| Code | Description | Claims | Beneficiaries | Total Paid |
| 99283 |
|
17,353 |
14,997 |
$1.09M |
| U0003 |
Cov-19 amp prb hgh thruput |
16,303 |
14,459 |
$1.06M |
| G0463 |
Hospital outpt clinic visit |
59,591 |
41,807 |
$951K |
| 96361 |
|
8,134 |
5,367 |
$743K |
| 80053 |
|
26,621 |
21,813 |
$599K |
| 99284 |
|
12,018 |
10,419 |
$595K |
| 99285 |
|
14,448 |
12,160 |
$537K |
| 99282 |
|
4,378 |
3,955 |
$334K |
| 80048 |
|
19,463 |
15,117 |
$290K |
| 87507 |
|
900 |
831 |
$262K |
| 96365 |
|
5,159 |
3,396 |
$243K |
| 74177 |
|
3,813 |
3,437 |
$211K |
| 43239 |
|
1,484 |
1,314 |
$208K |
| 87491 |
|
6,205 |
5,680 |
$191K |
| 87591 |
|
6,174 |
5,653 |
$187K |
| 70450 |
|
3,493 |
3,034 |
$182K |
| 85025 |
|
36,297 |
27,453 |
$175K |
| 92014 |
|
5,104 |
4,950 |
$171K |
| 96366 |
|
2,657 |
1,511 |
$164K |
| 99214 |
|
13,148 |
10,980 |
$151K |
| 96360 |
|
2,786 |
1,980 |
$146K |
| 93306 |
|
1,888 |
1,752 |
$138K |
| 87631 |
|
1,668 |
1,475 |
$134K |
| 99213 |
|
8,969 |
7,565 |
$132K |
| 84443 |
|
12,858 |
11,753 |
$129K |
| U0005 |
Infec agen detec ampli probe |
11,051 |
9,754 |
$126K |
| C9803 |
Hopd covid-19 spec collect |
6,274 |
5,514 |
$118K |
| 45380 |
|
875 |
767 |
$109K |
| 0241U |
|
3,182 |
2,899 |
$108K |
| 88305 |
|
7,119 |
5,507 |
$105K |
| 94640 |
|
3,939 |
2,593 |
$98K |
| 87651 |
|
2,463 |
2,316 |
$94K |
| 87086 |
|
11,014 |
9,604 |
$93K |
| 96413 |
|
2,729 |
1,429 |
$92K |
| 80061 |
|
8,356 |
7,850 |
$79K |
| 87624 |
|
2,800 |
2,647 |
$76K |
| G0127 |
Trim nail(s) |
2,088 |
2,026 |
$75K |
| 45385 |
|
446 |
416 |
$74K |
| 87480 |
|
4,164 |
3,693 |
$71K |
| 76816 |
|
1,183 |
1,008 |
$69K |
| 99212 |
|
1,288 |
1,158 |
$68K |
| 80307 |
|
2,017 |
1,544 |
$65K |
| 87510 |
|
4,167 |
3,693 |
$63K |
| 87660 |
|
4,164 |
3,693 |
$63K |
| 87389 |
|
2,992 |
2,764 |
$62K |
| 83036 |
|
10,269 |
9,700 |
$62K |
| 71046 |
|
6,089 |
5,470 |
$62K |
| 82948 |
|
6,596 |
2,414 |
$58K |
| 74176 |
|
904 |
830 |
$54K |
| 77067 |
|
1,954 |
1,877 |
$53K |
| 87636 |
|
769 |
682 |
$49K |
| 84484 |
|
5,627 |
4,635 |
$46K |
| 95886 |
|
917 |
800 |
$44K |
| 87077 |
|
4,251 |
3,795 |
$44K |
| 76856 |
|
1,093 |
986 |
$43K |
| 71275 |
|
852 |
784 |
$42K |
| 81025 |
|
5,130 |
4,402 |
$42K |
| 87070 |
|
2,354 |
2,080 |
$41K |
| G0123 |
Screen cerv/vag thin layer |
2,567 |
2,438 |
$41K |
| 82728 |
|
3,927 |
3,649 |
$40K |
| 87653 |
|
1,127 |
1,045 |
$40K |
| 81001 |
|
11,817 |
10,089 |
$39K |
| 83880 |
|
2,860 |
2,526 |
$38K |
| G0378 |
Hospital observation per hr |
10,414 |
3,436 |
$37K |
| 76830 |
|
1,037 |
940 |
$36K |
| M0243 |
Casirivi and imdevi inj |
95 |
88 |
$36K |
| 70553 |
|
447 |
404 |
$36K |
| 80050 |
|
1,079 |
883 |
$36K |
| 36415 |
|
33,814 |
24,494 |
$35K |
| 59025 |
|
620 |
393 |
$35K |
| 76801 |
|
541 |
473 |
$34K |
| 80306 |
|
2,277 |
1,956 |
$33K |
| 84702 |
|
1,882 |
1,443 |
$30K |
| 76642 |
|
975 |
815 |
$29K |
| 83690 |
|
6,091 |
5,207 |
$29K |
| 82947 |
|
5,774 |
3,474 |
$29K |
| 85610 |
|
11,129 |
6,177 |
$28K |
| 93325 |
|
656 |
597 |
$27K |
| 86803 |
|
2,297 |
2,133 |
$27K |
| 90471 |
|
3,233 |
3,045 |
$27K |
| 83605 |
|
4,134 |
3,488 |
$27K |
| 97110 |
|
8,252 |
3,518 |
$27K |
| 85027 |
|
6,382 |
5,291 |
$26K |
| 99211 |
|
1,603 |
1,136 |
$25K |
| 83735 |
|
6,994 |
5,175 |
$25K |
| 82306 |
|
1,583 |
1,514 |
$24K |
| 82607 |
|
2,589 |
2,452 |
$24K |
| 76705 |
|
842 |
743 |
$24K |
| 97140 |
|
5,099 |
2,026 |
$22K |
| 96374 |
|
9,502 |
6,959 |
$21K |
| 99215 |
Prolong outpt/office vis |
2,768 |
2,462 |
$21K |
| 86850 |
|
2,904 |
2,420 |
$21K |
| 87186 |
|
3,615 |
3,274 |
$20K |
| 93971 |
|
817 |
737 |
$20K |
| 20610 |
|
1,602 |
1,304 |
$20K |
| 72100 |
|
1,425 |
1,336 |
$20K |
| 87340 |
|
2,307 |
2,111 |
$19K |
| 87103 |
|
1,988 |
1,705 |
$19K |
| 86780 |
|
2,076 |
1,906 |
$19K |
| 82565 |
|
2,583 |
2,099 |
$19K |
| 71260 |
|
403 |
363 |
$18K |
| 85379 |
|
2,751 |
2,488 |
$18K |
| 87040 |
|
3,788 |
1,704 |
$17K |
| 88142 |
|
895 |
802 |
$17K |
| 72148 |
|
433 |
400 |
$17K |
| 76700 |
|
312 |
300 |
$17K |
| 73630 |
|
2,042 |
1,716 |
$17K |
| 96372 |
|
12,357 |
7,474 |
$17K |
| 73030 |
|
1,496 |
1,299 |
$16K |
| 77063 |
|
1,080 |
1,038 |
$16K |
| 84439 |
|
1,946 |
1,784 |
$16K |
| 71250 |
|
828 |
764 |
$15K |
| 81003 |
|
6,212 |
5,562 |
$14K |
| 83550 |
|
2,579 |
2,408 |
$14K |
| 99204 |
|
1,223 |
1,144 |
$14K |
| 93321 |
|
199 |
188 |
$13K |
| 82077 |
|
1,517 |
1,264 |
$13K |
| 73610 |
|
1,467 |
1,277 |
$13K |
| 82570 |
|
3,455 |
3,098 |
$13K |
| 86140 |
|
4,352 |
3,867 |
$13K |
| 93296 |
|
695 |
677 |
$13K |
| 41899 |
|
33 |
27 |
$13K |
| 87880 |
|
745 |
669 |
$12K |
| 97112 |
|
3,424 |
1,761 |
$12K |
| 74018 |
|
668 |
595 |
$11K |
| 78815 |
|
119 |
105 |
$11K |
| 70551 |
|
194 |
173 |
$11K |
| 83540 |
|
2,606 |
2,432 |
$11K |
| 97162 |
|
1,878 |
1,759 |
$11K |
| 20611 |
|
883 |
779 |
$11K |
| 76805 |
|
131 |
119 |
$10K |
| 99203 |
|
1,045 |
990 |
$10K |
| 83970 |
|
430 |
380 |
$10K |
| 82043 |
|
2,459 |
2,319 |
$10K |
| 82746 |
|
1,239 |
1,174 |
$10K |
| 93976 |
|
307 |
282 |
$9K |
| 87801 |
|
217 |
210 |
$9K |
| 73502 |
|
1,139 |
1,032 |
$9K |
| 80143 |
|
908 |
749 |
$9K |
| 42820 |
|
12 |
12 |
$9K |
| 86480 |
|
243 |
227 |
$9K |
| 72125 |
|
356 |
316 |
$9K |
| 73721 |
|
150 |
131 |
$9K |
| 80179 |
|
847 |
701 |
$8K |
| 96367 |
|
154 |
101 |
$8K |
| 87635 |
|
275 |
255 |
$8K |
| 77080 |
|
478 |
440 |
$8K |
| 76817 |
|
436 |
352 |
$8K |
| 84153 |
|
630 |
590 |
$7K |
| 86769 |
|
370 |
340 |
$7K |
| 82248 |
|
2,834 |
2,403 |
$7K |
| 82805 |
|
433 |
378 |
$7K |
| 90715 |
|
733 |
667 |
$7K |
| 82247 |
|
423 |
331 |
$6K |
| M0247 |
Sotrovimab infusion |
13 |
13 |
$6K |
| 80047 |
|
146 |
120 |
$6K |
| 90686 |
|
1,832 |
1,738 |
$6K |
| 73130 |
|
635 |
528 |
$6K |
| 62323 |
|
51 |
49 |
$5K |
| 86618 |
|
386 |
361 |
$5K |
| 73564 |
|
969 |
813 |
$5K |
| 86900 |
|
2,184 |
1,818 |
$5K |
| 92004 |
|
293 |
280 |
$5K |
| 73562 |
|
733 |
573 |
$5K |
| 71045 |
|
5,170 |
4,494 |
$5K |
| 73110 |
|
486 |
403 |
$5K |
| 67028 |
|
972 |
890 |
$5K |
| 76770 |
|
156 |
145 |
$5K |
| 92567 |
|
482 |
465 |
$5K |
| 93005 |
|
12,914 |
10,317 |
$5K |
| 84460 |
|
1,282 |
1,082 |
$4K |
| 84450 |
|
1,361 |
1,115 |
$4K |
| 92557 |
|
586 |
565 |
$4K |
| Q3014 |
Telehealth facility fee |
1,844 |
1,538 |
$4K |
| 86901 |
|
2,194 |
1,829 |
$4K |
| 96368 |
|
55 |
28 |
$4K |
| 80076 |
|
454 |
416 |
$4K |
| 84132 |
|
913 |
706 |
$4K |
| 91322 |
|
583 |
564 |
$4K |
| J0248 |
Inj, remdesivir, 1 mg |
43 |
15 |
$3K |
| J0585 |
Injection,onabotulinumtoxina |
195 |
136 |
$3K |
| 84156 |
|
780 |
643 |
$3K |
| 69210 |
|
414 |
398 |
$3K |
| 82550 |
|
638 |
535 |
$3K |
| 86706 |
|
365 |
331 |
$3K |
| G0124 |
Screen c/v thin layer by md |
136 |
134 |
$3K |
| 85018 |
|
1,206 |
991 |
$3K |
| 97166 |
|
352 |
323 |
$3K |
| 92012 |
|
150 |
141 |
$3K |
| 80069 |
|
242 |
199 |
$2K |
| 97161 |
|
600 |
553 |
$2K |
| 96375 |
|
7,769 |
5,483 |
$2K |
| 77091 |
|
367 |
336 |
$2K |
| 86762 |
|
193 |
168 |
$2K |
| 77065 |
Tomosynthesis, mammo |
131 |
110 |
$2K |
| 83516 |
|
368 |
287 |
$2K |
| 94729 |
|
200 |
189 |
$2K |
| G0480 |
Drug test def 1-7 classes |
120 |
93 |
$2K |
| 93351 |
|
27 |
25 |
$2K |
| 97530 |
|
762 |
398 |
$2K |
| 88342 |
|
578 |
485 |
$2K |
| 92134 |
|
1,940 |
1,790 |
$2K |
| 36591 |
|
319 |
223 |
$2K |
| 82950 |
|
335 |
321 |
$2K |
| 93017 |
|
42 |
37 |
$2K |
| 84165 |
|
196 |
131 |
$2K |
| 97165 |
|
353 |
329 |
$2K |
| 99024 |
|
865 |
658 |
$2K |
| 84100 |
|
710 |
485 |
$2K |
| C9257 |
Bevacizumab injection |
44 |
37 |
$1K |
| 85652 |
|
904 |
830 |
$1K |
| 64493 |
|
18 |
13 |
$1K |
| 86787 |
|
218 |
189 |
$1K |
| 93225 |
|
102 |
92 |
$1K |
| 90677 |
|
359 |
334 |
$1K |
| 64494 |
|
23 |
13 |
$1K |
| G0108 |
Diab manage trn per indiv |
256 |
235 |
$1K |
| 0753T |
|
571 |
423 |
$1K |
| 88304 |
|
460 |
399 |
$1K |
| G0439 |
Ppps, subseq visit |
221 |
219 |
$1K |
| 77066 |
Tomosynthesis, mammo |
143 |
130 |
$1K |
| 97116 |
|
595 |
268 |
$1K |
| 90480 |
|
582 |
563 |
$1K |
| 86704 |
|
131 |
120 |
$955.38 |
| 82784 |
|
143 |
140 |
$935.84 |
| 77062 |
|
58 |
56 |
$888.14 |
| 90662 |
|
1,422 |
1,361 |
$881.06 |
| 70498 |
|
13 |
12 |
$876.35 |
| 52000 |
|
28 |
26 |
$875.15 |
| 97535 |
|
296 |
172 |
$836.51 |
| 90834 |
|
223 |
155 |
$828.29 |
| J0178 |
Aflibercept injection |
75 |
64 |
$818.59 |
| 36416 |
|
2,445 |
1,226 |
$817.40 |
| 90750 |
|
248 |
234 |
$798.11 |
| 72141 |
|
15 |
13 |
$792.51 |
| 95800 |
|
14 |
14 |
$786.58 |
| 86431 |
|
173 |
168 |
$761.77 |
| 96376 |
|
2,892 |
1,667 |
$753.66 |
| 76819 |
|
52 |
38 |
$742.61 |
| G0008 |
Admin influenza virus vac |
1,989 |
1,903 |
$724.52 |
| 72040 |
|
40 |
37 |
$663.07 |
| 84075 |
|
112 |
94 |
$658.00 |
| 74183 |
|
13 |
13 |
$625.84 |
| 11721 |
|
105 |
98 |
$601.16 |
| 11102 |
|
14 |
14 |
$584.63 |
| 86364 |
|
71 |
70 |
$511.71 |
| 99205 |
Prolong outpt/office vis |
146 |
138 |
$492.38 |
| 99496 |
|
273 |
259 |
$463.40 |
| 94762 |
|
82 |
80 |
$455.44 |
| J3490 |
Drugs unclassified injection |
2,598 |
1,771 |
$452.37 |
| G0379 |
Direct refer hospital observ |
99 |
90 |
$450.08 |
| G0482 |
Drug test def 15-21 classes |
28 |
25 |
$442.25 |
| 0097U |
|
386 |
333 |
$421.90 |
| G0279 |
Tomosynthesis, mammo |
38 |
33 |
$418.32 |
| 11056 |
|
37 |
30 |
$383.65 |
| 77061 |
|
14 |
12 |
$381.17 |
| 93226 |
|
102 |
92 |
$328.72 |
| 84155 |
|
169 |
155 |
$327.82 |
| 29581 |
|
264 |
53 |
$327.61 |
| 94060 |
|
141 |
133 |
$295.23 |
| 76942 |
|
265 |
238 |
$293.63 |
| 93010 |
|
54 |
39 |
$271.80 |
| 98926 |
|
95 |
86 |
$263.12 |
| 84550 |
|
156 |
143 |
$256.69 |
| 76376 |
|
563 |
511 |
$247.63 |
| 85730 |
|
71 |
62 |
$235.38 |
| 83615 |
|
93 |
78 |
$227.01 |
| 83001 |
|
13 |
12 |
$215.88 |
| J2704 |
Inj, propofol, 10 mg |
20,590 |
6,450 |
$166.28 |
| 0004A |
|
139 |
122 |
$156.83 |
| 0054A |
|
323 |
304 |
$148.74 |
| 64615 |
|
26 |
26 |
$143.85 |
| 84146 |
|
12 |
12 |
$137.60 |
| 51798 |
|
272 |
247 |
$134.51 |
| 94726 |
|
162 |
155 |
$132.82 |
| 0124A |
|
335 |
313 |
$132.05 |
| J3301 |
Triamcinolone acet inj nos |
1,227 |
1,087 |
$127.96 |
| 80164 |
|
12 |
12 |
$122.20 |
| 0001A |
|
17 |
15 |
$120.81 |
| 87075 |
|
30 |
26 |
$119.16 |
| 85014 |
|
90 |
73 |
$114.40 |
| 82040 |
|
47 |
41 |
$113.55 |
| 82310 |
|
31 |
25 |
$111.00 |
| J3010 |
Fentanyl citrate injection |
4,027 |
3,032 |
$107.55 |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
4,966 |
2,733 |
$105.36 |
| J1644 |
Inj heparin sodium per 1000u |
3,821 |
1,297 |
$97.47 |
| 73080 |
|
28 |
26 |
$92.44 |
| 84295 |
|
29 |
16 |
$86.43 |
| 81015 |
|
220 |
194 |
$84.49 |
| J2250 |
Inj midazolam hydrochloride |
5,764 |
5,012 |
$79.11 |
| J1650 |
Inj enoxaparin sodium |
331 |
113 |
$77.04 |
| 96523 |
|
15 |
12 |
$70.75 |
| J0690 |
Cefazolin sodium injection |
2,581 |
2,076 |
$69.61 |
| 90656 |
|
124 |
122 |
$69.44 |
| J1885 |
Ketorolac tromethamine inj |
6,859 |
4,660 |
$65.60 |
| 82375 |
|
15 |
13 |
$52.20 |
| J2001 |
Lidocaine injection |
6,687 |
3,523 |
$50.30 |
| 11719 |
|
14 |
13 |
$44.26 |
| J1100 |
Dexamethasone sodium phos |
5,893 |
4,621 |
$43.87 |
| 92133 |
|
87 |
82 |
$42.41 |
| 84560 |
|
19 |
18 |
$42.14 |
| 92083 |
|
71 |
65 |
$40.86 |
| 73590 |
|
13 |
12 |
$40.80 |
| J1040 |
Methylprednisolone 80 mg inj |
518 |
504 |
$40.60 |
| 87147 |
|
12 |
12 |
$36.35 |
| 0764T |
|
88 |
79 |
$30.78 |
| 90472 |
|
283 |
260 |
$23.19 |
| 88141 |
|
12 |
12 |
$23.09 |
| 83050 |
|
14 |
12 |
$16.90 |
| J7030 |
Normal saline solution infus |
2,786 |
1,949 |
$15.16 |
| 92015 |
|
17 |
17 |
$11.88 |
| J1010 |
Inj, methylpred acetate 1 mg |
246 |
200 |
$10.28 |
| 90739 |
|
40 |
37 |
$8.82 |
| J0665 |
Inj, bupivacaine, nos, 0.5mg |
832 |
421 |
$7.92 |
| J8499 |
Oral prescrip drug non chemo |
627 |
245 |
$5.67 |
| J7050 |
Normal saline solution infus |
1,832 |
1,062 |
$5.53 |
| J0696 |
Ceftriaxone sodium injection |
1,372 |
752 |
$4.93 |
| 90732 |
|
98 |
92 |
$3.68 |
| J1030 |
Methylprednisolone 40 mg inj |
841 |
784 |
$3.35 |
| G1004 |
Cdsm ndsc |
3,874 |
2,949 |
$3.09 |
| J2405 |
Ondansetron hcl injection |
9,195 |
6,479 |
$2.93 |
| G8990 |
Other pt/ot current status |
19 |
15 |
$2.00 |
| Q9969 |
Non-heu tc-99m add-on/dose |
349 |
313 |
$1.42 |
| 82465 |
|
31 |
28 |
$0.18 |
| J2919 |
Inj, methylpred sod succ 5mg |
57 |
34 |
$0.16 |
| J2370 |
Phenylephrine hcl injection |
347 |
302 |
$0.00 |
| G8987 |
Self care current status |
65 |
56 |
$0.00 |
| A9270 |
Non-covered item or service |
8,052 |
4,010 |
$0.00 |
| J1790 |
Droperidol injection |
643 |
563 |
$0.00 |
| G8980 |
Mobility d/c status |
272 |
225 |
$0.00 |
| G0009 |
Admin pneumococcal vaccine |
252 |
243 |
$0.00 |
| J1170 |
Hydromorphone injection |
2,830 |
1,820 |
$0.00 |
| J2795 |
Ropivacaine hcl injection |
815 |
394 |
$0.00 |
| J3420 |
Vitamin b12 injection |
129 |
121 |
$0.00 |
| C1769 |
Guide wire |
13 |
12 |
$0.00 |
| 99495 |
|
132 |
129 |
$0.00 |
| J0330 |
Succinycholine chloride inj |
717 |
337 |
$0.00 |
| A9585 |
Gadobutrol injection |
858 |
467 |
$0.00 |
| J2060 |
Lorazepam injection |
91 |
75 |
$0.00 |
| G8988 |
Self care goal status |
83 |
72 |
$0.00 |
| J1642 |
Inj heparin sodium per 10 u |
86 |
43 |
$0.00 |
| G8991 |
Other pt/ot goal status |
45 |
40 |
$0.00 |
| J7620 |
Albuterol ipratrop non-comp |
59 |
42 |
$0.00 |
| 17000 |
|
24 |
24 |
$0.00 |
| 88300 |
|
25 |
25 |
$0.00 |
| J0131 |
Inj, acetaminophen (nos) |
34 |
24 |
$0.00 |
| 90632 |
|
12 |
12 |
$0.00 |
| 0134A |
|
16 |
15 |
$0.00 |
| G8981 |
Body pos current status |
13 |
12 |
$0.00 |
| 0064A |
|
44 |
43 |
$0.00 |
| G8982 |
Body pos goal status |
13 |
12 |
$0.00 |
| 91305 |
|
129 |
121 |
$0.00 |
| V2632 |
Post chmbr intraocular lens |
13 |
12 |
$0.00 |
| J2765 |
Metoclopramide hcl injection |
17 |
14 |
$0.00 |
| Q0162 |
Ondansetron oral |
29 |
25 |
$0.00 |
| J7120 |
Ringers lactate infusion |
1,933 |
1,693 |
$0.00 |
| J1756 |
Iron sucrose injection |
207 |
103 |
$0.00 |
| J1200 |
Diphenhydramine hcl injectio |
2,413 |
1,893 |
$0.00 |
| J0171 |
Adrenalin epinephrine inject |
100 |
66 |
$0.00 |
| G8978 |
Mobility current status |
425 |
346 |
$0.00 |
| A9552 |
F18 fdg |
135 |
120 |
$0.00 |
| J3475 |
Inj magnesium sulfate |
449 |
293 |
$0.00 |
| J1596 |
Inj, glycopyrrolate, 0.1 mg |
39 |
38 |
$0.00 |
| J2930 |
Methylprednisolone injection |
71 |
51 |
$0.00 |
| 91312 |
|
70 |
68 |
$0.00 |
| J7040 |
Normal saline solution infus |
35 |
27 |
$0.00 |
| G8979 |
Mobility goal status |
495 |
397 |
$0.00 |
| 91300 |
|
15 |
15 |
$0.00 |
| 97542 |
|
13 |
12 |
$0.00 |
| 0003A |
|
21 |
21 |
$0.00 |
| C1894 |
Intro/sheath, non-laser |
25 |
24 |
$0.00 |
| J2550 |
Promethazine hcl injection |
72 |
57 |
$0.00 |
| Q9957 |
Inj perflutren lip micros,ml |
12 |
12 |
$0.00 |
| J2710 |
Neostigmine methylslfte inj |
15 |
13 |
$0.00 |
| J1171 |
Inj, hydromorphone, 0.1 mg |
20 |
14 |
$0.00 |
| J0780 |
Prochlorperazine injection |
30 |
25 |
$0.00 |
| 83718 |
|
16 |
15 |
$0.00 |
| C1713 |
Anchor/screw bn/bn,tis/bn |
27 |
25 |
$0.00 |
| G8989 |
Self care d/c status |
13 |
12 |
$0.00 |
| 0752T |
|
15 |
14 |
$0.00 |
| J2270 |
Morphine sulfate injection |
17 |
12 |
$0.00 |