| Code | Description | Claims | Beneficiaries | Total Paid |
| 99283 |
|
191,675 |
168,256 |
$17.41M |
| 99284 |
|
135,188 |
120,637 |
$13.93M |
| G0378 |
Hospital observation per hr |
38,143 |
20,398 |
$7.66M |
| 99285 |
|
43,832 |
37,560 |
$4.91M |
| 99282 |
|
46,960 |
44,632 |
$3.84M |
| 96374 |
|
63,244 |
56,147 |
$2.52M |
| 93975 |
|
15,158 |
13,447 |
$2.39M |
| 74177 |
|
18,449 |
17,153 |
$2.32M |
| 54161 |
|
2,891 |
2,744 |
$1.72M |
| G0480 |
Drug test def 1-7 classes |
35,307 |
27,572 |
$1.43M |
| 96372 |
|
34,182 |
26,562 |
$1.08M |
| 99281 |
|
12,138 |
11,374 |
$1.05M |
| 70450 |
|
23,836 |
21,901 |
$1.05M |
| 96361 |
|
52,943 |
43,436 |
$1.01M |
| 54300 |
|
732 |
697 |
$864K |
| 71046 |
|
34,013 |
32,122 |
$838K |
| 80307 |
|
32,937 |
27,531 |
$780K |
| 71275 |
|
4,927 |
4,614 |
$674K |
| 72125 |
|
8,943 |
8,255 |
$618K |
| 80053 |
|
109,691 |
91,389 |
$618K |
| C1713 |
Anchor/screw bn/bn,tis/bn |
1,512 |
1,355 |
$564K |
| 96375 |
|
42,001 |
34,412 |
$542K |
| 44970 |
|
377 |
330 |
$533K |
| 54360 |
|
737 |
700 |
$533K |
| 71045 |
|
56,173 |
47,937 |
$522K |
| 97530 |
|
13,625 |
3,138 |
$516K |
| 85027 |
|
175,061 |
133,813 |
$405K |
| 41899 |
|
505 |
458 |
$404K |
| 93005 |
|
93,357 |
80,433 |
$401K |
| 96365 |
|
19,282 |
17,435 |
$397K |
| 76815 |
|
10,931 |
9,521 |
$390K |
| 76700 |
|
6,676 |
6,263 |
$377K |
| 96360 |
|
17,255 |
16,207 |
$368K |
| 92507 |
|
6,650 |
2,062 |
$348K |
| 78452 |
|
1,502 |
1,369 |
$335K |
| 76830 |
|
5,762 |
5,384 |
$320K |
| 74176 |
|
4,331 |
4,066 |
$320K |
| 80048 |
|
55,401 |
42,703 |
$279K |
| 76856 |
|
6,381 |
5,941 |
$273K |
| 87637 |
|
7,826 |
7,491 |
$273K |
| 76817 |
|
6,838 |
5,809 |
$262K |
| 74018 |
|
13,481 |
12,562 |
$253K |
| 94640 |
|
17,309 |
14,697 |
$252K |
| 14040 |
|
1,614 |
1,533 |
$251K |
| 84484 |
|
56,696 |
45,259 |
$240K |
| 70553 |
|
1,132 |
1,047 |
$229K |
| 87400 |
|
16,630 |
15,781 |
$229K |
| 70486 |
|
2,865 |
2,739 |
$224K |
| 76705 |
|
5,123 |
4,831 |
$222K |
| 83880 |
|
17,209 |
15,496 |
$222K |
| 76770 |
|
2,886 |
2,716 |
$210K |
| 93306 |
|
2,525 |
2,228 |
$194K |
| J7030 |
Normal saline solution infus |
79,065 |
64,973 |
$188K |
| 87150 |
|
1,043 |
854 |
$188K |
| 12011 |
|
2,715 |
2,590 |
$186K |
| 10060 |
|
1,813 |
1,724 |
$179K |
| 43239 |
|
362 |
304 |
$167K |
| 15002 |
|
295 |
224 |
$165K |
| 84703 |
|
49,850 |
44,254 |
$156K |
| 12001 |
|
2,659 |
2,527 |
$155K |
| 81001 |
|
81,230 |
73,707 |
$154K |
| 87086 |
|
29,971 |
28,308 |
$153K |
| 87798 |
|
5,635 |
5,354 |
$144K |
| 74019 |
|
5,159 |
4,930 |
$142K |
| 0450 |
|
3,123 |
2,847 |
$140K |
| 70551 |
|
1,060 |
979 |
$138K |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
26,814 |
12,921 |
$137K |
| 87491 |
|
9,158 |
8,626 |
$135K |
| 93971 |
|
3,065 |
2,815 |
$129K |
| 87591 |
|
9,164 |
8,632 |
$129K |
| 80047 |
|
25,121 |
22,050 |
$128K |
| 90471 |
|
4,975 |
4,621 |
$127K |
| 83690 |
|
46,348 |
41,129 |
$121K |
| 93970 |
|
1,901 |
1,730 |
$119K |
| 54304 |
|
115 |
109 |
$113K |
| 73564 |
|
6,001 |
5,457 |
$112K |
| 47562 |
|
67 |
66 |
$110K |
| 95819 |
|
486 |
450 |
$109K |
| 71260 |
|
1,343 |
1,236 |
$107K |
| 87040 |
|
23,301 |
19,475 |
$107K |
| 96376 |
|
14,853 |
8,610 |
$106K |
| 96366 |
|
5,577 |
3,787 |
$103K |
| 80076 |
|
24,699 |
22,082 |
$101K |
| 73130 |
|
6,114 |
5,744 |
$95K |
| 12002 |
|
1,500 |
1,424 |
$93K |
| 70491 |
|
1,016 |
949 |
$92K |
| A9500 |
Tc99m sestamibi |
1,489 |
1,359 |
$88K |
| J0696 |
Ceftriaxone sodium injection |
18,543 |
15,191 |
$87K |
| 84702 |
|
14,510 |
12,434 |
$85K |
| 87636 |
|
2,476 |
2,269 |
$83K |
| 73630 |
|
5,898 |
5,374 |
$82K |
| 99213 |
|
2,186 |
1,598 |
$81K |
| 29125 |
|
1,522 |
1,464 |
$79K |
| 87430 |
|
14,877 |
14,366 |
$78K |
| 73610 |
|
5,015 |
4,651 |
$76K |
| 70498 |
|
506 |
475 |
$72K |
| 85610 |
|
46,905 |
39,755 |
$72K |
| 82550 |
|
25,846 |
22,480 |
$71K |
| 87486 |
|
5,590 |
5,325 |
$71K |
| 87581 |
|
5,581 |
5,321 |
$68K |
| G0383 |
Lev 4 hosp type b ed visit |
1,872 |
1,564 |
$67K |
| 72100 |
|
4,633 |
4,379 |
$67K |
| 87070 |
|
11,756 |
11,059 |
$66K |
| 85730 |
|
32,469 |
27,464 |
$66K |
| 15004 |
|
125 |
105 |
$61K |
| 70496 |
|
430 |
406 |
$61K |
| 83605 |
|
13,117 |
10,576 |
$59K |
| 87426 |
|
6,395 |
5,784 |
$56K |
| 73110 |
|
2,909 |
2,704 |
$54K |
| 81025 |
|
18,368 |
17,071 |
$53K |
| 73030 |
|
4,173 |
3,796 |
$53K |
| J2270 |
Morphine sulfate injection |
26,990 |
19,876 |
$44K |
| 73090 |
|
3,272 |
2,998 |
$44K |
| J7050 |
Normal saline solution infus |
27,680 |
16,250 |
$41K |
| 73080 |
|
2,607 |
2,472 |
$41K |
| 76870 |
|
1,690 |
1,594 |
$40K |
| 97163 |
|
1,893 |
1,544 |
$37K |
| 97162 |
|
1,451 |
1,226 |
$36K |
| 73590 |
|
3,083 |
2,779 |
$36K |
| 83735 |
|
18,502 |
13,632 |
$36K |
| 81003 |
|
19,184 |
17,636 |
$35K |
| 84443 |
|
6,087 |
5,400 |
$34K |
| 90715 |
|
1,634 |
1,576 |
$34K |
| 72072 |
|
2,158 |
2,054 |
$34K |
| 82805 |
|
3,539 |
2,659 |
$34K |
| 87077 |
|
7,599 |
7,043 |
$32K |
| 73502 |
|
2,062 |
1,920 |
$32K |
| 72050 |
|
1,582 |
1,509 |
$31K |
| 87661 |
|
3,759 |
3,532 |
$31K |
| 87420 |
|
4,878 |
4,694 |
$29K |
| 87635 |
|
3,197 |
2,945 |
$29K |
| 84112 |
|
1,529 |
1,390 |
$28K |
| 93017 |
|
1,514 |
1,380 |
$27K |
| 71101 |
|
1,531 |
1,477 |
$26K |
| 87186 |
|
5,379 |
4,909 |
$25K |
| J1885 |
Ketorolac tromethamine inj |
36,280 |
21,499 |
$24K |
| 93458 |
|
70 |
52 |
$24K |
| 76536 |
|
455 |
437 |
$22K |
| 72131 |
|
441 |
414 |
$22K |
| J3370 |
Vancomycin hcl injection |
4,342 |
2,710 |
$21K |
| 86140 |
|
11,676 |
10,716 |
$21K |
| A9575 |
Inj gadoterate meglumi 0.1ml |
1,828 |
982 |
$21K |
| 86901 |
|
21,033 |
18,401 |
$21K |
| 86900 |
|
21,024 |
18,395 |
$21K |
| J3490 |
Drugs unclassified injection |
3,171 |
2,276 |
$20K |
| J0500 |
Dicyclomine injection |
830 |
794 |
$20K |
| 99211 |
|
2,588 |
1,837 |
$19K |
| J2543 |
Piperacillin/tazobactam |
4,433 |
2,742 |
$19K |
| 85379 |
|
5,070 |
4,658 |
$18K |
| J0780 |
Prochlorperazine injection |
4,031 |
3,766 |
$18K |
| 86850 |
|
12,073 |
10,514 |
$18K |
| J2405 |
Ondansetron hcl injection |
40,664 |
33,063 |
$17K |
| 73552 |
|
1,337 |
1,231 |
$17K |
| 96368 |
|
3,938 |
3,536 |
$17K |
| J2930 |
Methylprednisolone injection |
3,331 |
2,597 |
$16K |
| 97161 |
|
841 |
746 |
$16K |
| 74021 |
|
926 |
871 |
$15K |
| 75574 |
|
56 |
55 |
$15K |
| 97167 |
|
585 |
465 |
$15K |
| 99070 |
|
1,402 |
704 |
$15K |
| 86923 |
|
1,593 |
1,304 |
$14K |
| 73060 |
|
1,189 |
1,102 |
$14K |
| 97116 |
|
2,368 |
746 |
$14K |
| 29515 |
|
250 |
242 |
$14K |
| 83036 |
|
4,643 |
4,107 |
$13K |
| 95700 |
|
110 |
97 |
$13K |
| 80061 |
|
3,360 |
2,970 |
$13K |
| J1200 |
Diphenhydramine hcl injectio |
18,665 |
15,873 |
$13K |
| 87205 |
|
7,164 |
6,284 |
$13K |
| J1100 |
Dexamethasone sodium phos |
26,419 |
16,725 |
$13K |
| 24640 |
|
139 |
134 |
$13K |
| 87389 |
|
1,638 |
1,509 |
$13K |
| 76857 |
|
623 |
603 |
$12K |
| J7120 |
Ringers lactate infusion |
5,433 |
4,125 |
$12K |
| 82077 |
|
3,021 |
2,794 |
$12K |
| 80074 |
|
1,005 |
889 |
$12K |
| J3486 |
Ziprasidone mesylate |
777 |
437 |
$12K |
| 12013 |
|
199 |
185 |
$11K |
| M0243 |
Casirivi and imdevi inj |
140 |
131 |
$11K |
| J1170 |
Hydromorphone injection |
6,771 |
4,743 |
$10K |
| 99151 |
|
601 |
556 |
$10K |
| J2060 |
Lorazepam injection |
13,910 |
11,071 |
$10K |
| J0456 |
Azithromycin |
3,960 |
3,268 |
$9K |
| 90714 |
|
1,254 |
1,192 |
$9K |
| 82330 |
|
1,928 |
1,598 |
$9K |
| 80069 |
|
4,843 |
2,484 |
$9K |
| 87088 |
|
2,096 |
1,938 |
$9K |
| 16020 |
|
94 |
71 |
$8K |
| 72170 |
|
907 |
841 |
$8K |
| 82140 |
|
1,944 |
1,563 |
$8K |
| J7040 |
Normal saline solution infus |
4,658 |
4,176 |
$8K |
| 0250 |
|
867 |
381 |
$8K |
| 30300 |
|
38 |
36 |
$8K |
| J1630 |
Haloperidol injection |
7,336 |
6,201 |
$8K |
| 69200 |
|
83 |
81 |
$8K |
| 86780 |
|
1,177 |
1,122 |
$7K |
| 96367 |
|
1,128 |
990 |
$7K |
| J8540 |
Oral dexamethasone |
3,756 |
3,467 |
$7K |
| 51600 |
|
28 |
26 |
$6K |
| 73000 |
|
432 |
409 |
$6K |
| U0002 |
Covid-19 lab test non-cdc |
648 |
486 |
$6K |
| J1650 |
Inj enoxaparin sodium |
2,776 |
1,418 |
$6K |
| 73140 |
|
265 |
258 |
$6K |
| 84439 |
|
1,903 |
1,692 |
$6K |
| 88305 |
|
3,284 |
2,920 |
$6K |
| 84100 |
|
5,658 |
4,024 |
$5K |
| J2765 |
Metoclopramide hcl injection |
7,235 |
6,379 |
$5K |
| J0561 |
Penicillin g benzathine inj |
25 |
25 |
$5K |
| 82248 |
|
3,004 |
2,378 |
$5K |
| J1644 |
Inj heparin sodium per 1000u |
6,161 |
2,694 |
$5K |
| 99153 |
Mod sedat endo service >5yrs |
1,657 |
1,429 |
$5K |
| J1815 |
Insulin injection |
5,838 |
2,659 |
$5K |
| J0360 |
Hydralazine hcl injection |
1,289 |
950 |
$5K |
| 85384 |
|
1,667 |
1,371 |
$5K |
| 87808 |
|
1,655 |
1,582 |
$5K |
| 99152 |
|
780 |
643 |
$5K |
| J1953 |
Levetiracetam injection |
1,509 |
1,107 |
$4K |
| L1830 |
Ko immob canvas long pre ots |
174 |
168 |
$4K |
| 80320 |
|
1,607 |
1,389 |
$4K |
| 85651 |
|
3,139 |
2,830 |
$4K |
| A9585 |
Gadobutrol injection |
94 |
54 |
$4K |
| 88307 |
|
355 |
292 |
$4K |
| 72148 |
|
27 |
25 |
$3K |
| 82728 |
|
916 |
765 |
$3K |
| 71250 |
|
54 |
45 |
$3K |
| J7611 |
Albuterol non-comp con |
4,216 |
3,606 |
$3K |
| J0692 |
Cefepime hcl for injection |
1,013 |
684 |
$3K |
| G0381 |
Lev 2 hosp type b ed visit |
39 |
39 |
$3K |
| 93320 |
|
136 |
119 |
$3K |
| J2785 |
Regadenoson injection |
116 |
102 |
$3K |
| S0028 |
Injection, famotidine, 20 mg |
5,193 |
4,731 |
$3K |
| 76000 |
|
1,659 |
1,519 |
$3K |
| 70360 |
|
258 |
243 |
$3K |
| 15853 |
|
498 |
458 |
$3K |
| 29105 |
|
54 |
50 |
$3K |
| 94644 |
|
108 |
100 |
$3K |
| J1790 |
Droperidol injection |
1,063 |
995 |
$3K |
| J0295 |
Ampicillin sulbactam 1.5 gm |
818 |
516 |
$3K |
| C1781 |
Mesh (implantable) |
25 |
25 |
$3K |
| 74175 |
|
26 |
25 |
$3K |
| 85007 |
|
1,675 |
1,520 |
$3K |
| C1760 |
Closure dev, vasc |
34 |
26 |
$2K |
| J2704 |
Inj, propofol, 10 mg |
3,859 |
3,034 |
$2K |
| 70487 |
|
39 |
39 |
$2K |
| P9016 |
Rbc leukocytes reduced |
357 |
314 |
$2K |
| 84132 |
|
2,942 |
2,219 |
$2K |
| 97112 |
|
50 |
25 |
$2K |
| J1940 |
Furosemide injection |
2,011 |
1,046 |
$2K |
| 93880 |
|
30 |
28 |
$2K |
| 80055 |
|
15 |
15 |
$2K |
| J7999 |
Compounded drug, noc |
135 |
106 |
$2K |
| 93325 |
|
167 |
146 |
$2K |
| 15275 |
|
15 |
14 |
$2K |
| 86920 |
|
125 |
107 |
$2K |
| 92610 |
|
79 |
67 |
$2K |
| S0077 |
Injection, clindamycin phosp |
1,058 |
717 |
$2K |
| 76881 |
|
40 |
39 |
$2K |
| 97166 |
|
73 |
65 |
$2K |
| A9541 |
Tc99m sulfur colloid |
81 |
75 |
$2K |
| 82553 |
|
288 |
246 |
$2K |
| C2617 |
Stent, non-cor, tem w/o del |
14 |
13 |
$2K |
| 72128 |
|
27 |
26 |
$2K |
| 92523 |
|
13 |
12 |
$2K |
| 86308 |
|
481 |
467 |
$2K |
| 36430 |
|
98 |
80 |
$1K |
| J3475 |
Inj magnesium sulfate |
1,266 |
1,155 |
$1K |
| C9113 |
Inj pantoprazole sodium, via |
1,669 |
1,076 |
$1K |
| G0463 |
Hospital outpt clinic visit |
824 |
496 |
$1K |
| 74240 |
|
14 |
14 |
$1K |
| 93315 |
|
16 |
13 |
$1K |
| 83540 |
|
830 |
696 |
$1K |
| J3360 |
Diazepam injection |
308 |
258 |
$1K |
| 83550 |
|
813 |
684 |
$1K |
| 85045 |
|
816 |
664 |
$1K |
| 88304 |
|
2,127 |
1,977 |
$1K |
| 83615 |
|
486 |
436 |
$1K |
| J3480 |
Inj potassium chloride |
764 |
569 |
$1K |
| 82009 |
|
591 |
542 |
$1K |
| 73560 |
|
99 |
92 |
$1K |
| 87210 |
|
163 |
160 |
$1K |
| 31720 |
|
12 |
12 |
$1K |
| J0690 |
Cefazolin sodium injection |
2,647 |
1,795 |
$944.27 |
| 82607 |
|
143 |
116 |
$939.32 |
| 82150 |
|
309 |
282 |
$916.18 |
| 73100 |
|
94 |
86 |
$904.46 |
| J3010 |
Fentanyl citrate injection |
4,614 |
3,797 |
$902.68 |
| 74455 |
|
28 |
26 |
$881.12 |
| G0384 |
Lev 5 hosp type b ed visit |
111 |
105 |
$840.00 |
| J1956 |
Levofloxacin injection |
67 |
50 |
$835.44 |
| 82570 |
|
566 |
499 |
$825.30 |
| 87631 |
|
4,573 |
4,394 |
$760.05 |
| J2250 |
Inj midazolam hydrochloride |
3,754 |
2,592 |
$740.38 |
| J7620 |
Albuterol ipratrop non-comp |
3,231 |
2,630 |
$712.69 |
| J2920 |
Methylprednisolone injection |
321 |
194 |
$694.89 |
| J7644 |
Ipratropium bromide non-comp |
2,262 |
2,095 |
$660.86 |
| J7613 |
Albuterol non-comp unit |
1,591 |
1,388 |
$645.27 |
| J0171 |
Adrenalin epinephrine inject |
831 |
476 |
$643.85 |
| 99203 |
|
15 |
15 |
$641.46 |
| 84550 |
|
384 |
344 |
$632.45 |
| 0270 |
|
52 |
38 |
$611.63 |
| Q9957 |
Inj perflutren lip micros,ml |
12 |
12 |
$583.44 |
| Q9966 |
Locm 200-299mg/ml iodine,1ml |
117 |
63 |
$580.82 |
| 0272 |
|
15 |
12 |
$532.60 |
| J2919 |
Inj, methylpred sod succ 5mg |
527 |
349 |
$525.85 |
| 85018 |
|
1,861 |
1,326 |
$479.82 |
| 82310 |
|
230 |
206 |
$468.16 |
| 84156 |
|
414 |
365 |
$440.69 |
| 87147 |
|
318 |
282 |
$435.60 |
| 36600 |
|
120 |
68 |
$431.42 |
| 87633 |
|
946 |
867 |
$429.00 |
| 88300 |
|
892 |
767 |
$427.07 |
| 77075 |
|
13 |
13 |
$425.25 |
| 86803 |
|
74 |
69 |
$354.45 |
| A0429 |
Bls-emergency |
20 |
14 |
$347.20 |
| J7042 |
5% dextrose/normal saline |
154 |
111 |
$304.36 |
| 73070 |
|
69 |
66 |
$241.34 |
| 97597 |
|
45 |
26 |
$192.69 |
| J2310 |
Inj naloxone hydrochloride |
51 |
37 |
$191.88 |
| J2470 |
Inj pantoprazole sodium 40mg |
170 |
137 |
$187.86 |
| J1836 |
Inj, metronidazole, 10 mg |
401 |
289 |
$185.74 |
| 84295 |
|
391 |
346 |
$180.78 |
| 87899 |
|
14 |
13 |
$179.96 |
| J0153 |
Adenosine inj 1mg |
13 |
12 |
$174.78 |
| 85049 |
|
390 |
331 |
$171.36 |
| 87046 |
|
13 |
13 |
$167.44 |
| 82565 |
|
152 |
105 |
$165.40 |
| 87075 |
|
296 |
238 |
$161.50 |
| J0736 |
Inj, clindamycin phosp 300mg |
159 |
119 |
$157.06 |
| J1171 |
Inj, hydromorphone, 0.1 mg |
208 |
153 |
$156.04 |
| C1769 |
Guide wire |
2,429 |
1,969 |
$153.90 |
| 88342 |
|
64 |
54 |
$148.63 |
| 73600 |
|
38 |
31 |
$131.64 |
| 36415 |
|
74 |
42 |
$130.83 |
| 82947 |
|
295 |
282 |
$107.54 |
| 82306 |
|
14 |
13 |
$100.00 |
| J3535 |
Metered dose inhaler drug |
16 |
15 |
$91.70 |
| 82746 |
|
15 |
15 |
$90.27 |
| 85014 |
|
424 |
296 |
$79.60 |
| 82435 |
|
264 |
252 |
$78.77 |
| A9270 |
Non-covered item or service |
22,590 |
7,174 |
$74.39 |
| 87045 |
|
13 |
13 |
$70.84 |
| 72220 |
|
13 |
12 |
$65.82 |
| 82247 |
|
75 |
62 |
$61.56 |
| J0670 |
Inj mepivacaine hcl/10 ml |
97 |
76 |
$59.18 |
| G0008 |
Admin influenza virus vac |
33 |
30 |
$53.40 |
| J2800 |
Methocarbamol injection |
16 |
14 |
$30.60 |
| S0030 |
Injection, metronidazole |
62 |
48 |
$29.40 |
| 51702 |
|
14 |
12 |
$28.47 |
| 80202 |
|
18 |
12 |
$27.75 |
| J2550 |
Promethazine hcl injection |
12 |
12 |
$26.43 |
| 86592 |
|
17 |
16 |
$26.19 |
| S0191 |
Misoprostol, oral, 200 mcg |
19 |
12 |
$24.48 |
| J2003 |
Inj, lidocaine hcl, 1 mg |
398 |
267 |
$19.17 |
| C1758 |
Catheter, ureteral |
80 |
73 |
$6.90 |
| S5010 |
5% dextrose and 0.45% saline |
30 |
14 |
$5.60 |
| J0665 |
Inj, bupivacaine, nos, 0.5mg |
75 |
62 |
$2.78 |
| J2004 |
Inj, lidocaine w epinephrine |
15 |
15 |
$1.70 |
| J1920 |
Inj, labetalol hcl, 5mg |
16 |
12 |
$1.01 |
| C1894 |
Intro/sheath, non-laser |
1,644 |
1,310 |
$0.00 |
| J2710 |
Neostigmine methylslfte inj |
26 |
24 |
$0.00 |
| C1887 |
Catheter, guiding |
529 |
391 |
$0.00 |
| G1003 |
Cdsm medicalis |
1,287 |
1,053 |
$0.00 |
| 88312 |
|
61 |
58 |
$0.00 |
| Q4227 |
Amniocore per sq cm |
48 |
44 |
$0.00 |
| G1004 |
Cdsm ndsc |
30 |
29 |
$0.00 |
| C1849 |
Skin substitute, synthetic |
17 |
12 |
$0.00 |
| J0131 |
Inj, acetaminophen (nos) |
156 |
131 |
$0.00 |
| Q4100 |
Skin substitute, nos |
48 |
38 |
$0.00 |
| 70320 |
|
199 |
188 |
$0.00 |
| 80329 |
|
47 |
42 |
$0.00 |
| C1725 |
Cath, translumin non-laser |
33 |
24 |
$0.00 |
| 64488 |
|
14 |
12 |
$0.00 |