| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
|
96,049 |
90,302 |
$8.41M |
| G9005 |
Mccd, risk adj, maintenance |
15,017 |
15,012 |
$5.27M |
| H0040 |
Assert comm tx pgm per diem |
2,510 |
2,509 |
$4.50M |
| 99214 |
|
43,285 |
39,907 |
$3.88M |
| H0020 |
Alcohol and/or drug services |
134,584 |
8,592 |
$3.63M |
| 90832 |
|
39,095 |
27,866 |
$3.26M |
| 99212 |
|
25,655 |
21,841 |
$2.44M |
| 90834 |
|
22,124 |
15,694 |
$2.41M |
| T2022 |
Case management, per month |
4,826 |
4,825 |
$1.89M |
| H2016 |
Comp comm supp svc, per diem |
2,720 |
2,717 |
$1.89M |
| G2067 |
Med assist tx meth wk |
9,407 |
2,992 |
$1.85M |
| 99283 |
|
14,566 |
14,023 |
$1.74M |
| 99284 |
|
12,891 |
12,172 |
$1.57M |
| H2019 |
Ther behav svc, per 15 min |
2,428 |
2,428 |
$1.52M |
| G0396 |
Alcohol/subs interv 15-30mn |
12,752 |
8,272 |
$1.18M |
| H0005 |
Alcohol and/or drug services |
19,397 |
3,997 |
$1.04M |
| 99285 |
|
8,274 |
7,844 |
$972K |
| S9480 |
Intensive outpatient psychia |
9,613 |
3,171 |
$955K |
| 90791 |
|
5,522 |
5,205 |
$892K |
| 96361 |
|
4,331 |
3,832 |
$868K |
| 90853 |
|
13,829 |
2,321 |
$717K |
| U0002 |
Covid-19 lab test non-cdc |
19,113 |
16,409 |
$714K |
| 74177 |
|
2,720 |
2,657 |
$678K |
| 80053 |
|
36,246 |
32,946 |
$650K |
| 99203 |
|
6,012 |
5,949 |
$596K |
| G0397 |
Alcohol/subs interv >30 min |
4,635 |
3,431 |
$578K |
| 70450 |
|
1,935 |
1,902 |
$525K |
| T1015 |
Clinic service |
1,735 |
1,735 |
$448K |
| 99392 |
|
4,922 |
4,891 |
$410K |
| 99215 |
Prolong outpt/office vis |
3,848 |
3,756 |
$390K |
| 74176 |
|
1,454 |
1,433 |
$389K |
| H2011 |
Crisis interven svc, 15 min |
2,477 |
1,867 |
$385K |
| 99395 |
|
3,739 |
3,709 |
$376K |
| 87637 |
|
5,180 |
4,925 |
$375K |
| 99204 |
|
3,410 |
3,363 |
$372K |
| 99391 |
|
4,407 |
3,980 |
$370K |
| 43239 |
|
622 |
618 |
$316K |
| 99396 |
|
3,055 |
3,034 |
$309K |
| G0463 |
Hospital outpt clinic visit |
9,479 |
8,017 |
$298K |
| 99393 |
|
3,216 |
3,211 |
$277K |
| 90792 |
|
1,441 |
1,418 |
$270K |
| H0001 |
Alcohol and/or drug assess |
1,802 |
1,772 |
$255K |
| H0004 |
Alcohol and/or drug services |
5,125 |
4,339 |
$236K |
| 99282 |
|
2,026 |
2,007 |
$235K |
| 90837 |
|
1,903 |
1,454 |
$208K |
| 96360 |
|
1,370 |
1,230 |
$205K |
| 99394 |
|
2,140 |
2,133 |
$199K |
| 87491 |
|
5,999 |
5,894 |
$192K |
| 82306 |
|
6,397 |
6,345 |
$192K |
| 96372 |
|
15,149 |
11,694 |
$175K |
| 71275 |
|
619 |
610 |
$169K |
| J2426 |
Inj, invega sustenna, 1 mg |
165 |
149 |
$163K |
| 97530 |
|
3,698 |
1,116 |
$161K |
| 77067 |
|
2,637 |
2,630 |
$157K |
| J0401 |
Inj, abilify maintena, 1 mg |
204 |
189 |
$149K |
| 59025 |
|
2,092 |
1,242 |
$147K |
| 12001 |
|
397 |
394 |
$146K |
| 96365 |
|
1,480 |
1,139 |
$143K |
| 76700 |
|
894 |
890 |
$142K |
| 90846 |
|
1,415 |
1,239 |
$134K |
| 99281 |
|
1,016 |
1,005 |
$122K |
| 99202 |
|
1,194 |
1,191 |
$119K |
| 87591 |
|
5,916 |
5,815 |
$116K |
| 97110 |
|
1,774 |
550 |
$105K |
| 96110 |
|
861 |
842 |
$101K |
| 96156 |
|
745 |
741 |
$98K |
| 80061 |
|
12,809 |
12,653 |
$97K |
| 93306 |
|
536 |
533 |
$88K |
| H0038 |
Self-help/peer svc per 15min |
1,037 |
544 |
$88K |
| 87502 |
|
2,030 |
2,005 |
$87K |
| 86850 |
|
3,203 |
3,045 |
$87K |
| 84443 |
|
12,999 |
12,745 |
$85K |
| 76817 |
|
989 |
870 |
$80K |
| 76830 |
|
1,644 |
1,622 |
$78K |
| 88305 |
|
2,146 |
2,117 |
$75K |
| S9083 |
Urgent care center global |
364 |
356 |
$73K |
| H2018 |
Psysoc rehab svc, per diem |
194 |
194 |
$73K |
| 85025 |
|
41,452 |
36,920 |
$73K |
| 76705 |
|
1,846 |
1,816 |
$72K |
| 99000 |
|
8,120 |
7,846 |
$70K |
| 69436 |
|
55 |
55 |
$68K |
| 99385 |
|
659 |
657 |
$67K |
| 88142 |
|
2,411 |
2,406 |
$66K |
| 76856 |
|
270 |
268 |
$66K |
| 45385 |
|
90 |
90 |
$60K |
| 93971 |
|
1,028 |
993 |
$58K |
| 96160 |
|
1,805 |
1,791 |
$55K |
| 86901 |
|
3,212 |
3,058 |
$54K |
| 36415 |
|
23,721 |
21,343 |
$52K |
| 90715 |
|
2,353 |
2,337 |
$49K |
| 71046 |
|
10,534 |
10,313 |
$49K |
| 83655 |
|
3,621 |
3,596 |
$48K |
| 83036 |
|
6,956 |
6,877 |
$48K |
| 90686 |
|
3,729 |
3,715 |
$47K |
| 77063 |
|
2,588 |
2,581 |
$47K |
| 80048 |
|
3,883 |
3,458 |
$45K |
| 86900 |
|
3,211 |
3,057 |
$44K |
| 87624 |
|
1,366 |
1,363 |
$44K |
| 84439 |
|
7,247 |
7,127 |
$44K |
| 97161 |
|
578 |
573 |
$44K |
| 81025 |
|
11,947 |
11,312 |
$40K |
| 76770 |
|
233 |
232 |
$39K |
| 80307 |
|
2,306 |
2,070 |
$39K |
| 76805 |
|
837 |
835 |
$35K |
| 45380 |
|
66 |
66 |
$33K |
| 88342 |
|
849 |
837 |
$30K |
| J1631 |
Haloperidol decanoate inj |
1,188 |
764 |
$29K |
| 87086 |
|
11,172 |
10,622 |
$29K |
| 83880 |
|
962 |
923 |
$29K |
| 70553 |
|
74 |
73 |
$27K |
| G0378 |
Hospital observation per hr |
553 |
457 |
$27K |
| 82607 |
|
2,857 |
2,825 |
$27K |
| 87081 |
|
12,019 |
11,659 |
$26K |
| 90460 |
|
4,810 |
4,758 |
$25K |
| 82728 |
|
2,597 |
2,520 |
$25K |
| 90670 |
|
1,962 |
1,956 |
$23K |
| 76536 |
|
749 |
748 |
$22K |
| 70486 |
|
225 |
224 |
$22K |
| 93005 |
|
12,610 |
11,393 |
$22K |
| J1050 |
Medroxyprogesterone acetate |
654 |
653 |
$21K |
| 71250 |
|
218 |
218 |
$21K |
| 76816 |
|
1,121 |
1,101 |
$21K |
| 90471 |
|
5,764 |
4,370 |
$19K |
| 87389 |
|
1,947 |
1,934 |
$19K |
| 82746 |
|
1,907 |
1,887 |
$18K |
| G0101 |
Ca screen;pelvic/breast exam |
3,014 |
3,010 |
$17K |
| J2680 |
Fluphenazine decanoate 25 mg |
1,792 |
950 |
$17K |
| 90674 |
|
860 |
857 |
$17K |
| 84153 |
|
1,191 |
1,166 |
$16K |
| 64615 |
|
38 |
38 |
$14K |
| 99211 |
|
906 |
798 |
$14K |
| 87800 |
|
374 |
371 |
$14K |
| 85610 |
|
5,446 |
4,771 |
$13K |
| 99386 |
|
127 |
127 |
$13K |
| 99205 |
Prolong outpt/office vis |
125 |
125 |
$13K |
| 83540 |
|
3,151 |
3,106 |
$12K |
| 94010 |
|
150 |
149 |
$12K |
| 87661 |
|
588 |
576 |
$12K |
| 84702 |
|
2,062 |
1,691 |
$12K |
| 81001 |
|
10,394 |
9,848 |
$12K |
| 99232 |
|
491 |
206 |
$11K |
| 90651 |
|
412 |
410 |
$11K |
| G9001 |
Mccd, initial rate |
140 |
140 |
$11K |
| 51798 |
|
38 |
38 |
$10K |
| H0046 |
Mental health service, nos |
140 |
138 |
$10K |
| 81220 |
|
41 |
40 |
$10K |
| 90680 |
|
1,622 |
1,617 |
$10K |
| 99442 |
|
191 |
180 |
$10K |
| J0585 |
Injection,onabotulinumtoxina |
36 |
25 |
$10K |
| 86762 |
|
1,361 |
1,348 |
$9K |
| 86803 |
|
1,602 |
1,592 |
$9K |
| 87481 |
|
272 |
271 |
$9K |
| 72110 |
|
699 |
697 |
$9K |
| 85027 |
|
3,406 |
3,328 |
$9K |
| 82043 |
|
2,344 |
2,303 |
$9K |
| H0002 |
Alcohol and/or drug screenin |
60 |
60 |
$8K |
| 99173 |
|
182 |
180 |
$8K |
| 88304 |
|
317 |
317 |
$8K |
| 99381 |
|
74 |
74 |
$7K |
| 81003 |
|
9,923 |
9,555 |
$7K |
| 80306 |
|
4,421 |
4,184 |
$7K |
| 73562 |
|
1,690 |
1,677 |
$7K |
| 99406 |
|
1,489 |
1,410 |
$7K |
| 76642 |
|
267 |
267 |
$7K |
| 80076 |
|
890 |
865 |
$7K |
| 86618 |
|
505 |
504 |
$7K |
| 73630 |
|
2,122 |
2,094 |
$7K |
| 90472 |
|
1,498 |
963 |
$7K |
| 85730 |
|
4,256 |
4,089 |
$7K |
| 83735 |
|
5,130 |
4,253 |
$6K |
| 90698 |
|
1,955 |
1,949 |
$6K |
| 87186 |
|
2,733 |
2,662 |
$6K |
| 99222 |
|
132 |
126 |
$6K |
| 86038 |
|
1,356 |
1,323 |
$6K |
| 99239 |
|
142 |
138 |
$6K |
| 73030 |
|
1,362 |
1,330 |
$6K |
| 87798 |
|
44 |
43 |
$6K |
| 96374 |
|
8,071 |
7,372 |
$5K |
| 82784 |
|
519 |
453 |
$5K |
| 99383 |
|
50 |
50 |
$5K |
| 74019 |
|
938 |
930 |
$5K |
| 90744 |
|
1,219 |
1,218 |
$5K |
| A9585 |
Gadobutrol injection |
555 |
544 |
$5K |
| 71271 |
|
202 |
201 |
$5K |
| 73610 |
|
1,928 |
1,907 |
$5K |
| 86140 |
|
1,558 |
1,505 |
$5K |
| 99231 |
|
359 |
122 |
$5K |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
4,350 |
4,232 |
$5K |
| 93970 |
|
12 |
12 |
$5K |
| 90633 |
|
1,392 |
1,387 |
$5K |
| 86617 |
|
241 |
202 |
$5K |
| 87077 |
|
1,549 |
1,509 |
$5K |
| 99238 |
|
141 |
138 |
$5K |
| 87340 |
|
1,205 |
1,197 |
$5K |
| 96366 |
|
44 |
36 |
$5K |
| 12002 |
|
12 |
12 |
$5K |
| 85652 |
|
2,919 |
2,831 |
$5K |
| 73721 |
|
13 |
12 |
$4K |
| 76641 |
|
144 |
143 |
$4K |
| 72148 |
|
12 |
12 |
$4K |
| 72100 |
|
623 |
618 |
$4K |
| 76815 |
|
141 |
131 |
$4K |
| J3490 |
Drugs unclassified injection |
164 |
157 |
$4K |
| 84403 |
|
189 |
188 |
$4K |
| 72125 |
|
141 |
137 |
$4K |
| 70551 |
|
12 |
12 |
$4K |
| 11721 |
|
74 |
58 |
$4K |
| 82950 |
|
743 |
738 |
$4K |
| 86787 |
|
1,073 |
1,060 |
$4K |
| 99051 |
|
329 |
225 |
$4K |
| 73130 |
|
1,341 |
1,323 |
$4K |
| 82248 |
|
1,709 |
1,621 |
$4K |
| 80069 |
|
439 |
403 |
$4K |
| 83690 |
|
5,475 |
5,123 |
$4K |
| 96161 |
|
97 |
96 |
$4K |
| 90734 |
|
839 |
836 |
$3K |
| 96375 |
|
5,066 |
4,582 |
$3K |
| 87088 |
|
1,440 |
1,414 |
$3K |
| 90620 |
|
341 |
340 |
$3K |
| 76775 |
|
84 |
82 |
$3K |
| 90716 |
|
225 |
220 |
$3K |
| 82570 |
|
780 |
770 |
$3K |
| 86769 |
|
94 |
92 |
$3K |
| 99443 |
|
44 |
43 |
$3K |
| 86592 |
|
1,611 |
1,601 |
$3K |
| 0012A |
|
130 |
130 |
$3K |
| 0241U |
|
1,109 |
1,077 |
$3K |
| 87635 |
|
55 |
54 |
$3K |
| 84484 |
|
6,265 |
4,811 |
$3K |
| 96150 |
|
217 |
215 |
$3K |
| 73110 |
|
1,088 |
1,072 |
$3K |
| 84550 |
|
715 |
688 |
$3K |
| 99460 |
|
39 |
39 |
$3K |
| G0506 |
Comp asses care plan ccm svc |
14 |
14 |
$3K |
| 84436 |
|
696 |
686 |
$3K |
| 82150 |
|
1,818 |
1,768 |
$2K |
| 86003 |
|
42 |
37 |
$2K |
| 86430 |
|
569 |
564 |
$2K |
| 74018 |
|
742 |
725 |
$2K |
| G0008 |
Admin influenza virus vac |
199 |
197 |
$2K |
| 85379 |
|
1,561 |
1,509 |
$2K |
| 87205 |
|
1,182 |
1,079 |
$2K |
| 87880 |
|
8,128 |
7,979 |
$2K |
| 71260 |
|
12 |
12 |
$2K |
| 0011A |
|
123 |
123 |
$2K |
| 71045 |
|
3,451 |
3,320 |
$2K |
| 83970 |
|
44 |
44 |
$2K |
| 90707 |
|
246 |
246 |
$2K |
| 96413 |
|
41 |
24 |
$2K |
| 90656 |
|
177 |
177 |
$2K |
| 77065 |
Tomosynthesis, mammo |
26 |
26 |
$2K |
| 77066 |
Tomosynthesis, mammo |
24 |
24 |
$2K |
| 86480 |
|
33 |
33 |
$2K |
| 87522 |
Neg quan hep c or qual rna |
41 |
39 |
$2K |
| 86141 |
|
248 |
234 |
$2K |
| 99384 |
|
13 |
13 |
$1K |
| H2010 |
Comprehensive med svc 15 min |
20 |
20 |
$1K |
| 77080 |
|
24 |
24 |
$1K |
| 73502 |
|
361 |
345 |
$1K |
| 69210 |
|
12 |
12 |
$1K |
| 90710 |
|
520 |
520 |
$1K |
| 84481 |
|
115 |
112 |
$1K |
| 84480 |
|
305 |
294 |
$1K |
| 81513 |
|
300 |
299 |
$1K |
| 73140 |
|
629 |
622 |
$927.21 |
| 94640 |
|
411 |
336 |
$921.17 |
| 87040 |
|
1,604 |
1,053 |
$901.46 |
| 83605 |
|
1,614 |
1,408 |
$890.43 |
| 90696 |
|
315 |
314 |
$868.43 |
| 82550 |
|
793 |
694 |
$853.26 |
| 94760 |
|
8,030 |
7,605 |
$812.12 |
| 84681 |
|
40 |
39 |
$805.35 |
| 99459 |
|
37 |
37 |
$794.76 |
| 90661 |
|
29 |
29 |
$783.72 |
| 84703 |
|
1,233 |
1,204 |
$758.22 |
| 96376 |
|
547 |
516 |
$724.12 |
| 82308 |
|
27 |
27 |
$723.33 |
| 81002 |
|
3,423 |
3,357 |
$687.13 |
| 90474 |
|
286 |
166 |
$680.00 |
| 86308 |
|
215 |
213 |
$636.48 |
| 85007 |
|
595 |
576 |
$607.87 |
| 82627 |
|
27 |
27 |
$600.21 |
| 70360 |
|
93 |
92 |
$592.86 |
| 87147 |
|
2,222 |
2,184 |
$575.55 |
| 72070 |
|
66 |
65 |
$575.26 |
| G0009 |
Admin pneumococcal vaccine |
46 |
46 |
$494.32 |
| 90671 |
|
441 |
441 |
$458.76 |
| 99221 |
|
13 |
13 |
$453.70 |
| 85014 |
|
485 |
480 |
$437.69 |
| 90733 |
|
49 |
48 |
$410.55 |
| 86580 |
|
86 |
83 |
$398.15 |
| 86376 |
|
39 |
38 |
$388.85 |
| 84154 |
|
26 |
25 |
$386.19 |
| 84402 |
|
15 |
15 |
$382.05 |
| 87660 |
|
129 |
126 |
$368.15 |
| 87801 |
|
12 |
12 |
$360.95 |
| 73080 |
|
116 |
112 |
$359.26 |
| 85018 |
|
426 |
422 |
$356.98 |
| J7030 |
Normal saline solution infus |
3,146 |
2,767 |
$354.35 |
| 86765 |
|
28 |
28 |
$347.76 |
| 95806 |
|
13 |
13 |
$319.00 |
| 86709 |
|
37 |
37 |
$310.00 |
| J7040 |
Normal saline solution infus |
3,790 |
3,478 |
$309.58 |
| J2405 |
Ondansetron hcl injection |
5,420 |
4,899 |
$275.24 |
| 87807 |
|
180 |
178 |
$266.10 |
| 86735 |
|
37 |
37 |
$264.99 |
| 87468 |
|
12 |
12 |
$258.69 |
| 99441 |
|
13 |
13 |
$254.44 |
| G2211 |
Complex e/m visit add on |
16 |
16 |
$238.35 |
| 82553 |
|
558 |
474 |
$223.18 |
| 86665 |
|
22 |
12 |
$219.80 |
| 84100 |
|
105 |
97 |
$211.59 |
| 72050 |
|
24 |
24 |
$208.00 |
| 87045 |
|
36 |
36 |
$203.75 |
| 87510 |
|
108 |
105 |
$197.21 |
| 87480 |
|
108 |
105 |
$197.21 |
| 86160 |
|
12 |
12 |
$194.04 |
| 71101 |
|
147 |
145 |
$189.65 |
| 87484 |
|
13 |
13 |
$183.47 |
| 90662 |
|
133 |
133 |
$173.35 |
| J1885 |
Ketorolac tromethamine inj |
6,760 |
6,349 |
$157.93 |
| Q0091 |
Obtaining screen pap smear |
1,843 |
1,837 |
$157.40 |
| J2704 |
Inj, propofol, 10 mg |
4,042 |
3,963 |
$155.99 |
| 83001 |
|
12 |
12 |
$152.54 |
| 83529 |
|
14 |
14 |
$146.44 |
| 87478 |
|
12 |
12 |
$140.19 |
| 87469 |
|
12 |
12 |
$140.19 |
| C9399 |
Unclassified drugs or biolog |
14 |
14 |
$134.70 |
| J0696 |
Ceftriaxone sodium injection |
1,359 |
1,157 |
$132.34 |
| 90677 |
|
20 |
20 |
$122.60 |
| 87328 |
|
12 |
12 |
$118.40 |
| 87329 |
|
12 |
12 |
$118.40 |
| 86800 |
|
13 |
12 |
$117.94 |
| J0780 |
Prochlorperazine injection |
593 |
576 |
$114.46 |
| 86664 |
|
12 |
12 |
$107.33 |
| 73620 |
|
40 |
40 |
$106.00 |
| J1100 |
Dexamethasone sodium phos |
4,166 |
3,806 |
$102.00 |
| 86705 |
|
13 |
13 |
$101.00 |
| 87046 |
|
24 |
24 |
$100.30 |
| 86663 |
|
12 |
12 |
$97.69 |
| 82105 |
|
16 |
16 |
$97.50 |
| 84146 |
|
12 |
12 |
$96.90 |
| 72081 |
|
12 |
12 |
$93.74 |
| 82140 |
|
25 |
15 |
$87.42 |
| 73090 |
|
71 |
66 |
$82.80 |
| 83615 |
|
31 |
26 |
$80.89 |
| 83874 |
|
541 |
466 |
$78.18 |
| J7120 |
Ringers lactate infusion |
520 |
509 |
$73.12 |
| 87324 |
|
12 |
12 |
$65.80 |
| J2270 |
Morphine sulfate injection |
2,407 |
2,137 |
$62.14 |
| 94727 |
|
12 |
12 |
$60.58 |
| J0690 |
Cefazolin sodium injection |
1,341 |
1,271 |
$59.25 |
| 82565 |
|
13 |
12 |
$58.91 |
| 72040 |
|
13 |
13 |
$52.08 |
| 84156 |
|
13 |
12 |
$49.83 |
| J1200 |
Diphenhydramine hcl injectio |
1,171 |
1,107 |
$45.65 |
| 94729 |
|
13 |
12 |
$43.68 |
| J3370 |
Vancomycin hcl injection |
68 |
64 |
$40.29 |
| J1170 |
Hydromorphone injection |
444 |
357 |
$40.26 |
| 96127 |
|
3,373 |
3,260 |
$37.19 |
| 87449 |
|
12 |
12 |
$36.40 |
| 73590 |
|
28 |
26 |
$36.00 |
| 82948 |
|
359 |
350 |
$33.50 |
| 73560 |
|
14 |
14 |
$24.72 |
| J3010 |
Fentanyl citrate injection |
2,744 |
2,708 |
$24.22 |
| J2765 |
Metoclopramide hcl injection |
1,012 |
923 |
$19.09 |
| J2060 |
Lorazepam injection |
335 |
306 |
$12.39 |
| J2250 |
Inj midazolam hydrochloride |
1,986 |
1,942 |
$11.81 |
| J2001 |
Lidocaine injection |
140 |
136 |
$7.15 |
| J3475 |
Inj magnesium sulfate |
61 |
56 |
$6.70 |
| J2274 |
Inj morphine pf epid ithc |
94 |
93 |
$4.28 |
| J0330 |
Succinycholine chloride inj |
121 |
121 |
$3.56 |
| J1642 |
Inj heparin sodium per 10 u |
20 |
14 |
$3.46 |
| J2930 |
Methylprednisolone injection |
114 |
113 |
$1.66 |
| J2251 |
Inj midazolam in 0.9% nacl |
178 |
178 |
$1.00 |
| M1069 |
Pt scr ft fall rsk |
640 |
628 |
$0.00 |
| G8510 |
Scr dep neg, no plan reqd |
477 |
468 |
$0.00 |
| 82962 |
|
14 |
14 |
$0.00 |
| 88300 |
|
14 |
14 |
$0.00 |
| 90647 |
|
27 |
26 |
$0.00 |
| 90723 |
|
34 |
34 |
$0.00 |
| 82803 |
|
18 |
12 |
$0.00 |
| 80359 |
|
15 |
15 |
$0.00 |
| G8431 |
Pos clin depres scrn f/u doc |
841 |
825 |
$0.00 |
| 82075 |
|
91 |
84 |
$0.00 |
| C1713 |
Anchor/screw bn/bn,tis/bn |
70 |
70 |
$0.00 |
| J1650 |
Inj enoxaparin sodium |
37 |
12 |
$0.00 |
| J0665 |
Inj, bupivacaine, nos, 0.5mg |
27 |
27 |
$0.00 |
| C9113 |
Inj pantoprazole sodium, via |
60 |
37 |
$0.00 |
| 90473 |
|
12 |
12 |
$0.00 |
| 99360 |
|
15 |
15 |
$0.00 |