| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99284 |
|
129,761 |
124,914 |
$82.42M |
| 99285 |
|
74,614 |
70,649 |
$67.97M |
| 99283 |
|
177,305 |
169,883 |
$63.21M |
| 42820 |
|
5,736 |
5,646 |
$20.14M |
| 93303 |
|
21,030 |
20,077 |
$16.52M |
| 44970 |
|
2,524 |
2,467 |
$14.35M |
| 95004 |
|
6,079 |
6,015 |
$11.73M |
| J1459 |
Inj ivig privigen 500 mg |
2,894 |
1,807 |
$11.06M |
| 93306 |
|
16,320 |
15,637 |
$10.25M |
| 88305 |
|
13,211 |
12,854 |
$9.46M |
| J1745 |
Infliximab not biosimil 10mg |
1,604 |
1,525 |
$9.02M |
| 54161 |
|
3,299 |
3,223 |
$8.43M |
| 67311 |
|
2,828 |
2,799 |
$8.30M |
| 92587 |
|
18,047 |
17,524 |
$7.47M |
| G0378 |
Hospital observation per hr |
41,028 |
19,215 |
$7.18M |
| 99282 |
|
44,927 |
43,974 |
$7.06M |
| 95810 |
|
5,954 |
5,876 |
$6.74M |
| 69436 |
|
5,277 |
5,184 |
$6.56M |
| 80053 |
|
91,852 |
71,530 |
$6.21M |
| 70551 |
|
13,736 |
13,322 |
$6.11M |
| J0585 |
Injection,onabotulinumtoxina |
2,709 |
2,379 |
$5.37M |
| C1713 |
Anchor/screw bn/bn,tis/bn |
2,798 |
2,700 |
$5.34M |
| 97530 |
|
50,967 |
21,211 |
$4.77M |
| 70553 |
|
6,097 |
5,945 |
$4.60M |
| 99214 |
|
158,804 |
149,007 |
$4.08M |
| 94060 |
|
10,826 |
10,511 |
$4.01M |
| J1569 |
Gammagard liquid injection |
1,158 |
556 |
$3.93M |
| 43239 |
|
8,294 |
8,153 |
$3.81M |
| 97112 |
|
32,652 |
10,908 |
$3.30M |
| 96361 |
|
17,678 |
12,289 |
$3.30M |
| 92526 |
|
32,790 |
15,474 |
$2.96M |
| 97110 |
|
32,921 |
13,803 |
$2.94M |
| 95782 |
|
2,612 |
2,585 |
$2.92M |
| 54640 |
|
1,106 |
1,076 |
$2.87M |
| 92507 |
|
30,441 |
12,778 |
$2.81M |
| 20680 |
|
1,069 |
997 |
$2.79M |
| 99215 |
Prolong outpt/office vis |
93,523 |
80,445 |
$2.64M |
| 87633 |
|
14,437 |
13,963 |
$2.59M |
| L8699 |
Prosthetic implant nos |
1,702 |
1,535 |
$2.40M |
| P9016 |
Rbc leukocytes reduced |
5,262 |
4,212 |
$2.21M |
| 99213 |
|
103,719 |
98,993 |
$2.15M |
| 76770 |
|
17,430 |
17,179 |
$2.13M |
| 81229 |
|
2,018 |
1,968 |
$1.98M |
| 99244 |
|
56,136 |
54,901 |
$1.96M |
| 76825 |
|
2,243 |
2,149 |
$1.95M |
| 93005 |
|
66,160 |
63,331 |
$1.89M |
| 36430 |
|
5,818 |
4,129 |
$1.89M |
| 86902 |
|
4,501 |
3,238 |
$1.78M |
| 93975 |
|
3,810 |
3,736 |
$1.67M |
| 70450 |
|
7,984 |
7,825 |
$1.67M |
| 92611 |
|
6,726 |
6,581 |
$1.64M |
| 24538 |
|
210 |
202 |
$1.63M |
| 74177 |
|
3,404 |
3,307 |
$1.61M |
| 31526 |
|
1,606 |
1,571 |
$1.58M |
| 90378 |
|
675 |
428 |
$1.58M |
| 94010 |
|
8,461 |
8,374 |
$1.53M |
| 95819 |
|
5,267 |
5,207 |
$1.49M |
| J3262 |
Tocilizumab injection |
858 |
467 |
$1.39M |
| J0475 |
Baclofen 10 mg injection |
1,267 |
1,162 |
$1.38M |
| 92018 |
|
1,253 |
1,162 |
$1.35M |
| 87635 |
|
49,958 |
48,153 |
$1.25M |
| 54300 |
|
811 |
798 |
$1.24M |
| 87799 |
|
16,295 |
10,330 |
$1.20M |
| 42830 |
|
644 |
639 |
$1.17M |
| 73521 |
|
7,350 |
7,194 |
$1.09M |
| 72146 |
|
2,045 |
1,994 |
$1.09M |
| 72157 |
|
1,194 |
1,165 |
$1.08M |
| 70543 |
|
1,334 |
1,304 |
$1.07M |
| 99243 |
|
38,219 |
37,681 |
$1.00M |
| 25600 |
|
2,749 |
2,725 |
$987K |
| 87497 |
|
15,119 |
10,025 |
$982K |
| 74018 |
|
15,694 |
13,893 |
$964K |
| 74230 |
|
6,667 |
6,534 |
$960K |
| 72082 |
|
5,950 |
5,877 |
$877K |
| 96409 |
|
6,127 |
3,977 |
$865K |
| 96413 |
|
8,277 |
4,973 |
$861K |
| 41899 |
|
3,092 |
2,998 |
$817K |
| 92523 |
|
6,912 |
6,856 |
$792K |
| 29075 |
|
2,477 |
2,351 |
$787K |
| 99203 |
|
37,321 |
36,989 |
$786K |
| 73090 |
|
13,284 |
11,185 |
$782K |
| 96133 |
|
863 |
850 |
$776K |
| 77072 |
|
5,235 |
5,194 |
$773K |
| 93304 |
|
1,008 |
959 |
$739K |
| 95816 |
|
3,194 |
3,163 |
$737K |
| 43762 |
|
2,077 |
1,956 |
$694K |
| 92652 |
|
2,575 |
2,520 |
$689K |
| 72197 |
|
727 |
715 |
$666K |
| 99204 |
|
22,831 |
22,635 |
$648K |
| 96365 |
|
16,340 |
11,902 |
$646K |
| 87507 |
|
2,619 |
2,542 |
$643K |
| 99245 |
|
15,804 |
15,545 |
$640K |
| 71046 |
|
41,970 |
40,445 |
$637K |
| 95715 |
|
1,907 |
1,506 |
$614K |
| 74455 |
|
1,737 |
1,710 |
$596K |
| 30140 |
|
174 |
172 |
$570K |
| 92610 |
|
6,050 |
5,905 |
$559K |
| 73080 |
|
8,778 |
7,955 |
$557K |
| 74240 |
|
2,851 |
2,820 |
$554K |
| 73610 |
|
8,557 |
8,046 |
$553K |
| J0490 |
Belimumab injection |
117 |
107 |
$545K |
| 29065 |
|
1,521 |
1,447 |
$511K |
| 88185 |
|
1,279 |
1,054 |
$505K |
| 73721 |
|
1,687 |
1,597 |
$493K |
| 97162 |
|
6,042 |
5,962 |
$485K |
| 0225U |
|
4,234 |
4,123 |
$480K |
| 73100 |
|
5,427 |
4,906 |
$475K |
| B4088 |
Gastro/jejuno tube, low-pro |
2,671 |
2,562 |
$471K |
| 72141 |
|
2,382 |
2,314 |
$454K |
| 73140 |
|
7,999 |
7,101 |
$451K |
| J0586 |
Abobotulinumtoxina |
239 |
180 |
$444K |
| 73590 |
|
7,639 |
7,017 |
$444K |
| J9070 |
Cyclophosphamide 100 mg inj |
501 |
309 |
$437K |
| 72148 |
|
3,177 |
3,098 |
$433K |
| 96372 |
|
10,714 |
9,540 |
$424K |
| 54360 |
|
422 |
413 |
$422K |
| 97161 |
|
7,614 |
7,505 |
$413K |
| 73110 |
|
5,905 |
5,436 |
$400K |
| 73630 |
|
7,568 |
7,124 |
$384K |
| 37241 |
|
25 |
24 |
$378K |
| 80197 |
|
16,027 |
9,352 |
$377K |
| 42821 |
|
175 |
174 |
$375K |
| 77073 |
|
4,177 |
4,114 |
$372K |
| 96131 |
|
563 |
556 |
$371K |
| 97166 |
|
4,456 |
4,413 |
$368K |
| 94621 |
|
1,592 |
1,559 |
$366K |
| 73130 |
|
6,037 |
5,611 |
$365K |
| 95117 |
|
7,463 |
4,534 |
$360K |
| 93460 |
|
56 |
54 |
$352K |
| 76700 |
|
2,628 |
2,599 |
$351K |
| 36512 |
|
625 |
548 |
$344K |
| 99393 |
|
8,157 |
8,104 |
$340K |
| 31624 |
|
594 |
567 |
$334K |
| 76536 |
|
4,307 |
4,219 |
$334K |
| 99392 |
|
7,686 |
7,628 |
$333K |
| 70486 |
|
2,169 |
2,107 |
$332K |
| 62322 |
|
4,244 |
4,091 |
$324K |
| 72081 |
|
2,935 |
2,891 |
$312K |
| 71260 |
|
1,706 |
1,647 |
$310K |
| 95812 |
|
1,053 |
1,044 |
$309K |
| 93976 |
|
5,043 |
4,881 |
$306K |
| 92585 |
|
1,458 |
1,402 |
$303K |
| 97165 |
|
5,518 |
5,448 |
$293K |
| 24530 |
|
826 |
812 |
$289K |
| 90837 |
|
2,159 |
1,382 |
$287K |
| 99205 |
Prolong outpt/office vis |
6,745 |
6,675 |
$281K |
| 83036 |
|
18,817 |
18,226 |
$280K |
| 99391 |
|
5,727 |
5,637 |
$280K |
| 96366 |
|
8,410 |
5,438 |
$276K |
| 49500 |
|
69 |
68 |
$273K |
| 93308 |
|
670 |
634 |
$270K |
| 86920 |
|
4,641 |
3,852 |
$267K |
| 25605 |
|
552 |
526 |
$266K |
| 74183 |
|
733 |
720 |
$265K |
| 92579 |
|
8,673 |
8,478 |
$254K |
| 76856 |
|
4,284 |
4,187 |
$252K |
| 88341 |
|
2,294 |
2,128 |
$244K |
| 73552 |
|
3,562 |
3,410 |
$240K |
| 73560 |
|
2,729 |
2,405 |
$239K |
| 85025 |
|
125,372 |
96,869 |
$238K |
| 71555 |
|
201 |
186 |
$237K |
| 76705 |
|
20,621 |
19,982 |
$237K |
| 49450 |
|
447 |
432 |
$235K |
| 67312 |
|
75 |
69 |
$229K |
| J2997 |
Alteplase recombinant |
1,652 |
1,255 |
$219K |
| 94664 |
|
19,505 |
18,863 |
$216K |
| 26720 |
|
600 |
585 |
$215K |
| 99394 |
|
5,080 |
5,057 |
$214K |
| 92588 |
|
518 |
499 |
$209K |
| 72170 |
|
2,293 |
2,229 |
$208K |
| 97116 |
|
9,025 |
3,733 |
$207K |
| 73562 |
|
4,601 |
4,364 |
$202K |
| 73564 |
|
987 |
971 |
$201K |
| 82728 |
|
14,262 |
13,080 |
$201K |
| 73000 |
|
3,372 |
3,270 |
$201K |
| 96450 |
|
2,956 |
2,435 |
$194K |
| 73070 |
|
2,485 |
2,300 |
$194K |
| C1769 |
Guide wire |
5,339 |
4,913 |
$191K |
| 96375 |
|
25,104 |
18,354 |
$185K |
| 49452 |
|
1,476 |
1,396 |
$184K |
| 29450 |
|
826 |
354 |
$182K |
| A4649 |
Surgical supplies |
1,137 |
1,074 |
$181K |
| 97750 |
|
681 |
644 |
$169K |
| 92557 |
|
1,605 |
1,548 |
$168K |
| 80048 |
|
15,713 |
13,585 |
$167K |
| 94726 |
|
764 |
745 |
$166K |
| 77080 |
|
1,256 |
1,238 |
$164K |
| 36593 |
|
1,188 |
932 |
$163K |
| 90471 |
|
3,353 |
3,223 |
$159K |
| 73620 |
|
1,213 |
1,184 |
$156K |
| 70491 |
|
605 |
588 |
$155K |
| P9035 |
Platelet pheres leukoreduced |
243 |
149 |
$154K |
| 95700 |
|
1,406 |
1,385 |
$153K |
| 76885 |
|
1,687 |
1,616 |
$152K |
| J9312 |
Inj., rituximab, 10 mg |
25 |
12 |
$146K |
| 72156 |
|
1,149 |
1,121 |
$146K |
| 96156 |
|
1,933 |
1,890 |
$144K |
| 64450 |
|
878 |
851 |
$142K |
| 81268 |
|
310 |
270 |
$138K |
| 99212 |
|
7,767 |
7,629 |
$135K |
| 64447 |
|
1,340 |
1,306 |
$135K |
| 99242 |
|
9,721 |
9,595 |
$134K |
| 96374 |
|
33,155 |
30,122 |
$133K |
| J7298 |
Mirena, 52 mg |
44 |
44 |
$131K |
| 27750 |
|
381 |
378 |
$130K |
| 92650 |
|
888 |
886 |
$128K |
| 73060 |
|
2,410 |
2,256 |
$128K |
| 69210 |
|
461 |
457 |
$125K |
| 30802 |
|
122 |
118 |
$121K |
| 73030 |
|
2,226 |
2,152 |
$121K |
| 92582 |
|
3,366 |
3,268 |
$120K |
| 24640 |
|
504 |
497 |
$120K |
| J3490 |
Drugs unclassified injection |
7,093 |
5,864 |
$115K |
| 72100 |
|
2,080 |
2,050 |
$113K |
| 49591 |
|
42 |
42 |
$111K |
| 74270 |
|
383 |
381 |
$109K |
| 97760 |
|
1,317 |
1,043 |
$108K |
| 93971 |
|
1,171 |
1,125 |
$108K |
| 72158 |
|
1,346 |
1,309 |
$108K |
| 90834 |
|
814 |
620 |
$107K |
| 45380 |
|
2,174 |
2,148 |
$106K |
| 29405 |
|
302 |
259 |
$106K |
| 94770 |
|
604 |
579 |
$105K |
| 51726 |
|
153 |
148 |
$104K |
| J1610 |
Glucagon hydrochloride/1 mg |
221 |
216 |
$103K |
| V5261 |
Hearing aid, digit, bin, bte |
212 |
204 |
$102K |
| 76604 |
|
777 |
773 |
$102K |
| 78816 |
|
48 |
42 |
$100K |
| 36591 |
|
5,896 |
4,020 |
$97K |
| 76882 |
|
2,358 |
2,297 |
$92K |
| 10060 |
|
747 |
734 |
$92K |
| 17110 |
|
324 |
312 |
$92K |
| 47562 |
|
12 |
12 |
$92K |
| 86850 |
|
13,618 |
11,586 |
$90K |
| J1756 |
Iron sucrose injection |
517 |
284 |
$90K |
| J3489 |
Zoledronic acid 1mg |
245 |
242 |
$89K |
| 62252 |
|
317 |
298 |
$86K |
| 97535 |
|
1,416 |
955 |
$85K |
| 29085 |
|
344 |
317 |
$82K |
| 68815 |
|
38 |
38 |
$79K |
| 67808 |
|
40 |
39 |
$78K |
| 29888 |
|
38 |
38 |
$77K |
| 93225 |
|
870 |
831 |
$73K |
| 36590 |
|
104 |
103 |
$72K |
| 93531 |
|
13 |
13 |
$72K |
| 11900 |
|
323 |
305 |
$71K |
| 74712 |
|
216 |
213 |
$70K |
| 85046 |
|
5,935 |
5,489 |
$69K |
| 89230 |
|
1,811 |
1,776 |
$69K |
| 95951 |
|
53 |
41 |
$65K |
| 73660 |
|
1,350 |
1,306 |
$64K |
| 93505 |
|
126 |
122 |
$63K |
| 92552 |
|
2,439 |
2,346 |
$62K |
| 77075 |
|
1,417 |
1,371 |
$62K |
| 92602 |
|
351 |
204 |
$61K |
| 96360 |
|
7,057 |
6,747 |
$61K |
| 86644 |
|
139 |
110 |
$60K |
| C8911 |
Mra w/o fol w/cont, chest |
125 |
116 |
$59K |
| 74019 |
|
15,837 |
15,343 |
$59K |
| 92524 |
|
518 |
516 |
$59K |
| 99381 |
|
1,619 |
1,609 |
$57K |
| 83880 |
|
3,948 |
3,527 |
$57K |
| 99202 |
|
3,454 |
3,427 |
$57K |
| 87040 |
|
17,444 |
16,360 |
$56K |
| 72125 |
|
634 |
620 |
$55K |
| 67314 |
|
54 |
54 |
$55K |
| 96130 |
|
896 |
883 |
$55K |
| 70544 |
|
1,283 |
1,239 |
$55K |
| 92567 |
|
19,984 |
19,653 |
$55K |
| 29125 |
|
1,669 |
1,609 |
$53K |
| A9573 |
Inj, gadopiclenol, 1 ml |
279 |
161 |
$53K |
| T1002 |
Rn services up to 15 minutes |
892 |
547 |
$52K |
| 0202U |
|
371 |
363 |
$52K |
| 64642 |
|
1,754 |
1,695 |
$52K |
| 97802 |
|
684 |
669 |
$52K |
| 26727 |
|
16 |
15 |
$51K |
| A9554 |
I125 iothalamate, dx |
100 |
92 |
$51K |
| 97803 |
|
913 |
888 |
$50K |
| 90791 |
|
334 |
332 |
$49K |
| 76870 |
|
3,062 |
2,963 |
$49K |
| 93242 |
|
788 |
768 |
$48K |
| J1566 |
Immune globulin, powder |
41 |
12 |
$48K |
| 42975 |
|
222 |
220 |
$47K |
| 94729 |
|
657 |
643 |
$46K |
| 29105 |
|
2,373 |
2,276 |
$45K |
| S3620 |
Newborn metabolic screening |
606 |
599 |
$44K |
| 38220 |
|
364 |
331 |
$43K |
| 76937 |
|
2,235 |
1,975 |
$43K |
| 71250 |
|
303 |
301 |
$43K |
| 70360 |
|
818 |
814 |
$42K |
| 31541 |
|
25 |
25 |
$42K |
| 76800 |
|
333 |
333 |
$40K |
| 99281 |
|
428 |
425 |
$40K |
| C1788 |
Port, indwelling, imp |
1,216 |
1,169 |
$40K |
| 97164 |
|
736 |
731 |
$40K |
| 87530 |
|
432 |
238 |
$39K |
| 97168 |
|
665 |
661 |
$39K |
| 69209 |
|
223 |
220 |
$37K |
| P9073 |
Platelets pheresis path redu |
41 |
27 |
$37K |
| 73723 |
|
42 |
40 |
$36K |
| 99211 |
|
3,106 |
2,972 |
$36K |
| 94640 |
|
26,453 |
20,754 |
$34K |
| 70480 |
|
190 |
189 |
$34K |
| 64415 |
|
314 |
303 |
$34K |
| 81025 |
|
36,677 |
33,910 |
$34K |
| 81267 |
|
470 |
434 |
$33K |
| 93296 |
|
750 |
724 |
$32K |
| 85055 |
|
1,264 |
1,117 |
$32K |
| 78708 |
|
40 |
38 |
$31K |
| 99383 |
|
698 |
691 |
$31K |
| 96113 |
|
142 |
138 |
$30K |
| 93356 |
|
2,226 |
2,154 |
$30K |
| 75561 |
|
71 |
70 |
$30K |
| 99291 |
|
27 |
26 |
$30K |
| 71045 |
|
5,096 |
4,830 |
$29K |
| 85240 |
|
1,496 |
1,447 |
$29K |
| 29425 |
|
144 |
52 |
$29K |
| 12011 |
|
4,004 |
3,933 |
$29K |
| 75565 |
|
671 |
616 |
$28K |
| V5264 |
Ear mold/insert |
2,462 |
2,390 |
$27K |
| 97163 |
|
262 |
262 |
$27K |
| 88237 |
|
292 |
270 |
$26K |
| 95115 |
|
560 |
357 |
$26K |
| J1815 |
Insulin injection |
1,585 |
926 |
$26K |
| 70250 |
|
1,577 |
1,487 |
$25K |
| 95180 |
|
69 |
39 |
$24K |
| 83021 |
|
1,640 |
1,506 |
$24K |
| 87880 |
|
24,869 |
24,407 |
$24K |
| 90792 |
|
185 |
184 |
$23K |
| 27786 |
|
65 |
64 |
$23K |
| 68811 |
|
16 |
14 |
$23K |
| 73720 |
|
25 |
24 |
$22K |
| 87070 |
|
12,015 |
11,623 |
$22K |
| 96112 |
|
149 |
145 |
$20K |
| C1726 |
Cath, bal dil, non-vascular |
102 |
86 |
$20K |
| 97167 |
|
149 |
148 |
$20K |
| 29130 |
|
189 |
183 |
$20K |
| 31599 |
|
39 |
39 |
$20K |
| 80069 |
|
5,504 |
3,607 |
$20K |
| 0241U |
|
12,103 |
11,897 |
$19K |
| 82784 |
|
9,288 |
6,510 |
$19K |
| 72040 |
|
612 |
603 |
$19K |
| 12001 |
|
3,034 |
2,988 |
$18K |
| 86356 |
|
70 |
69 |
$18K |
| 97140 |
|
1,910 |
1,073 |
$18K |
| 90670 |
|
2,184 |
2,141 |
$18K |
| 96415 |
|
4,262 |
2,987 |
$18K |
| 80307 |
|
9,209 |
8,818 |
$18K |
| 82306 |
|
8,669 |
8,405 |
$18K |
| 99395 |
|
433 |
432 |
$17K |
| 93280 |
|
505 |
495 |
$17K |
| 12002 |
|
544 |
530 |
$17K |
| 92651 |
|
31 |
31 |
$17K |
| 90686 |
|
3,038 |
2,938 |
$17K |
| 93325 |
|
25,571 |
24,270 |
$17K |
| 0002A |
|
179 |
179 |
$17K |
| 28470 |
|
61 |
56 |
$17K |
| 75557 |
|
159 |
149 |
$16K |
| 0001A |
|
203 |
202 |
$16K |
| 99382 |
|
371 |
365 |
$16K |
| 96376 |
|
8,426 |
5,721 |
$16K |
| 88342 |
|
5,245 |
4,922 |
$16K |
| 58300 |
|
114 |
112 |
$16K |
| 97763 |
|
228 |
156 |
$16K |
| 90472 |
|
193 |
187 |
$15K |
| 26600 |
|
43 |
41 |
$15K |
| 81403 |
|
86 |
83 |
$15K |
| 96139 |
|
66 |
65 |
$15K |
| 85610 |
|
16,074 |
13,876 |
$15K |
| 86921 |
|
1,654 |
1,188 |
$15K |
| 92586 |
|
41 |
40 |
$14K |
| 83970 |
|
1,315 |
1,228 |
$13K |
| 86703 |
|
933 |
906 |
$13K |
| 31720 |
|
3,173 |
3,092 |
$13K |
| 92593 |
|
424 |
420 |
$13K |
| 36415 |
|
41,576 |
35,646 |
$12K |
| 25565 |
|
32 |
28 |
$12K |
| 36000 |
|
17,621 |
17,215 |
$12K |
| 76942 |
|
1,237 |
1,198 |
$12K |
| 97542 |
|
747 |
629 |
$12K |
| 86360 |
|
1,514 |
1,394 |
$11K |
| 71275 |
|
12 |
12 |
$11K |
| 83020 |
|
367 |
344 |
$11K |
| 96411 |
|
3,189 |
1,796 |
$11K |
| 0071A |
|
89 |
89 |
$11K |
| 0072A |
|
81 |
81 |
$11K |
| 99384 |
|
210 |
210 |
$11K |
| V5010 |
Assessment for hearing aid |
150 |
144 |
$11K |
| 84443 |
|
7,078 |
6,881 |
$10K |
| 22899 |
|
40 |
40 |
$10K |
| 87186 |
|
11,151 |
10,837 |
$10K |
| 92553 |
|
245 |
244 |
$10K |
| 36592 |
|
2,801 |
1,401 |
$10K |
| 64640 |
|
49 |
32 |
$10K |
| 25560 |
|
26 |
26 |
$10K |
| 92595 |
|
523 |
517 |
$9K |
| 86900 |
|
14,315 |
12,091 |
$9K |
| 70555 |
|
19 |
17 |
$9K |
| 96167 |
|
170 |
134 |
$9K |
| 64643 |
|
1,722 |
1,508 |
$9K |
| 85730 |
|
13,604 |
12,785 |
$9K |
| 96132 |
|
869 |
855 |
$9K |
| 73700 |
|
67 |
56 |
$9K |
| 86832 |
|
24 |
24 |
$8K |
| 85250 |
|
233 |
226 |
$8K |
| 92604 |
|
51 |
37 |
$8K |
| J0834 |
Inj., cosyntropin, 0.25 mg |
64 |
63 |
$8K |
| C1729 |
Cath, drainage |
70 |
67 |
$8K |
| 80195 |
|
3,915 |
2,371 |
$8K |
| 62270 |
|
367 |
314 |
$8K |
| 74181 |
|
26 |
25 |
$8K |
| V5011 |
Hearing aid fitting/checking |
1,366 |
1,334 |
$7K |
| 51600 |
|
1,698 |
1,673 |
$7K |
| 43760 |
|
161 |
153 |
$7K |
| 72070 |
|
841 |
831 |
$7K |
| 31575 |
|
12 |
12 |
$7K |
| 78725 |
|
109 |
106 |
$7K |
| 29345 |
|
26 |
26 |
$7K |
| 86635 |
|
862 |
806 |
$7K |
| 82803 |
|
6,414 |
6,090 |
$7K |
| 76857 |
|
228 |
222 |
$7K |
| 95990 |
|
500 |
450 |
$7K |
| 92522 |
|
64 |
64 |
$7K |
| 73220 |
|
17 |
15 |
$6K |
| 87086 |
|
56,325 |
54,506 |
$6K |
| J8499 |
Oral prescrip drug non chemo |
3,484 |
2,171 |
$6K |
| 91122 |
|
43 |
40 |
$6K |
| 76506 |
|
38 |
37 |
$6K |
| 99195 |
|
124 |
120 |
$6K |
| 96158 |
|
56 |
51 |
$6K |
| 0450 |
|
148 |
132 |
$6K |
| 78264 |
|
13 |
12 |
$6K |
| 93270 |
|
392 |
385 |
$5K |
| 82140 |
|
186 |
160 |
$5K |
| 82533 |
|
844 |
767 |
$5K |
| 94375 |
|
13 |
13 |
$5K |
| 87102 |
|
1,266 |
1,215 |
$5K |
| 29505 |
|
629 |
598 |
$5K |
| 55175 |
|
12 |
12 |
$5K |
| 92550 |
|
821 |
796 |
$5K |
| V5257 |
Hearing aid, digit, mon, bte |
12 |
12 |
$5K |
| 54150 |
|
180 |
179 |
$5K |
| 27824 |
|
12 |
12 |
$5K |
| 76377 |
|
331 |
325 |
$4K |
| 24650 |
|
13 |
13 |
$4K |
| 11981 |
|
48 |
46 |
$4K |
| 81243 |
|
1,408 |
1,368 |
$4K |
| C1887 |
Catheter, guiding |
1,090 |
1,039 |
$4K |
| 96137 |
|
1,293 |
1,280 |
$4K |
| 85379 |
|
1,650 |
1,525 |
$4K |
| 87798 |
|
4,836 |
4,556 |
$4K |
| 80061 |
|
3,666 |
3,507 |
$4K |
| 93227 |
|
248 |
238 |
$4K |
| V5267 |
Hearing aid sup/access/dev |
40 |
36 |
$4K |
| 29086 |
|
12 |
12 |
$4K |
| 85670 |
|
2,806 |
2,655 |
$4K |
| 57410 |
|
15 |
15 |
$3K |
| 87081 |
|
11,962 |
11,649 |
$3K |
| 90685 |
|
250 |
241 |
$3K |
| 82657 |
|
3,447 |
2,064 |
$3K |
| S9441 |
Asthma education |
109 |
108 |
$3K |
| 76376 |
|
8,314 |
8,094 |
$3K |
| 85576 |
|
382 |
370 |
$3K |
| 92626 |
|
15 |
13 |
$3K |
| 50200 |
|
13 |
13 |
$3K |
| 45331 |
|
147 |
143 |
$3K |
| 96040 |
|
4,029 |
3,896 |
$3K |
| A9575 |
Inj gadoterate meglumi 0.1ml |
19,103 |
10,387 |
$3K |
| 81001 |
|
72,633 |
68,097 |
$3K |
| 91040 |
|
83 |
83 |
$3K |
| 97533 |
|
131 |
91 |
$3K |
| 93229 |
|
14 |
14 |
$2K |
| 51701 |
|
110 |
109 |
$2K |
| 72020 |
|
12 |
12 |
$2K |
| A9552 |
F18 fdg |
265 |
244 |
$2K |
| 88312 |
|
426 |
404 |
$2K |
| 96900 |
|
51 |
13 |
$2K |
| 83516 |
|
1,011 |
965 |
$2K |
| B4087 |
Gastro/jejuno tube, std |
28 |
27 |
$2K |
| 96523 |
|
56 |
52 |
$2K |
| 72202 |
|
12 |
12 |
$2K |
| 82105 |
|
786 |
732 |
$2K |
| A9562 |
Tc99m mertiatide |
43 |
41 |
$2K |
| 86880 |
|
1,928 |
1,485 |
$2K |
| 85097 |
|
828 |
777 |
$2K |
| 81003 |
|
13,828 |
11,926 |
$2K |
| 62370 |
|
118 |
109 |
$2K |
| 72195 |
|
15 |
15 |
$2K |
| 75573 |
|
12 |
12 |
$2K |
| J1817 |
Insulin for insulin pump use |
83 |
77 |
$2K |
| 76010 |
|
2,121 |
2,074 |
$2K |
| 20610 |
|
14 |
12 |
$2K |
| 87804 |
|
6,379 |
6,307 |
$2K |
| 94762 |
|
4,005 |
3,013 |
$2K |
| 20611 |
|
32 |
29 |
$2K |
| 82248 |
|
14,131 |
10,252 |
$2K |
| J7342 |
Ciprofloxacin otic susp 6 mg |
426 |
398 |
$1K |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
16,875 |
9,520 |
$1K |
| 86359 |
|
65 |
58 |
$1K |
| 0353U |
|
578 |
549 |
$1K |
| 95886 |
|
75 |
70 |
$1K |
| 82272 |
|
1,919 |
1,848 |
$1K |
| P9011 |
Blood split unit |
70 |
52 |
$1K |
| 72080 |
|
30 |
30 |
$1K |
| 0112A |
|
12 |
12 |
$1K |
| J2704 |
Inj, propofol, 10 mg |
46,823 |
44,180 |
$1K |
| J3535 |
Metered dose inhaler drug |
60 |
56 |
$1K |
| J2405 |
Ondansetron hcl injection |
89,800 |
80,347 |
$1K |
| 96116 |
|
732 |
723 |
$1K |
| 70481 |
|
57 |
56 |
$1K |
| G0008 |
Admin influenza virus vac |
20 |
20 |
$1K |
| 0003A |
|
12 |
12 |
$1K |
| 85384 |
|
2,902 |
2,702 |
$1K |
| 88184 |
|
1,487 |
1,119 |
$1K |
| J1642 |
Inj heparin sodium per 10 u |
25,314 |
11,197 |
$1K |
| 84439 |
|
6,254 |
6,087 |
$1K |
| 87491 |
|
1,213 |
1,178 |
$1K |
| 85652 |
|
10,734 |
10,331 |
$1K |
| 90688 |
|
39 |
39 |
$1K |
| 0115U |
|
103 |
102 |
$1K |
| 92591 |
|
12 |
12 |
$1K |
| 80074 |
|
59 |
58 |
$1K |
| 92555 |
|
2,074 |
2,035 |
$1K |
| 88108 |
|
4,226 |
3,616 |
$1K |
| 86945 |
|
3,839 |
2,658 |
$1K |
| 83520 |
|
49 |
39 |
$1K |
| 88307 |
|
1,120 |
1,084 |
$1K |
| J2919 |
Inj, methylpred sod succ 5mg |
217 |
187 |
$1K |
| 95012 |
|
3,035 |
2,978 |
$1K |
| 70460 |
|
24 |
24 |
$1K |
| 99417 |
Prolong home eval add 15m |
452 |
421 |
$1K |
| 94644 |
|
2,255 |
2,177 |
$1K |
| 87400 |
|
2,441 |
2,415 |
$957.92 |
| 92592 |
|
106 |
105 |
$948.94 |
| 82570 |
|
8,846 |
6,645 |
$909.14 |
| 90734 |
|
36 |
30 |
$825.03 |
| 76827 |
|
2,245 |
2,150 |
$820.95 |
| 88313 |
|
1,590 |
1,513 |
$807.43 |
| 84145 |
|
10,789 |
10,185 |
$776.08 |
| 88348 |
|
38 |
38 |
$769.38 |
| J0735 |
Clonidine hydrochloride |
8,758 |
8,497 |
$765.64 |
| 95873 |
|
1,165 |
1,118 |
$763.99 |
| 83735 |
|
38,891 |
25,957 |
$755.65 |
| 89051 |
|
5,308 |
4,648 |
$747.13 |
| 90620 |
|
12 |
12 |
$746.18 |
| 64425 |
|
24 |
24 |
$744.64 |
| 96125 |
|
16 |
12 |
$714.46 |
| 29515 |
|
241 |
228 |
$693.19 |
| 88264 |
|
289 |
268 |
$629.75 |
| 82962 |
|
21,759 |
17,608 |
$626.75 |
| 87651 |
|
5,632 |
5,534 |
$626.60 |
| 76981 |
|
1,961 |
1,952 |
$603.51 |
| Q0162 |
Ondansetron oral |
7,191 |
6,980 |
$593.66 |
| 83690 |
|
11,944 |
11,350 |
$591.17 |
| 73200 |
|
16 |
13 |
$574.77 |
| J0131 |
Inj, acetaminophen (nos) |
3,003 |
2,734 |
$566.02 |
| 84703 |
|
897 |
878 |
$558.26 |
| 84100 |
|
29,346 |
21,006 |
$556.77 |
| 93321 |
|
1,991 |
1,909 |
$553.37 |
| 86140 |
|
19,518 |
18,689 |
$545.13 |
| 87389 |
|
1,194 |
1,152 |
$528.90 |
| 96168 |
|
85 |
66 |
$528.28 |
| 80076 |
|
51 |
38 |
$510.73 |
| J1100 |
Dexamethasone sodium phos |
49,960 |
47,138 |
$507.04 |
| 86922 |
|
1,664 |
1,188 |
$506.06 |
| 93299 |
|
12 |
12 |
$488.20 |
| 84484 |
|
688 |
635 |
$487.56 |
| C1751 |
Cath, inf, per/cent/midline |
243 |
237 |
$473.40 |
| 86352 |
|
111 |
104 |
$468.59 |
| 87591 |
|
1,221 |
1,177 |
$457.55 |
| 82139 |
|
55 |
40 |
$449.95 |
| 87449 |
|
101 |
94 |
$443.40 |
| 92556 |
|
2,262 |
2,188 |
$442.74 |
| 90656 |
|
67 |
67 |
$431.13 |
| 87486 |
|
4,118 |
3,976 |
$418.43 |
| 87581 |
|
4,120 |
3,977 |
$408.29 |
| 86901 |
|
14,315 |
12,092 |
$403.03 |
| A4216 |
Sterile water/saline, 10 ml |
12,470 |
9,763 |
$398.56 |
| 87077 |
|
14,050 |
13,622 |
$380.12 |
| 76776 |
|
15 |
12 |
$363.71 |
| 86833 |
|
12 |
12 |
$361.16 |
| C1894 |
Intro/sheath, non-laser |
1,787 |
1,701 |
$354.60 |
| 84702 |
|
167 |
154 |
$352.20 |
| J2175 |
Meperidine hydrochl /100 mg |
28,765 |
26,861 |
$350.32 |
| 83605 |
|
6,891 |
6,426 |
$337.66 |
| J0696 |
Ceftriaxone sodium injection |
9,608 |
8,259 |
$334.52 |
| J8540 |
Oral dexamethasone |
47,882 |
29,816 |
$332.70 |
| 99360 |
|
470 |
186 |
$326.22 |
| 76642 |
|
12 |
12 |
$321.51 |
| 93320 |
|
21,100 |
20,115 |
$318.08 |
| 82565 |
|
3,138 |
3,037 |
$312.61 |
| 96136 |
|
1,296 |
1,282 |
$307.28 |
| J3010 |
Fentanyl citrate injection |
31,600 |
30,060 |
$285.97 |
| J1885 |
Ketorolac tromethamine inj |
38,645 |
35,381 |
$282.25 |
| 85027 |
|
3,679 |
3,401 |
$279.07 |
| 36416 |
|
1,598 |
1,153 |
$256.10 |
| 82550 |
|
5,250 |
4,948 |
$255.43 |
| 88304 |
|
5,393 |
5,277 |
$252.91 |
| 86357 |
|
1,550 |
1,428 |
$242.78 |
| 99152 |
|
1,082 |
1,057 |
$233.25 |
| 82330 |
|
4,441 |
4,147 |
$224.19 |
| 83540 |
|
8,880 |
8,398 |
$217.01 |
| 83615 |
|
6,755 |
4,654 |
$209.92 |
| C1766 |
Intro/sheath,strble,non-peel |
259 |
255 |
$206.25 |
| 72072 |
|
15 |
14 |
$204.29 |
| S0119 |
Ondansetron 4 mg |
1,940 |
1,904 |
$202.21 |
| J1644 |
Inj heparin sodium per 1000u |
384 |
226 |
$200.26 |
| J2930 |
Methylprednisolone injection |
1,807 |
1,391 |
$183.08 |
| 86923 |
|
1,849 |
1,561 |
$182.07 |
| 82150 |
|
3,956 |
3,753 |
$180.95 |
| 82977 |
|
6,961 |
4,942 |
$178.91 |
| 87533 |
|
2,363 |
1,120 |
$166.98 |
| J1720 |
Hydrocortisone sodium succ i |
2,622 |
2,055 |
$164.32 |
| 85018 |
|
3,484 |
3,263 |
$147.14 |
| 87205 |
|
6,898 |
6,595 |
$138.70 |
| J2003 |
Inj, lidocaine hcl, 1 mg |
2,844 |
2,416 |
$132.08 |
| J0690 |
Cefazolin sodium injection |
15,282 |
13,126 |
$127.38 |
| 82043 |
|
50 |
49 |
$126.13 |
| 86706 |
|
453 |
445 |
$120.84 |
| S9443 |
Lactation class |
463 |
416 |
$119.04 |
| 90633 |
|
14 |
13 |
$118.60 |
| 86665 |
|
217 |
201 |
$115.87 |
| 88300 |
|
6,556 |
6,432 |
$108.87 |
| 85045 |
|
13,044 |
9,227 |
$95.61 |
| J3301 |
Triamcinolone acet inj nos |
1,636 |
1,546 |
$94.57 |
| 92594 |
|
39 |
39 |
$93.26 |
| J7050 |
Normal saline solution infus |
11,738 |
10,147 |
$91.25 |
| 86803 |
|
424 |
388 |
$90.95 |
| 90744 |
|
1,125 |
1,101 |
$86.37 |
| J7030 |
Normal saline solution infus |
9,752 |
7,943 |
$86.04 |
| J1170 |
Hydromorphone injection |
4,029 |
3,762 |
$81.84 |
| 96367 |
|
2,629 |
2,178 |
$78.74 |
| A7521 |
Trach/laryn tube cuffed |
65 |
55 |
$78.44 |
| 51702 |
|
27 |
26 |
$71.75 |
| 86171 |
|
13 |
13 |
$68.82 |
| 84156 |
|
8,499 |
6,323 |
$63.79 |
| 87210 |
|
1,270 |
1,218 |
$60.31 |
| J3370 |
Vancomycin hcl injection |
338 |
291 |
$59.96 |
| J2710 |
Neostigmine methylslfte inj |
2,422 |
2,371 |
$59.73 |
| 84550 |
|
1,838 |
1,599 |
$59.30 |
| J2250 |
Inj midazolam hydrochloride |
1,001 |
958 |
$56.39 |
| 85660 |
|
3,163 |
1,653 |
$54.54 |
| 30300 |
|
172 |
169 |
$51.36 |
| J2270 |
Morphine sulfate injection |
781 |
752 |
$47.49 |
| 93272 |
|
28 |
28 |
$45.84 |
| 87340 |
|
318 |
300 |
$45.22 |
| J3410 |
Hydroxyzine hcl injection |
164 |
77 |
$44.29 |
| J1200 |
Diphenhydramine hcl injectio |
10,644 |
7,988 |
$44.01 |
| 86308 |
|
983 |
969 |
$37.17 |
| J7507 |
Tacrolimus imme rel oral 1mg |
715 |
396 |
$31.92 |
| J7040 |
Normal saline solution infus |
5,042 |
4,606 |
$30.33 |
| S0020 |
Injection, bupivicaine hydro |
2,673 |
2,554 |
$30.05 |
| J0780 |
Prochlorperazine injection |
2,186 |
1,972 |
$29.34 |
| 83550 |
|
8,810 |
8,332 |
$27.55 |
| 82310 |
|
318 |
288 |
$22.13 |
| J3480 |
Inj potassium chloride |
504 |
392 |
$20.40 |
| J3475 |
Inj magnesium sulfate |
1,041 |
877 |
$18.95 |
| 85014 |
|
1,128 |
1,029 |
$18.65 |
| J7120 |
Ringers lactate infusion |
3,572 |
3,440 |
$18.19 |
| 86038 |
|
446 |
437 |
$18.12 |
| 94645 |
|
614 |
596 |
$13.53 |
| J0610 |
Calcium glucon (fresenius) |
1,009 |
366 |
$13.05 |
| 84295 |
|
411 |
382 |
$9.27 |
| 82945 |
|
578 |
534 |
$8.13 |
| J2060 |
Lorazepam injection |
946 |
756 |
$5.91 |
| J1940 |
Furosemide injection |
733 |
521 |
$5.83 |
| 82247 |
|
734 |
580 |
$5.57 |
| 84132 |
|
303 |
293 |
$4.25 |
| 82435 |
|
242 |
234 |
$4.10 |
| J0665 |
Inj, bupivacaine, nos, 0.5mg |
935 |
910 |
$2.98 |
| J2001 |
Lidocaine injection |
1,091 |
937 |
$0.18 |
| Q0163 |
Diphenhydramine hcl 50mg |
1,319 |
1,107 |
$0.16 |
| 84630 |
|
69 |
67 |
$0.00 |
| 82785 |
|
102 |
99 |
$0.00 |
| 87150 |
|
85 |
53 |
$0.00 |
| J2550 |
Promethazine hcl injection |
52 |
50 |
$0.00 |
| A7520 |
Trach/laryn tube non-cuffed |
59 |
54 |
$0.00 |
| 87045 |
|
91 |
89 |
$0.00 |
| 88344 |
|
114 |
110 |
$0.00 |
| J1171 |
Inj, hydromorphone, 0.1 mg |
207 |
195 |
$0.00 |
| C9113 |
Inj pantoprazole sodium, via |
35 |
25 |
$0.00 |
| J1953 |
Levetiracetam injection |
1,075 |
662 |
$0.00 |
| 82652 |
|
111 |
105 |
$0.00 |
| S0028 |
Injection, famotidine, 20 mg |
158 |
123 |
$0.00 |
| G0168 |
Wound closure by adhesive |
186 |
182 |
$0.00 |
| J9000 |
Doxorubicin hcl injection |
60 |
25 |
$0.00 |
| J0295 |
Ampicillin sulbactam 1.5 gm |
396 |
214 |
$0.00 |
| 88188 |
|
13 |
12 |
$0.00 |
| 86480 |
|
17 |
14 |
$0.00 |
| 86645 |
|
118 |
93 |
$0.00 |
| 84305 |
|
12 |
12 |
$0.00 |
| 87252 |
|
18 |
13 |
$0.00 |
| 93568 |
|
96 |
91 |
$0.00 |
| 93567 |
|
52 |
51 |
$0.00 |
| 90715 |
|
27 |
24 |
$0.00 |
| 86039 |
|
107 |
102 |
$0.00 |
| 87324 |
|
13 |
13 |
$0.00 |
| 75827 |
|
35 |
31 |
$0.00 |
| 96138 |
|
67 |
65 |
$0.00 |
| J1580 |
Garamycin gentamicin inj |
28 |
25 |
$0.00 |
| A9541 |
Tc99m sulfur colloid |
12 |
12 |
$0.00 |
| 86663 |
|
27 |
27 |
$0.00 |
| J0612 |
Inj, calcium gluconate, nos |
18 |
12 |
$0.00 |
| J2004 |
Inj, lidocaine w epinephrine |
172 |
172 |
$0.00 |
| 69200 |
|
54 |
54 |
$0.00 |
| 77003 |
|
16 |
13 |
$0.00 |
| 87254 |
|
18 |
13 |
$0.00 |
| 99354 |
|
29 |
28 |
$0.00 |
| 82610 |
|
13 |
13 |
$0.00 |
| 0141U |
|
14 |
14 |
$0.00 |
| A9999 |
Dme supply or accessory, nos |
12 |
12 |
$0.00 |
| 82553 |
|
97 |
89 |
$0.00 |
| 82438 |
|
1,748 |
1,718 |
$0.00 |
| 80320 |
|
3,420 |
3,067 |
$0.00 |
| J2371 |
Inj phenylephrine hcl 20 mcg |
164 |
162 |
$0.00 |
| 86664 |
|
81 |
81 |
$0.00 |
| 84478 |
|
13 |
12 |
$0.00 |
| 86355 |
|
1,640 |
1,501 |
$0.00 |
| 87015 |
|
110 |
100 |
$0.00 |
| 87184 |
|
154 |
146 |
$0.00 |
| J2920 |
Methylprednisolone injection |
714 |
458 |
$0.00 |
| 83051 |
|
59 |
50 |
$0.00 |
| 86364 |
|
366 |
348 |
$0.00 |
| 88271 |
|
249 |
237 |
$0.00 |
| 80177 |
|
219 |
209 |
$0.00 |
| A4354 |
Cath insertion tray w/bag |
100 |
97 |
$0.00 |
| 94761 |
|
282 |
235 |
$0.00 |
| 80329 |
|
2,769 |
2,411 |
$0.00 |
| 84157 |
|
577 |
531 |
$0.00 |
| J3360 |
Diazepam injection |
61 |
53 |
$0.00 |
| 88275 |
|
243 |
222 |
$0.00 |
| 88311 |
|
338 |
328 |
$0.00 |
| 82040 |
|
64 |
62 |
$0.00 |
| 86769 |
|
166 |
166 |
$0.00 |
| 80180 |
|
248 |
214 |
$0.00 |
| 87206 |
|
110 |
100 |
$0.00 |
| 86160 |
|
126 |
123 |
$0.00 |
| C1725 |
Cath, translumin non-laser |
340 |
264 |
$0.00 |
| J2370 |
Phenylephrine hcl injection |
62 |
59 |
$0.00 |
| J2795 |
Ropivacaine hcl injection |
241 |
234 |
$0.00 |
| V5160 |
Dispensing fee binaural |
15 |
14 |
$0.00 |
| J2765 |
Metoclopramide hcl injection |
156 |
153 |
$0.00 |
| 94760 |
|
374 |
244 |
$0.00 |
| 88291 |
|
20 |
12 |
$0.00 |
| 90673 |
|
1,533 |
1,504 |
$0.00 |
| 76816 |
|
81 |
80 |
$0.00 |
| J2470 |
Inj pantoprazole sodium 40mg |
29 |
27 |
$0.00 |
| A4215 |
Sterile needle |
62 |
62 |
$0.00 |
| 87116 |
|
110 |
100 |
$0.00 |
| J7042 |
5% dextrose/normal saline |
104 |
89 |
$0.00 |
| 86225 |
|
29 |
28 |
$0.00 |
| 85335 |
|
12 |
12 |
$0.00 |
| 67515 |
|
14 |
13 |
$0.00 |
| C1889 |
Implant/insert device, noc |
41 |
41 |
$0.00 |
| 90696 |
|
22 |
20 |
$0.00 |
| J9250 |
Methotrexate sodium inj |
19 |
14 |
$0.00 |
| 12013 |
|
26 |
26 |
$0.00 |
| 31622 |
|
31 |
31 |
$0.00 |
| 82607 |
|
14 |
14 |
$0.00 |
| 75825 |
|
36 |
31 |
$0.00 |
| 36011 |
|
13 |
12 |
$0.00 |
| J2794 |
Inj risperdal consta, 0.5 mg |
199 |
82 |
$0.00 |
| J7060 |
5% dextrose/water |
12 |
12 |
$0.00 |
| J0461 |
Atropine sulfate injection |
12 |
12 |
$0.00 |
| 86258 |
|
21 |
17 |
$0.00 |
| Q9968 |
Visualization adjunct |
14 |
12 |
$0.00 |
| 86341 |
|
15 |
15 |
$0.00 |
| 84446 |
|
15 |
12 |
$0.00 |
| 10140 |
|
12 |
12 |
$0.00 |
| 77001 |
|
15 |
15 |
$0.00 |