1,843 |
1,494 |
$0.25 |
| J3480 |
Inj potassium chloride |
1,712 |
989 |
$0.14 |
| G1004 |
Cdsm ndsc |
2,776 |
2,649 |
$0.03 |
| J1580 |
Garamycin gentamicin inj |
72 |
66 |
$0.00 |
| C1760 |
Closure dev, vasc |
543 |
539 |
$0.00 |
| C1887 |
Catheter, guiding |
1,089 |
1,071 |
$0.00 |
| J1650 |
Inj enoxaparin sodium |
1,972 |
813 |
$0.00 |
| A9552 |
F18 fdg |
120 |
120 |
$0.00 |
| 94729 |
|
799 |
796 |
$0.00 |
| 93325 |
|
1,018 |
1,011 |
$0.00 |
| J0780 |
Prochlorperazine injection |
1,667 |
1,521 |
$0.00 |
| 90633 |
|
2,778 |
2,777 |
$0.00 |
| 82800 |
|
294 |
287 |
$0.00 |
| A9537 |
Tc99m mebrofenin |
1,149 |
1,146 |
$0.00 |
| 90700 |
|
883 |
883 |
$0.00 |
| J3301 |
Triamcinolone acet inj nos |
1,013 |
979 |
$0.00 |
| 99152 |
|
158 |
154 |
$0.00 |
| 80143 |
|
1,094 |
1,036 |
$0.00 |
| 90707 |
|
1,916 |
1,914 |
$0.00 |
| J7040 |
Normal saline solution infus |
1,130 |
1,071 |
$0.00 |
| A9578 |
Inj multihance multipack |
277 |
276 |
$0.00 |
| J1956 |
Levofloxacin injection |
330 |
274 |
$0.00 |
| J1953 |
Levetiracetam injection |
590 |
465 |
$0.00 |
| 58340 |
|
44 |
44 |
$0.00 |
| J0295 |
Ampicillin sulbactam 1.5 gm |
1,769 |
788 |
$0.00 |
| J1050 |
Medroxyprogesterone acetate |
406 |
399 |
$0.00 |
| 81220 |
|
406 |
400 |
$0.00 |
| 80179 |
|
1,082 |
1,026 |
$0.00 |
| J0171 |
Adrenalin epinephrine inject |
119 |
118 |
$0.00 |
| 94727 |
|
189 |
189 |
$0.00 |
| J2550 |
Promethazine hcl injection |
59 |
40 |
$0.00 |
| J2004 |
Inj, lidocaine w epinephrine |
116 |
116 |
$0.00 |
| J9190 |
Fluorouracil injection |
150 |
38 |
$0.00 |
| J1596 |
Inj, glycopyrrolate, 0.1 mg |
834 |
827 |
$0.00 |
| J0694 |
Cefoxitin sodium injection |
17 |
12 |
$0.00 |
| J2919 |
Inj, methylpred sod succ 5mg |
407 |
289 |
$0.00 |
| J2272 |
Inj, morphine (fresenius) |
184 |
156 |
$0.00 |
| J2310 |
Inj naloxone hydrochloride |
30 |
25 |
$0.00 |
| 91312 |
|
63 |
63 |
$0.00 |
| Q9957 |
Inj perflutren lip micros,ml |
12 |
12 |
$0.00 |
| J0702 |
Betamethasone acet&sod phosp |
365 |
209 |
$0.00 |
| J1171 |
Inj, hydromorphone, 0.1 mg |
167 |
126 |
$0.00 |
| G8979 |
Mobility goal status |
175 |
168 |
$0.00 |
| 64643 |
|
52 |
52 |
$0.00 |
| 82375 |
|
21 |
21 |
$0.00 |
| C1874 |
Stent, coated/cov w/del sys |
12 |
12 |
$0.00 |
| 91300 |
|
36 |
36 |
$0.00 |
| 82397 |
|
12 |
12 |
$0.00 |
| 59426 |
|
12 |
12 |
$0.00 |
| 77012 |
|
12 |
12 |
$0.00 |
| Q0243 |
Casirivimab and imdevimab |
24 |
12 |
$0.00 |
| 90647 |
|
3,562 |
3,558 |
$0.00 |
| J2543 |
Piperacillin/tazobactam |
368 |
178 |
$0.00 |
| J0456 |
Azithromycin |
105 |
54 |
$0.00 |
| J0330 |
Succinycholine chloride inj |
4,264 |
4,203 |
$0.00 |
| 90696 |
|
758 |
757 |
$0.00 |
| C1781 |
Mesh (implantable) |
320 |
320 |
$0.00 |
| G8988 |
Self care goal status |
195 |
189 |
$0.00 |
| 93320 |
|
125 |
124 |
$0.00 |
| J3420 |
Vitamin b12 injection |
1,681 |
1,314 |
$0.00 |
| J0360 |
Hydralazine hcl injection |
1,156 |
936 |
$0.00 |
| J3411 |
Thiamine hcl 100 mg |
255 |
200 |
$0.00 |
| J2370 |
Phenylephrine hcl injection |
3,145 |
3,029 |
$0.00 |
| G8987 |
Self care current status |
197 |
190 |
$0.00 |
| J2785 |
Regadenoson injection |
2,555 |
2,538 |
$0.00 |
| 74430 |
|
30 |
29 |
$0.00 |
| 84270 |
|
1,402 |
1,377 |
$0.00 |
| J1630 |
Haloperidol injection |
3,249 |
2,611 |
$0.00 |
| 90680 |
|
3,046 |
3,041 |
$0.00 |
| J3490 |
Drugs unclassified injection |
3,060 |
2,959 |
$0.00 |
| J2001 |
Lidocaine injection |
103 |
103 |
$0.00 |
| J0280 |
Aminophyllin 250 mg inj |
236 |
234 |
$0.00 |
| 83883 |
|
122 |
120 |
$0.00 |
| A9573 |
Inj, gadopiclenol, 1 ml |
480 |
476 |
$0.00 |
| J2790 |
Rho d immune globulin inj |
82 |
78 |
$0.00 |
| A9500 |
Tc99m sestamibi |
617 |
613 |
$0.00 |
| J2360 |
Orphenadrine injection |
884 |
863 |
$0.00 |
| 92558 |
|
71 |
71 |
$0.00 |
| J2371 |
Inj phenylephrine hcl 20 mcg |
938 |
909 |
$0.00 |
| 99153 |
Mod sedat endo service >5yrs |
105 |
104 |
$0.00 |
| J1642 |
Inj heparin sodium per 10 u |
222 |
189 |
$0.00 |
| 87450 |
|
26 |
25 |
$0.00 |
| A9270 |
Non-covered item or service |
58 |
14 |
$0.00 |
| 36410 |
|
96 |
77 |
$0.00 |
| J0500 |
Dicyclomine injection |
56 |
55 |
$0.00 |
| J7050 |
Normal saline solution infus |
1,939 |
1,395 |
$0.00 |
| J9267 |
Paclitaxel injection |
104 |
51 |
$0.00 |
| 96377 |
|
49 |
38 |
$0.00 |
| 0346T |
|
25 |
25 |
$0.00 |
| J9045 |
Carboplatin injection |
48 |
37 |
$0.00 |
| J7121 |
5% dextrose in lac ringers |
48 |
43 |
$0.00 |
| 99213 |
|
65 |
48 |
$0.00 |
| 90632 |
|
25 |
25 |
$0.00 |
| J2470 |
Inj pantoprazole sodium 40mg |
230 |
119 |
$0.00 |
| 91307 |
|
151 |
137 |
$0.00 |
| C2618 |
Probe/needle, cryo |
12 |
12 |
$0.00 |
| 76377 |
|
24 |
24 |
$0.00 |
| 81050 |
|
18 |
17 |
$0.00 |
| 82803 |
|
14 |
13 |
$0.00 |
| G0269 |
Occlusive device in vein art |
31 |
31 |
$0.00 |
| J2003 |
Inj, lidocaine hcl, 1 mg |
800 |
747 |
$0.00 |
| J2305 |
Inj, nitroglycerin, 5 mg |
19 |
17 |
$0.00 |
| 83874 |
|
12 |
12 |
$0.00 |