| Code | Description | Claims | Beneficiaries | Total Paid |
| 99213 |
|
575,655 |
548,993 |
$50.80M |
| 99214 |
|
179,556 |
172,754 |
$22.63M |
| 90670 |
|
50,508 |
48,486 |
$11.22M |
| 99392 |
|
90,301 |
88,707 |
$10.13M |
| 87636 |
|
106,591 |
102,827 |
$9.99M |
| 81420 |
|
13,246 |
12,850 |
$9.64M |
| 90471 |
|
386,577 |
376,290 |
$9.07M |
| 99391 |
|
85,268 |
75,399 |
$8.57M |
| 87635 |
|
122,337 |
109,440 |
$6.81M |
| 92014 |
|
50,301 |
49,370 |
$6.17M |
| 87591 |
|
154,970 |
146,112 |
$5.90M |
| 87491 |
|
155,174 |
146,310 |
$5.89M |
| 99212 |
|
103,292 |
98,315 |
$5.67M |
| 87637 |
|
54,156 |
52,245 |
$5.28M |
| 92004 |
|
35,053 |
34,360 |
$5.26M |
| 77067 |
|
33,883 |
33,514 |
$5.06M |
| 90472 |
|
140,949 |
136,555 |
$4.67M |
| 99393 |
|
42,006 |
41,372 |
$4.64M |
| 88305 |
|
27,542 |
24,376 |
$3.40M |
| 90686 |
|
166,617 |
165,024 |
$3.36M |
| 36415 |
|
686,676 |
612,114 |
$3.15M |
| 84443 |
|
175,818 |
171,378 |
$2.96M |
| 90677 |
|
10,063 |
9,762 |
$2.87M |
| 87389 |
|
118,654 |
115,399 |
$2.82M |
| V2020 |
Vision svcs frames purchases |
59,058 |
55,015 |
$2.57M |
| 80061 |
|
191,598 |
188,696 |
$2.55M |
| 99203 |
|
21,843 |
21,190 |
$2.51M |
| 82306 |
|
84,603 |
83,288 |
$2.48M |
| 90723 |
|
36,387 |
34,832 |
$2.37M |
| 99215 |
Prolong outpt/office vis |
13,416 |
12,909 |
$2.29M |
| 83036 |
|
230,740 |
226,592 |
$2.23M |
| 80051 |
|
309,147 |
286,597 |
$2.16M |
| 99442 |
|
26,309 |
24,877 |
$2.13M |
| 76811 |
|
10,673 |
10,353 |
$2.03M |
| 80307 |
|
32,944 |
29,365 |
$1.94M |
| 92015 |
|
91,847 |
90,147 |
$1.75M |
| 83721 |
|
165,307 |
162,912 |
$1.72M |
| V2103 |
Spherocylindr 4.00d/12-2.00d |
32,855 |
29,251 |
$1.71M |
| 85027 |
|
265,059 |
254,453 |
$1.70M |
| 82565 |
|
333,368 |
305,225 |
$1.70M |
| 99394 |
|
13,350 |
13,048 |
$1.63M |
| 86803 |
|
115,668 |
113,257 |
$1.63M |
| 71046 |
|
43,322 |
42,507 |
$1.58M |
| 76816 |
|
11,941 |
10,772 |
$1.50M |
| 87661 |
|
43,172 |
41,594 |
$1.49M |
| 85025 |
|
187,455 |
168,478 |
$1.45M |
| 86780 |
|
107,780 |
104,842 |
$1.43M |
| 97110 |
|
24,536 |
17,379 |
$1.39M |
| 86480 |
|
28,366 |
27,849 |
$1.39M |
| 87880 |
|
83,294 |
80,809 |
$1.30M |
| 82947 |
|
330,283 |
305,668 |
$1.29M |
| 74177 |
|
3,640 |
3,577 |
$1.25M |
| 92012 |
|
13,790 |
13,326 |
$1.24M |
| 84520 |
|
315,924 |
290,477 |
$1.24M |
| 80076 |
|
152,351 |
142,977 |
$1.23M |
| 90648 |
|
55,309 |
53,138 |
$1.21M |
| 86008 |
|
10,286 |
9,969 |
$1.12M |
| 93000 |
|
68,873 |
65,806 |
$1.11M |
| 88142 |
|
53,595 |
53,002 |
$1.08M |
| 82274 |
|
64,842 |
63,988 |
$1.03M |
| 76830 |
|
7,688 |
7,573 |
$1.03M |
| 81229 |
|
883 |
859 |
$930K |
| 82728 |
|
68,442 |
66,028 |
$922K |
| 92551 |
|
62,446 |
61,602 |
$861K |
| 99204 |
|
4,696 |
4,615 |
$854K |
| 90633 |
|
28,417 |
28,044 |
$844K |
| 99202 |
|
9,926 |
9,685 |
$784K |
| 90681 |
|
11,530 |
11,026 |
$765K |
| 87506 |
|
2,831 |
2,764 |
$732K |
| 82607 |
|
47,702 |
46,933 |
$714K |
| 95800 |
|
4,666 |
4,569 |
$707K |
| 87340 |
|
67,602 |
65,971 |
$690K |
| 99205 |
Prolong outpt/office vis |
2,890 |
2,825 |
$681K |
| 99441 |
|
13,915 |
13,075 |
$653K |
| 99460 |
|
8,032 |
7,399 |
$646K |
| 83655 |
|
53,259 |
52,363 |
$643K |
| 81025 |
|
76,404 |
71,452 |
$634K |
| 99443 |
|
4,811 |
4,419 |
$603K |
| 87624 |
|
16,831 |
16,621 |
$584K |
| 82746 |
|
39,587 |
38,962 |
$577K |
| 90480 |
|
9,473 |
9,423 |
$569K |
| 87086 |
|
70,937 |
66,784 |
$568K |
| 76805 |
|
3,698 |
3,220 |
$566K |
| 83550 |
|
65,090 |
63,152 |
$563K |
| 90656 |
|
25,681 |
25,618 |
$550K |
| 99243 |
|
4,090 |
3,979 |
$538K |
| 82570 |
|
99,009 |
95,429 |
$515K |
| 87536 |
|
6,077 |
5,863 |
$500K |
| 77063 |
|
8,618 |
8,532 |
$494K |
| 82043 |
|
89,389 |
87,225 |
$490K |
| 84153 |
|
24,084 |
23,565 |
$439K |
| 87651 |
|
12,487 |
12,124 |
$436K |
| 76705 |
|
4,555 |
4,473 |
$432K |
| 99238 |
|
6,494 |
6,001 |
$430K |
| 83540 |
|
66,117 |
64,236 |
$425K |
| 93306 |
|
2,017 |
1,960 |
$409K |
| 80053 |
|
39,136 |
36,461 |
$409K |
| 84460 |
|
75,916 |
73,032 |
$400K |
| 84702 |
|
28,029 |
19,881 |
$398K |
| 0001A |
|
8,265 |
8,262 |
$379K |
| 86235 |
|
4,910 |
4,256 |
$367K |
| 76642 |
|
3,613 |
3,550 |
$364K |
| 0002A |
|
7,382 |
7,381 |
$347K |
| 98968 |
|
10,170 |
9,435 |
$344K |
| 90734 |
|
1,807 |
1,745 |
$338K |
| 76856 |
|
2,752 |
2,718 |
$337K |
| 87081 |
|
49,131 |
47,919 |
$327K |
| 84484 |
|
24,901 |
23,106 |
$322K |
| 83880 |
|
8,236 |
7,820 |
$316K |
| 81001 |
|
100,528 |
95,298 |
$316K |
| 91320 |
|
2,283 |
2,281 |
$313K |
| 87338 |
|
18,850 |
18,555 |
$309K |
| 84403 |
|
11,825 |
11,434 |
$301K |
| 83970 |
|
7,276 |
6,776 |
$298K |
| 83690 |
|
42,887 |
40,013 |
$293K |
| 86762 |
|
20,377 |
19,972 |
$274K |
| 82105 |
|
15,829 |
15,336 |
$260K |
| 88185 |
|
430 |
417 |
$253K |
| 73721 |
|
1,079 |
1,023 |
$252K |
| 99173 |
|
69,434 |
68,564 |
$244K |
| 86706 |
|
22,782 |
22,342 |
$239K |
| 81162 |
|
134 |
134 |
$237K |
| 82670 |
|
8,367 |
8,115 |
$228K |
| 70450 |
|
1,858 |
1,809 |
$221K |
| 83001 |
|
12,143 |
11,869 |
$221K |
| 84439 |
|
24,373 |
23,214 |
$218K |
| 90834 |
|
2,612 |
2,153 |
$213K |
| 86787 |
|
16,991 |
16,601 |
$206K |
| 86704 |
|
17,139 |
16,742 |
$205K |
| 83020 |
|
16,215 |
15,853 |
$205K |
| 72100 |
|
4,622 |
4,573 |
$204K |
| 90716 |
|
2,360 |
2,310 |
$194K |
| 92134 |
|
4,082 |
3,929 |
$186K |
| 87517 |
|
4,520 |
4,341 |
$184K |
| V2203 |
Lens sphcyl bifocal 4.00d/.1 |
2,320 |
2,136 |
$179K |
| 87522 |
Neg quan hep c or qual rna |
4,305 |
4,170 |
$177K |
| 84146 |
|
9,279 |
9,084 |
$177K |
| 80074 |
|
3,744 |
3,678 |
$176K |
| 81220 |
|
311 |
305 |
$173K |
| 90710 |
|
732 |
713 |
$173K |
| 87186 |
|
18,515 |
17,746 |
$170K |
| 97161 |
|
1,713 |
1,658 |
$169K |
| 83735 |
|
24,768 |
21,251 |
$166K |
| 86850 |
|
18,705 |
18,145 |
$164K |
| 99395 |
|
1,267 |
1,229 |
$162K |
| 93303 |
|
647 |
608 |
$160K |
| 86705 |
|
13,737 |
13,496 |
$160K |
| 80349 |
|
8,073 |
7,650 |
$158K |
| V2750 |
Anti-reflective coating |
5,371 |
4,765 |
$158K |
| 87901 |
|
622 |
610 |
$157K |
| 87077 |
|
18,265 |
17,500 |
$155K |
| 86038 |
|
12,903 |
12,588 |
$154K |
| 76801 |
|
1,190 |
1,151 |
$153K |
| 82784 |
|
11,824 |
11,202 |
$153K |
| 88262 |
|
1,249 |
1,206 |
$153K |
| 83002 |
|
8,338 |
8,099 |
$151K |
| 98967 |
|
6,045 |
5,672 |
$151K |
| 99245 |
|
586 |
571 |
$143K |
| 80306 |
|
8,431 |
7,847 |
$142K |
| 0004A |
|
3,047 |
3,040 |
$142K |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
11,443 |
11,254 |
$141K |
| 76770 |
|
1,235 |
1,188 |
$138K |
| 84450 |
|
26,795 |
25,498 |
$138K |
| 80050 |
|
13,699 |
10,797 |
$138K |
| 99239 |
|
1,417 |
1,350 |
$136K |
| 86140 |
|
26,349 |
25,008 |
$136K |
| 71271 |
|
842 |
836 |
$134K |
| 83605 |
|
11,581 |
10,077 |
$134K |
| 73630 |
|
3,384 |
3,211 |
$133K |
| 96112 |
|
1,013 |
1,004 |
$133K |
| 86003 |
|
7,225 |
6,485 |
$132K |
| 99211 |
|
5,504 |
5,231 |
$130K |
| 87040 |
|
8,118 |
7,607 |
$127K |
| 88230 |
|
1,208 |
1,170 |
$126K |
| 83516 |
|
10,258 |
10,001 |
$126K |
| 90381 |
|
246 |
246 |
$125K |
| 84270 |
|
5,857 |
5,640 |
$124K |
| 84703 |
|
16,629 |
16,027 |
$123K |
| 86361 |
|
4,654 |
4,545 |
$122K |
| 97140 |
|
3,724 |
2,634 |
$120K |
| 99396 |
|
883 |
880 |
$119K |
| 82627 |
|
5,405 |
5,301 |
$118K |
| 85610 |
|
27,517 |
22,386 |
$117K |
| 82248 |
|
23,503 |
19,947 |
$115K |
| 85379 |
|
12,482 |
12,144 |
$113K |
| 87070 |
|
13,040 |
12,677 |
$113K |
| 90707 |
|
2,253 |
2,225 |
$111K |
| 80048 |
|
13,165 |
12,518 |
$111K |
| 84402 |
|
4,394 |
4,320 |
$110K |
| 80348 |
|
4,193 |
3,819 |
$109K |
| 73564 |
|
1,884 |
1,809 |
$105K |
| 84425 |
|
5,483 |
5,376 |
$103K |
| 92002 |
|
1,049 |
1,041 |
$98K |
| 84207 |
|
3,523 |
3,470 |
$97K |
| 87255 |
|
2,834 |
2,765 |
$95K |
| 76818 |
|
619 |
458 |
$91K |
| 72040 |
|
2,091 |
2,055 |
$91K |
| 86710 |
|
6,433 |
6,268 |
$91K |
| 99242 |
|
942 |
916 |
$90K |
| 86160 |
|
3,922 |
3,738 |
$88K |
| 99244 |
|
462 |
434 |
$88K |
| 76536 |
|
714 |
705 |
$86K |
| 77080 |
|
2,044 |
2,027 |
$86K |
| 83498 |
|
3,129 |
3,072 |
$83K |
| 86146 |
|
1,286 |
1,254 |
$83K |
| 87653 |
|
2,397 |
2,311 |
$83K |
| 83718 |
|
9,734 |
9,460 |
$81K |
| 0124A |
|
2,235 |
2,230 |
$81K |
| 87493 |
|
2,216 |
2,150 |
$81K |
| 81381 |
|
508 |
495 |
$80K |
| 90651 |
|
5,076 |
4,943 |
$80K |
| 87900 |
|
621 |
609 |
$80K |
| 96413 |
|
565 |
423 |
$79K |
| 86696 |
|
4,045 |
3,947 |
$79K |
| 87563 |
|
2,002 |
1,963 |
$78K |
| 76817 |
|
785 |
721 |
$76K |
| 85652 |
|
27,585 |
26,426 |
$74K |
| 82550 |
|
11,200 |
10,342 |
$74K |
| 77066 |
Tomosynthesis, mammo |
424 |
421 |
$74K |
| 77065 |
Tomosynthesis, mammo |
524 |
504 |
$71K |
| 98966 |
|
5,185 |
4,767 |
$70K |
| 67028 |
|
525 |
477 |
$70K |
| 84165 |
|
4,049 |
3,824 |
$69K |
| 86225 |
|
5,058 |
4,857 |
$68K |
| 97535 |
|
1,921 |
1,651 |
$68K |
| 92133 |
|
1,704 |
1,692 |
$68K |
| 84445 |
|
1,620 |
1,583 |
$68K |
| 86769 |
|
1,432 |
1,402 |
$67K |
| 86376 |
|
4,641 |
4,542 |
$67K |
| 80324 |
|
3,004 |
2,701 |
$67K |
| 99462 |
|
1,846 |
1,543 |
$66K |
| 95806 |
|
735 |
703 |
$65K |
| 86735 |
|
4,959 |
4,868 |
$64K |
| 86618 |
|
3,788 |
3,698 |
$64K |
| 86765 |
|
5,107 |
5,013 |
$63K |
| 92227 |
|
3,959 |
3,699 |
$63K |
| 85730 |
|
10,787 |
9,799 |
$63K |
| 99201 |
|
1,373 |
1,265 |
$61K |
| 86147 |
|
1,367 |
1,334 |
$61K |
| 80365 |
|
2,855 |
2,597 |
$60K |
| 87625 |
|
1,485 |
1,468 |
$59K |
| 74176 |
|
275 |
272 |
$59K |
| 80354 |
|
2,985 |
2,860 |
$59K |
| 83520 |
|
3,148 |
3,034 |
$59K |
| 90647 |
|
1,921 |
1,901 |
$59K |
| 81206 |
|
404 |
382 |
$59K |
| 86200 |
|
4,576 |
4,500 |
$59K |
| 80356 |
|
2,667 |
2,559 |
$58K |
| 80359 |
|
2,836 |
2,736 |
$56K |
| 20610 |
|
586 |
561 |
$56K |
| 72148 |
|
250 |
237 |
$56K |
| 70551 |
|
243 |
241 |
$56K |
| 80373 |
|
2,704 |
2,599 |
$56K |
| 92507 |
|
625 |
446 |
$55K |
| 86695 |
|
4,034 |
3,938 |
$54K |
| 82652 |
|
1,412 |
1,391 |
$53K |
| 90853 |
|
1,915 |
906 |
$53K |
| 84100 |
|
10,617 |
9,662 |
$52K |
| 73610 |
|
1,233 |
1,206 |
$52K |
| 84550 |
|
11,345 |
10,720 |
$51K |
| 82247 |
|
10,464 |
6,879 |
$51K |
| 82465 |
|
11,444 |
11,107 |
$50K |
| 92567 |
|
3,007 |
2,948 |
$50K |
| 86900 |
|
16,804 |
16,197 |
$49K |
| 86901 |
|
16,800 |
16,191 |
$49K |
| 90696 |
|
570 |
559 |
$48K |
| 86800 |
|
3,078 |
2,972 |
$48K |
| 74018 |
|
1,486 |
1,465 |
$48K |
| 82951 |
|
3,742 |
3,620 |
$48K |
| 86431 |
|
8,427 |
8,262 |
$47K |
| V2100 |
Lens spher single plano 4.00 |
1,106 |
1,029 |
$47K |
| V2104 |
Spherocylindr 4.00d/2.12-4d |
979 |
888 |
$47K |
| 86708 |
|
3,763 |
3,695 |
$47K |
| 0071A |
|
1,622 |
1,621 |
$46K |
| 84630 |
|
4,153 |
4,079 |
$46K |
| 82533 |
|
2,744 |
2,626 |
$46K |
| 84480 |
|
3,239 |
3,095 |
$46K |
| 80069 |
|
5,289 |
4,652 |
$45K |
| 90474 |
|
3,326 |
3,201 |
$45K |
| 87177 |
|
5,548 |
5,410 |
$44K |
| 84156 |
|
12,186 |
10,800 |
$44K |
| 85014 |
|
18,725 |
18,095 |
$44K |
| 85018 |
|
18,609 |
17,987 |
$43K |
| 91318 |
|
677 |
665 |
$43K |
| 97530 |
|
1,012 |
774 |
$43K |
| 80361 |
|
2,139 |
1,988 |
$42K |
| 73110 |
|
931 |
879 |
$42K |
| 86334 |
|
1,757 |
1,679 |
$42K |
| 82310 |
|
7,479 |
6,647 |
$41K |
| 82378 |
|
2,220 |
1,805 |
$41K |
| 86304 |
|
1,976 |
1,810 |
$41K |
| 83993 |
|
2,086 |
2,043 |
$40K |
| 87210 |
|
7,068 |
6,881 |
$40K |
| V2784 |
Lens polycarb or equal |
2,946 |
2,673 |
$40K |
| 82157 |
|
1,335 |
1,311 |
$38K |
| 96374 |
|
926 |
876 |
$38K |
| 84144 |
|
1,908 |
1,711 |
$38K |
| 0072A |
|
1,338 |
1,336 |
$38K |
| 86039 |
|
3,403 |
3,305 |
$37K |
| 83883 |
|
1,448 |
1,216 |
$37K |
| 90700 |
|
1,692 |
1,663 |
$36K |
| 97803 |
|
666 |
601 |
$36K |
| 84590 |
|
3,312 |
3,243 |
$36K |
| 70553 |
|
92 |
92 |
$36K |
| 83615 |
|
6,016 |
5,396 |
$36K |
| 83921 |
|
1,741 |
1,711 |
$36K |
| 87808 |
|
2,374 |
2,305 |
$35K |
| 73221 |
|
153 |
146 |
$34K |
| 88184 |
|
426 |
415 |
$34K |
| 82977 |
|
4,772 |
4,310 |
$34K |
| 91319 |
|
385 |
385 |
$34K |
| 84132 |
|
7,144 |
6,227 |
$34K |
| 73030 |
|
844 |
811 |
$33K |
| 97802 |
|
491 |
458 |
$33K |
| 70360 |
|
983 |
966 |
$33K |
| 97162 |
|
345 |
331 |
$33K |
| 85045 |
|
8,038 |
7,230 |
$32K |
| 87905 |
|
2,621 |
2,542 |
$32K |
| 80323 |
|
1,994 |
1,965 |
$31K |
| 87205 |
|
7,102 |
6,746 |
$31K |
| 83090 |
|
1,733 |
1,701 |
$31K |
| 80197 |
|
2,242 |
1,454 |
$30K |
| 87046 |
|
3,354 |
3,184 |
$30K |
| V2025 |
Eyeglasses delux frames |
1,516 |
1,434 |
$30K |
| 87045 |
|
3,214 |
3,145 |
$30K |
| 87634 |
|
415 |
411 |
$28K |
| 84481 |
|
1,770 |
1,714 |
$28K |
| 82525 |
|
2,298 |
2,253 |
$28K |
| 73130 |
|
635 |
590 |
$28K |
| 82397 |
|
2,242 |
2,186 |
$28K |
| 82024 |
|
723 |
683 |
$27K |
| 90715 |
|
717 |
696 |
$27K |
| 82040 |
|
5,371 |
5,097 |
$26K |
| 86665 |
|
996 |
968 |
$26K |
| 90791 |
|
148 |
145 |
$25K |
| 88189 |
|
289 |
283 |
$25K |
| 99241 |
|
493 |
483 |
$24K |
| V2107 |
Spherocylinder 4.25d/12-2d |
551 |
492 |
$24K |
| 93304 |
|
150 |
147 |
$24K |
| 84252 |
|
1,401 |
1,380 |
$24K |
| 83630 |
|
1,284 |
1,265 |
$24K |
| 82150 |
|
3,474 |
3,367 |
$23K |
| 84154 |
|
1,269 |
1,217 |
$23K |
| 80346 |
|
1,013 |
969 |
$23K |
| 81257 |
|
221 |
220 |
$22K |
| 76815 |
|
236 |
208 |
$22K |
| 82542 |
|
928 |
834 |
$21K |
| 84182 |
|
178 |
160 |
$21K |
| 81243 |
|
369 |
354 |
$21K |
| A9585 |
Gadobutrol injection |
726 |
711 |
$20K |
| 11900 |
|
315 |
305 |
$20K |
| 85240 |
|
1,183 |
1,134 |
$20K |
| 86592 |
|
4,655 |
4,481 |
$20K |
| 84466 |
|
1,583 |
1,558 |
$19K |
| 84305 |
|
988 |
967 |
$19K |
| 72070 |
|
518 |
512 |
$19K |
| 86021 |
|
1,145 |
1,022 |
$18K |
| 87449 |
|
1,500 |
1,467 |
$18K |
| 96365 |
|
233 |
209 |
$18K |
| 84075 |
|
3,371 |
3,160 |
$17K |
| 84681 |
|
840 |
820 |
$17K |
| 74183 |
|
44 |
43 |
$17K |
| 86812 |
|
662 |
647 |
$17K |
| 87807 |
|
1,251 |
1,210 |
$17K |
| 83525 |
|
1,549 |
1,522 |
$17K |
| 81403 |
|
105 |
103 |
$17K |
| 82390 |
|
1,617 |
1,598 |
$17K |
| 84155 |
|
4,456 |
4,200 |
$16K |
| 87209 |
|
914 |
885 |
$16K |
| 85008 |
|
4,641 |
4,345 |
$16K |
| 81402 |
|
106 |
104 |
$16K |
| 87109 |
|
1,027 |
1,011 |
$15K |
| 93320 |
|
257 |
251 |
$15K |
| 87804 |
|
459 |
455 |
$15K |
| 99383 |
|
116 |
116 |
$15K |
| 0064A |
|
370 |
370 |
$15K |
| 0054A |
|
396 |
395 |
$15K |
| 82103 |
|
1,108 |
1,098 |
$15K |
| 82164 |
|
1,026 |
989 |
$15K |
| 92310 |
|
1,159 |
885 |
$14K |
| 90713 |
|
580 |
579 |
$14K |
| 86382 |
|
465 |
458 |
$14K |
| 85613 |
|
1,464 |
1,433 |
$14K |
| 81241 |
|
195 |
194 |
$14K |
| 82952 |
|
3,524 |
3,454 |
$14K |
| 90750 |
|
117 |
117 |
$14K |
| 85246 |
|
679 |
658 |
$13K |
| 88342 |
|
95 |
94 |
$13K |
| 87329 |
|
1,092 |
1,077 |
$13K |
| 81219 |
|
108 |
106 |
$13K |
| 0081A |
|
471 |
454 |
$13K |
| 87906 |
|
94 |
94 |
$13K |
| 85245 |
|
648 |
628 |
$13K |
| 82077 |
|
746 |
709 |
$13K |
| 86308 |
|
2,442 |
2,397 |
$12K |
| 80353 |
|
691 |
651 |
$12K |
| 78815 |
|
12 |
12 |
$12K |
| 84080 |
|
903 |
881 |
$12K |
| 93325 |
|
440 |
425 |
$12K |
| 82088 |
|
259 |
236 |
$12K |
| 90837 |
|
86 |
63 |
$11K |
| 87350 |
|
1,097 |
1,078 |
$11K |
| 97164 |
|
157 |
141 |
$11K |
| 86341 |
|
339 |
300 |
$11K |
| 81270 |
|
133 |
131 |
$11K |
| 87902 |
|
42 |
42 |
$11K |
| 87147 |
|
1,685 |
1,648 |
$11K |
| 96372 |
|
663 |
627 |
$11K |
| 97165 |
|
107 |
95 |
$11K |
| 86301 |
|
512 |
434 |
$11K |
| A9575 |
Inj gadoterate meglumi 0.1ml |
726 |
566 |
$10K |
| 87633 |
|
25 |
25 |
$10K |
| 94729 |
|
166 |
159 |
$10K |
| 86707 |
|
900 |
881 |
$10K |
| 96381 |
|
523 |
516 |
$10K |
| 86593 |
|
2,280 |
2,206 |
$10K |
| 86317 |
|
96 |
93 |
$10K |
| 87324 |
|
792 |
774 |
$9K |
| J7030 |
Normal saline solution infus |
1,935 |
1,532 |
$9K |
| 72197 |
|
26 |
26 |
$9K |
| 43239 |
|
24 |
24 |
$9K |
| 87641 |
|
259 |
254 |
$9K |
| 83519 |
|
244 |
237 |
$9K |
| 87341 |
|
847 |
811 |
$9K |
| 84432 |
|
541 |
505 |
$9K |
| A9552 |
F18 fdg |
27 |
26 |
$9K |
| 92557 |
|
213 |
210 |
$8K |
| V2200 |
Lens spher bifoc plano 4.00d |
144 |
135 |
$8K |
| Q5103 |
Injection, inflectra |
14 |
12 |
$8K |
| 87529 |
|
115 |
114 |
$8K |
| 81002 |
|
2,443 |
2,369 |
$8K |
| 88304 |
|
143 |
140 |
$8K |
| 71275 |
|
26 |
25 |
$8K |
| 93015 |
|
94 |
92 |
$8K |
| 90792 |
|
37 |
37 |
$8K |
| 83010 |
|
611 |
582 |
$8K |
| 84295 |
|
1,717 |
1,232 |
$7K |
| 92504 |
|
210 |
201 |
$7K |
| 90839 |
|
47 |
45 |
$7K |
| 87101 |
|
945 |
924 |
$7K |
| 71045 |
|
248 |
246 |
$7K |
| 70486 |
|
48 |
47 |
$7K |
| 90691 |
|
119 |
115 |
$7K |
| 88341 |
|
14 |
14 |
$7K |
| 92550 |
|
313 |
311 |
$7K |
| 90678 |
|
16 |
16 |
$7K |
| 86644 |
|
520 |
507 |
$7K |
| 88271 |
|
55 |
54 |
$7K |
| 87106 |
|
627 |
617 |
$7K |
| 92523 |
|
39 |
39 |
$6K |
| 82330 |
|
529 |
499 |
$6K |
| V2744 |
Tint photochromatic lens/es |
853 |
796 |
$6K |
| 72082 |
|
167 |
161 |
$6K |
| 96110 |
|
464 |
453 |
$6K |
| V2520 |
Contact lens hydrophilic |
716 |
360 |
$6K |
| 88312 |
|
28 |
28 |
$6K |
| 93224 |
|
78 |
78 |
$6K |
| 77061 |
|
43 |
43 |
$6K |
| 86335 |
|
194 |
177 |
$6K |
| 86141 |
|
444 |
431 |
$6K |
| 99232 |
|
71 |
38 |
$6K |
| 87149 |
|
85 |
76 |
$6K |
| 88173 |
|
24 |
24 |
$6K |
| 99385 |
|
37 |
37 |
$6K |
| 90380 |
|
12 |
12 |
$5K |
| 87593 |
|
61 |
46 |
$5K |
| 77072 |
|
197 |
193 |
$5K |
| 0154A |
|
184 |
128 |
$5K |
| 95816 |
|
13 |
12 |
$5K |
| 89320 |
|
370 |
354 |
$5K |
| 71260 |
|
27 |
26 |
$5K |
| 73502 |
|
88 |
83 |
$5K |
| 73080 |
|
127 |
123 |
$5K |
| 94726 |
|
80 |
78 |
$5K |
| 0082A |
|
170 |
162 |
$5K |
| 86663 |
|
360 |
349 |
$5K |
| 86702 |
|
347 |
320 |
$5K |
| 90632 |
|
103 |
103 |
$5K |
| 83021 |
|
256 |
243 |
$4K |
| 99231 |
|
117 |
65 |
$4K |
| 00920 |
|
29 |
29 |
$4K |
| 76885 |
|
31 |
28 |
$4K |
| 81240 |
|
69 |
68 |
$4K |
| 81050 |
|
897 |
734 |
$4K |
| 87075 |
|
395 |
387 |
$4K |
| V2105 |
Spherocylinder 4.00d/4.25-6d |
82 |
78 |
$4K |
| V2108 |
Spherocylinder 4.25d/2.12-4d |
100 |
89 |
$4K |
| 94010 |
|
130 |
126 |
$4K |
| J7999 |
Compounded drug, noc |
212 |
212 |
$4K |
| 82955 |
|
397 |
391 |
$4K |
| 80178 |
|
570 |
539 |
$4K |
| 80164 |
|
280 |
264 |
$4K |
| 0052A |
|
110 |
110 |
$4K |
| 76820 |
|
60 |
48 |
$4K |
| J3301 |
Triamcinolone acet inj nos |
644 |
622 |
$4K |
| 95004 |
|
53 |
48 |
$4K |
| 86709 |
|
315 |
311 |
$3K |
| 85303 |
|
261 |
252 |
$3K |
| 72141 |
|
14 |
14 |
$3K |
| 71250 |
|
24 |
24 |
$3K |
| 85660 |
|
627 |
613 |
$3K |
| 84244 |
|
156 |
146 |
$3K |
| 88188 |
|
54 |
52 |
$3K |
| 54150 |
|
19 |
12 |
$3K |
| 82656 |
|
279 |
275 |
$3K |
| 94060 |
|
69 |
67 |
$3K |
| 0051A |
|
97 |
97 |
$3K |
| 84436 |
|
452 |
428 |
$3K |
| 86617 |
|
99 |
96 |
$3K |
| 86255 |
|
105 |
103 |
$3K |
| 86645 |
|
217 |
211 |
$3K |
| 86701 |
|
338 |
309 |
$3K |
| 81279 |
|
16 |
16 |
$3K |
| 81339 |
|
16 |
16 |
$3K |
| 73140 |
|
64 |
64 |
$3K |
| 85306 |
|
184 |
178 |
$3K |
| 82085 |
|
284 |
272 |
$3K |
| 99417 |
Prolong home eval add 15m |
41 |
40 |
$3K |
| 99223 |
Prolong inpt eval add15 m |
14 |
12 |
$3K |
| 87581 |
|
71 |
71 |
$2K |
| 86300 |
|
140 |
105 |
$2K |
| 85300 |
|
218 |
209 |
$2K |
| J1050 |
Medroxyprogesterone acetate |
36 |
36 |
$2K |
| 87426 |
|
49 |
49 |
$2K |
| 64615 |
|
13 |
13 |
$2K |
| 80047 |
|
197 |
185 |
$2K |
| 87798 |
|
114 |
113 |
$2K |
| 93971 |
|
17 |
16 |
$2K |
| 99386 |
|
12 |
12 |
$2K |
| 0074A |
|
69 |
69 |
$2K |
| 0011A |
|
49 |
49 |
$2K |
| 0111A |
|
70 |
70 |
$2K |
| 86162 |
|
104 |
102 |
$2K |
| 90746 |
|
42 |
42 |
$2K |
| 97799 |
|
97 |
79 |
$2K |
| 87799 |
|
57 |
50 |
$2K |
| 99384 |
|
12 |
12 |
$2K |
| 91321 |
|
12 |
12 |
$2K |
| 85004 |
|
261 |
251 |
$2K |
| 73521 |
|
37 |
36 |
$2K |
| 76882 |
|
28 |
28 |
$1K |
| 86340 |
|
124 |
119 |
$1K |
| 81207 |
|
13 |
13 |
$1K |
| 86777 |
|
117 |
116 |
$1K |
| 89051 |
|
240 |
223 |
$1K |
| 90674 |
|
58 |
58 |
$1K |
| 96375 |
|
52 |
51 |
$1K |
| 77062 |
|
12 |
12 |
$1K |
| 90685 |
|
62 |
62 |
$1K |
| 95125 |
|
211 |
88 |
$1K |
| 84478 |
|
224 |
192 |
$1K |
| 99222 |
|
13 |
12 |
$1K |
| 83521 |
|
97 |
86 |
$1K |
| 59025 |
|
22 |
13 |
$1K |
| 99221 |
|
13 |
13 |
$1K |
| 92587 |
|
43 |
42 |
$969.92 |
| 92570 |
|
25 |
24 |
$952.23 |
| 86355 |
|
25 |
25 |
$943.25 |
| 82668 |
|
56 |
56 |
$892.21 |
| 97750 |
|
25 |
25 |
$880.10 |
| 0003A |
|
19 |
19 |
$847.80 |
| 96900 |
|
37 |
13 |
$806.99 |
| 81256 |
|
12 |
12 |
$784.32 |
| 89240 |
|
535 |
390 |
$763.35 |
| J1885 |
Ketorolac tromethamine inj |
781 |
735 |
$757.61 |
| 36416 |
|
746 |
404 |
$749.57 |
| 88300 |
|
38 |
38 |
$738.53 |
| 97112 |
|
19 |
13 |
$706.18 |
| V2204 |
Lens sphcy bifocal 4.00d/2.1 |
14 |
13 |
$704.00 |
| 73562 |
|
13 |
13 |
$703.57 |
| 93296 |
|
28 |
28 |
$703.00 |
| 87497 |
|
17 |
14 |
$678.03 |
| 92025 |
|
15 |
15 |
$638.55 |
| 97014 |
|
49 |
28 |
$627.44 |
| 90717 |
|
15 |
15 |
$611.62 |
| 87535 |
|
18 |
14 |
$596.53 |
| 86870 |
|
110 |
100 |
$595.50 |
| 82104 |
|
49 |
49 |
$589.26 |
| 82610 |
|
33 |
32 |
$571.56 |
| 85305 |
|
52 |
51 |
$568.89 |
| 86325 |
|
13 |
13 |
$567.18 |
| 86360 |
|
12 |
12 |
$563.76 |
| 86922 |
|
61 |
51 |
$562.98 |
| V2111 |
Spherocylindr 7.25d/.25-2.25 |
14 |
12 |
$560.00 |
| 92579 |
|
14 |
14 |
$555.51 |
| 86920 |
|
60 |
51 |
$538.90 |
| 92552 |
|
12 |
12 |
$523.32 |
| 84300 |
|
100 |
95 |
$495.88 |
| 80230 |
|
14 |
14 |
$493.68 |
| 82140 |
|
33 |
27 |
$480.81 |
| 83835 |
|
28 |
27 |
$474.32 |
| 73560 |
|
13 |
13 |
$471.67 |
| 87486 |
|
13 |
13 |
$456.17 |
| 92250 |
|
14 |
12 |
$455.89 |
| 86359 |
|
12 |
12 |
$452.76 |
| 85049 |
|
102 |
93 |
$452.48 |
| 85384 |
|
62 |
55 |
$425.82 |
| 86880 |
|
55 |
52 |
$411.48 |
| 82785 |
|
24 |
24 |
$395.04 |
| 0112A |
|
14 |
14 |
$392.42 |
| 73090 |
|
13 |
12 |
$392.31 |
| 92555 |
|
12 |
12 |
$385.20 |
| 80177 |
|
29 |
28 |
$371.00 |
| V2745 |
Tint, any color/solid/grad |
26 |
26 |
$365.22 |
| 0083A |
|
12 |
12 |
$336.36 |
| 86664 |
|
27 |
25 |
$330.55 |
| 86750 |
|
26 |
26 |
$315.01 |
| 82365 |
|
27 |
27 |
$305.73 |
| 83789 |
|
12 |
12 |
$289.32 |
| 82945 |
|
69 |
67 |
$275.10 |
| 87207 |
|
41 |
39 |
$255.63 |
| J0702 |
Betamethasone acet&sod phosp |
14 |
14 |
$231.42 |
| 82530 |
|
14 |
12 |
$227.23 |
| 87184 |
|
13 |
13 |
$221.26 |
| 86336 |
|
13 |
12 |
$202.67 |
| 87015 |
|
26 |
25 |
$196.32 |
| 85670 |
|
39 |
38 |
$188.82 |
| V2783 |
Lens, >= 1.66 p/>=1.80 g |
115 |
105 |
$176.50 |
| 80183 |
|
13 |
13 |
$172.25 |
| 86682 |
|
12 |
12 |
$169.13 |
| 83825 |
|
12 |
12 |
$133.02 |
| 84157 |
|
30 |
28 |
$132.00 |
| J0696 |
Ceftriaxone sodium injection |
34 |
28 |
$82.80 |
| J2270 |
Morphine sulfate injection |
13 |
12 |
$75.82 |
| 83935 |
|
12 |
12 |
$67.11 |
| J3490 |
Drugs unclassified injection |
41 |
39 |
$58.30 |
| 84133 |
|
12 |
12 |
$56.76 |
| J1100 |
Dexamethasone sodium phos |
39 |
38 |
$42.83 |
| 81003 |
|
13 |
12 |
$36.01 |
| V2799 |
Misc vision item or service |
964 |
867 |
$30.00 |
| J7613 |
Albuterol non-comp unit |
125 |
122 |
$21.61 |
| J2405 |
Ondansetron hcl injection |
42 |
41 |
$14.58 |
| 80358 |
|
20 |
16 |
$8.78 |
| J7611 |
Albuterol non-comp con |
12 |
12 |
$3.00 |
| J7620 |
Albuterol ipratrop non-comp |
13 |
13 |
$1.82 |
| 91307 |
|
6,507 |
5,767 |
$0.00 |
| 99024 |
|
853 |
742 |
$0.00 |
| 91305 |
|
1,635 |
1,608 |
$0.00 |
| V2781 |
Progressive lens per lens |
633 |
568 |
$0.00 |
| 91301 |
|
52 |
52 |
$0.00 |
| 0500F |
|
52 |
51 |
$0.00 |
| 91306 |
|
376 |
376 |
$0.00 |
| 91315 |
|
236 |
154 |
$0.00 |
| J1010 |
Inj, methylpred acetate 1 mg |
20 |
13 |
$0.00 |
| 91303 |
|
36 |
36 |
$0.00 |
| 0503F |
|
12 |
12 |
$0.00 |
| 97804 |
|
12 |
12 |
$0.00 |
| 91317 |
|
40 |
40 |
$0.00 |
| G1004 |
Cdsm ndsc |
32,557 |
30,109 |
$0.00 |
| 0502F |
|
45,817 |
34,318 |
$0.00 |
| 91300 |
|
28,678 |
25,571 |
$0.00 |
| 91312 |
|
2,448 |
2,444 |
$0.00 |
| 91308 |
|
2,397 |
2,237 |
$0.00 |
| 91311 |
|
207 |
207 |
$0.00 |
| 99446 |
|
24 |
24 |
$0.00 |
| 0034A |
|
18 |
18 |
$0.00 |