Medicaid Provider Spending

$1.09 trillion in Medicaid claims data, 2018–2024 · 617K+ providers

SOUTHERN CALIFORNIA PERMANENTE MEDICAL GROUP

NPI: 1952333478 · WOODLAND HILLS, CA 91367 · Health Maintenance Organization · NPI assigned 07/07/2006

Billing Flags · Automated signals — not evidence of fraud
Entity Proliferation

Authorized official DAVIDOFF, RAMIN controls 20+ related entities in our dataset. Read more

$11.55M
Total Medicaid Paid
497,197
Total Claims
465,139
Beneficiaries
417
Codes Billed
2018-01
First Month
2024-12
Last Month

Provider Details

Authorized OfficialDAVIDOFF, RAMIN (EXECUTIVE MEDICAL DIRECTOR)
NPI Enumeration Date07/07/2006

Related Entities

Other providers sharing the same authorized official: DAVIDOFF, RAMIN

ProviderCityStateTotal Paid
SOUTHERN CALIFORNIA PERMANENTE MEDICAL GROUP N HOLLYWOOD CA $63.44M
SOUTHERN CALIFORNIA PERMANENTE MEDICAL GROUP BELLFLOWER CA $52.84M
SOUTHERN CALIFORNIA PERMANENTE MEDICAL GROUP CHINO HILLS CA $50.89M
SOUTHERN CALIFORNIA PERMANENTE MEDICAL GROUP LOS ANGELES CA $48.19M
SOUTHERN CALIFORNIA PERMANENTE MEDICAL GROUP SAN DIEGO CA $42.84M
SOUTHERN CALIFORNIA PERMANENTE MEDICAL GROUP PANORAMA CITY CA $35.56M
SOUTHERN CALIFORNIA PERMANENTE MEDICAL GROUP FONTANA CA $30.65M
SOUTHERN CALIFORNIA PERMANENTE MEDICAL GROUP LOS ANGELES CA $29.70M
SOUTHERN CALIFORNIA PERMANENTE MEDICAL GROUP BALDWIN PARK CA $27.51M
SOUTHERN CALIFORNIA PERMANENTE MEDICAL GROUP LANCASTER CA $25.36M
SOUTHERN CALIFORNIA PERMANENTE MEDICAL GROUP HARBOR CITY CA $20.06M
SOUTHERN CALIFORNIA PERMANENTE MEDICAL GROUP ANAHEIM CA $17.76M
SOUTHERN CALIFORNIA PERMANENTE MEDICAL GROUP RIVERSIDE CA $15.66M
SOUTHERN CALIFORNIA PERMANENTE MEDICAL GROUP BAKERSFIELD CA $6.92M
SOUTHERN CALIFORNIA PERMANENTE MEDICAL GROUP LOS ANGELES CA $1.56M
SOUTHERN CALIFORNIA PERMANENTE MEDICAL GROUP SAN DIEGO CA $196K
SOUTHERN CALIFORNIA PERMANENTE MEDICAL GROUP OXNARD CA $194K
SOUTHERN CALIFORNIA PERMANENTE MEDICAL GROUP HAWTHORNE CA $113K
SOUTHERN CALIFORNIA PERMANENTE MEDICAL GROUP HEMET CA $101K
SOUTHERN CALIFORNIA PERMANENTE MEDICAL GROUP FONTANA CA $77K

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2018 163,420 $53K
2019 45,057 $157K
2020 31,225 $656K
2021 48,363 $1.63M
2022 53,004 $1.72M
2023 66,807 $2.85M
2024 89,321 $4.48M

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
99214 Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity 34,676 33,331 $2.26M
99284 Emergency department visit for the evaluation and management, high severity 24,722 24,398 $2.24M
77067 Screening mammography, bilateral, including computer-aided detection 16,292 11,964 $686K
91320 4,398 4,395 $677K
99213 Office or other outpatient visit for the evaluation and management of an established patient, low complexity 46,244 43,985 $593K
93306 Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete 3,507 2,662 $485K
92012 Ophthalmological services: medical examination and evaluation, intermediate, established patient 7,231 7,069 $389K
88305 Level IV - Surgical pathology, gross and microscopic examination 13,827 8,896 $288K
90662 2,501 2,494 $274K
90471 Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine 49,363 48,828 $265K
90480 5,407 5,395 $264K
96365 Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour 3,545 3,297 $231K
99212 Office or other outpatient visit for the evaluation and management of an established patient, straightforward 13,161 12,646 $167K
92015 Determination of refractive state 18,158 18,070 $159K
99283 Emergency department visit for the evaluation and management, moderate severity 4,267 4,200 $132K
74177 Computed tomography, abdomen and pelvis; with contrast material 1,445 1,408 $122K
0001A 2,780 2,777 $107K
0002A 2,709 2,706 $106K
96413 Chemotherapy administration, intravenous infusion; up to 1 hour, single or initial substance 534 401 $101K
99285 Emergency department visit for the evaluation and management, high severity with immediate threat to life 944 920 $97K
97110 Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion 5,031 3,606 $91K
92014 Ophthalmological services: medical examination and evaluation, comprehensive, established patient 1,456 1,448 $78K
70450 Computed tomography, head or brain; without contrast material 1,535 1,482 $78K
0012A 1,968 1,968 $77K
0064A 1,765 1,764 $72K
90686 22,605 22,470 $71K
76641 2,456 2,394 $71K
99223 Prolong inpt eval add15 m 577 573 $71K
0011A 1,938 1,938 $70K
71045 Radiologic examination, chest; single view 11,813 10,975 $66K
93970 230 211 $53K
0124A 1,642 1,639 $52K
99204 Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity 408 404 $42K
0134A 1,098 1,098 $39K
62322 158 158 $39K
67028 Intravitreal injection of a pharmacologic agent 149 145 $38K
99442 613 571 $37K
77080 2,558 2,507 $36K
90837 Psychotherapy, 53 minutes with patient 1,559 1,156 $36K
0004A 783 783 $31K
71046 Radiologic examination, chest; 2 views 5,256 4,666 $31K
0054A 711 711 $30K
92002 1,292 1,289 $29K
92004 Ophthalmological services: medical examination and evaluation, comprehensive, new patient 723 723 $26K
90834 Psychotherapy, 45 minutes with patient 3,121 2,435 $25K
90750 336 336 $24K
93880 54 51 $19K
99391 Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) 1,841 1,650 $18K
0071A 450 450 $18K
93296 251 251 $17K
96374 Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance 924 726 $16K
93294 188 188 $16K
G0400 Home sleep test (hst) with type iv portable monitor, unattended; minimum of 3 channels 422 421 $16K
99443 179 139 $16K
77066 Tomosynthesis, mammo 191 169 $16K
20610 243 227 $16K
0072A 363 363 $14K
J7030 Infusion, normal saline solution , 1000 cc 7,004 4,629 $13K
99441 1,587 1,502 $13K
11055 116 111 $13K
77065 Tomosynthesis, mammo 148 139 $13K
78452 Myocardial perfusion imaging, tomographic (SPECT); multiple studies at rest and/or stress 140 140 $13K
74176 Computed tomography, abdomen and pelvis; without contrast material 206 194 $12K
99392 Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) 2,029 1,965 $12K
93010 Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only 2,602 2,559 $12K
90472 Immunization administration, each additional vaccine (list separately) 6,599 6,456 $11K
99215 Prolong outpt/office vis 1,389 1,284 $10K
92551 6,624 6,615 $10K
76705 Ultrasound, abdominal, real time with image documentation; limited 752 681 $10K
97161 517 509 $10K
99202 Office or other outpatient visit for the evaluation and management of a new patient, straightforward 1,336 1,313 $9K
92567 703 697 $9K
83921 321 320 $8K
96372 Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular 1,630 1,061 $8K
90656 1,798 1,789 $8K
77063 Screening digital breast tomosynthesis, bilateral 275 275 $8K
92557 303 302 $8K
99393 Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) 1,218 1,215 $8K
11721 141 141 $8K
99203 Office or other outpatient visit for the evaluation and management of a new patient, low complexity 1,151 1,122 $8K
90677 167 167 $8K
90674 596 596 $8K
92523 158 155 $7K
90853 Group psychotherapy (other than of a multiple-family group) 719 295 $7K
90694 63 63 $6K
0031A 147 147 $6K
99220 30 30 $6K
76856 Ultrasound, pelvic (nonobstetric), real time with image documentation; complete 772 679 $5K
76813 219 219 $5K
73721 Magnetic resonance imaging, any joint of lower extremity; without contrast material 135 125 $5K
76830 Ultrasound, transvaginal 660 582 $5K
90679 28 28 $5K
97535 Self-care/home management training, each 15 minutes 231 197 $4K
73562 750 620 $4K
90670 1,116 1,018 $4K
76816 Ultrasound, pregnant uterus, real time with image documentation, follow-up 341 331 $4K
99282 Emergency department visit for the evaluation and management, low to moderate severity 448 434 $3K
73030 535 422 $3K
73630 809 632 $3K
62323 25 25 $3K
G2012 Brief communication technology-based service, e.g. virtual check-in, by a physician or other qualified health care professional who can report evaluation and management services, provided to an established patient, not originating from a related e/m service provided within the previous 7 days nor leading to an e/m service or procedure within the next 24 hours or soonest available appointment; 5-10 minutes of medical discussion 10,803 10,628 $3K
J3301 Injection, triamcinolone acetonide, not otherwise specified, 10 mg 586 508 $3K
85025 Blood count; complete (CBC), automated, and automated differential WBC count 3,150 2,944 $3K
97597 29 24 $3K
72100 364 304 $3K
97140 Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) 390 264 $3K
73221 17 16 $2K
J1756 Injection, iron sucrose, 1 mg 75 66 $2K
90715 600 597 $2K
91319 84 83 $2K
85027 4,529 4,482 $2K
99394 Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) 691 688 $2K
99232 Subsequent hospital care, per day, moderate complexity 97 55 $2K
20611 13 13 $2K
99211 Office or other outpatient visit for the evaluation and management of an established patient, minimal severity 2,484 2,427 $2K
0154A 47 47 $2K
94729 14 14 $2K
92134 145 86 $2K
94726 14 14 $2K
99281 Emergency department visit for the evaluation and management, self-limited or minor 199 197 $1K
76536 146 110 $1K
76811 Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, detailed 27 26 $1K
J7999 Compounded drug, not otherwise classified 14 14 $1K
90723 675 601 $1K
99173 4,476 4,462 $1K
95117 192 107 $1K
69210 12 12 $1K
73130 258 169 $949.06
76770 102 65 $867.72
94060 26 26 $777.00
90648 1,179 1,080 $753.00
Q0091 Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory 73 73 $751.51
97162 12 12 $716.00
97530 Therapeutic activities, direct patient contact, each 15 minutes 161 132 $680.00
94640 Pressurized or nonpressurized inhalation treatment for acute airway obstruction 69 68 $566.38
0013A 14 14 $564.13
0003A 13 13 $520.00
80051 3,291 3,180 $515.25
81329 25 25 $505.00
81003 1,761 1,683 $495.86
86360 12 12 $460.00
97165 108 105 $450.00
82105 288 285 $445.00
90792 Psychiatric diagnostic evaluation with medical services 62 62 $428.70
99308 Subsequent nursing facility care, per day, straightforward 112 92 $418.31
99177 350 349 $416.00
90651 522 521 $407.49
99309 Subsequent nursing facility care, per day, low to moderate complexity 471 301 $407.32
86359 12 12 $380.00
88342 93 54 $360.00
J3475 Injection, magnesium sulfate, per 500 mg 336 335 $330.71
90633 509 465 $252.00
J0702 Injection, betamethasone acetate 3 mg and betamethasone sodium phosphate 3 mg 14 14 $242.00
93005 Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report 511 497 $241.00
96366 Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour 122 51 $227.06
99385 53 52 $225.92
82565 3,574 3,446 $178.32
12001 17 17 $174.78
87880 Infectious agent antigen detection by immunoassay; Streptococcus, group A 824 788 $166.92
73502 111 70 $159.59
76805 Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation 185 113 $148.02
81002 878 806 $142.13
99417 Prolong home eval add 15m 15 13 $140.00
J1885 Injection, ketorolac tromethamine, per 15 mg 622 428 $128.67
99291 Critical care, evaluation and management of the critically ill patient, first 30-74 minutes 27 27 $120.38
91318 24 23 $106.00
85652 515 508 $96.05
90655 28 27 $84.00
84460 2,742 2,685 $75.54
82247 1,076 1,012 $75.31
96110 Developmental screening, with scoring and documentation, per standardized instrument 61 61 $68.00
99201 414 407 $67.95
87338 184 184 $67.20
73610 386 238 $66.72
10060 13 12 $53.52
74018 200 119 $47.80
84075 963 933 $37.76
84132 406 392 $35.00
99307 41 27 $33.96
84295 196 191 $30.00
90785 13 13 $29.58
96417 38 12 $28.30
84450 460 441 $22.11
82947 1,162 1,130 $20.56
93971 48 40 $15.44
73590 103 53 $14.40
J3420 Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg 118 58 $14.26
99051 10,939 10,861 $11.20
73110 233 117 $8.46
J2405 Injection, ondansetron hydrochloride, per 1 mg 198 100 $6.72
87081 828 822 $5.68
81025 555 515 $2.77
G9920 Screening performed and negative 1,049 1,049 $0.02
1036F 7,489 7,291 $0.00
84443 Thyroid stimulating hormone (TSH) 2,233 2,217 $0.00
90696 112 112 $0.00
92227 246 246 $0.00
82677 79 79 $0.00
72040 83 55 $0.00
90688 13 13 $0.00
86762 103 102 $0.00
87591 Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe 1,341 1,264 $0.00
82040 222 218 $0.00
86780 691 673 $0.00
82306 Vitamin D; 25 hydroxy, includes fraction(s), if performed 549 548 $0.00
87340 605 601 $0.00
83001 86 86 $0.00
90716 246 214 $0.00
94010 30 30 $0.00
76801 40 32 $0.00
99217 53 52 $0.00
73090 82 44 $0.00
82607 359 359 $0.00
73120 22 13 $0.00
20550 52 38 $0.00
J7613 Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg 274 133 $0.00
58100 19 18 $0.00
83550 475 474 $0.00
G0145 Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, with screening by automated system and manual rescreening under physician supervision 574 574 $0.00
86140 202 198 $0.00
84484 48 47 $0.00
97112 Therapeutic procedure, each 15 minutes; neuromuscular reeducation of movement, balance, coordination 18 17 $0.00
83036 Hemoglobin; glycosylated (A1C) 3,521 3,506 $0.00
87255 48 47 $0.00
83735 162 154 $0.00
86580 221 208 $0.00
82728 475 474 $0.00
87088 1,633 1,575 $0.00
84153 163 161 $0.00
82670 75 75 $0.00
J2175 Injection, meperidine hydrochloride, per 100 mg 65 34 $0.00
86317 137 109 $0.00
88304 99 74 $0.00
45380 Colonoscopy, flexible; with biopsy, single or multiple 73 60 $0.00
3044F 800 795 $0.00
87389 Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies 754 749 $0.00
L1810 Knee orthosis, elastic with joints, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise 13 13 $0.00
90739 80 78 $0.00
57454 26 26 $0.00
84270 13 12 $0.00
80324 14 13 $0.00
83520 82 69 $0.00
11730 12 12 $0.00
86704 60 59 $0.00
86885 39 39 $0.00
87070 190 185 $0.00
82784 110 102 $0.00
J3010 Injection, fentanyl citrate, 0.1 mg 108 58 $0.00
82550 50 47 $0.00
71101 60 34 $0.00
82746 139 139 $0.00
J7644 Ipratropium bromide, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose form, per milligram 78 39 $0.00
92507 Treatment of speech, language, voice, communication, and/or auditory processing disorder 41 24 $0.00
84480 76 75 $0.00
86803 434 429 $0.00
76815 Ultrasound, pregnant uterus, real time with image documentation, limited 48 44 $0.00
86592 17 16 $0.00
J2250 Injection, midazolam hydrochloride, per 1 mg 173 92 $0.00
90732 98 97 $0.00
82962 83 78 $0.00
72148 Magnetic resonance imaging, lumbar spine; without contrast material 63 54 $0.00
82043 662 658 $0.00
99205 Prolong outpt/office vis 46 44 $0.00
J1100 Injection, dexamethasone sodium phosphate, 1 mg 28 13 $0.00
83021 76 76 $0.00
87505 36 35 $0.00
99386 12 12 $0.00
80359 14 13 $0.00
73560 24 12 $0.00
72081 51 27 $0.00
29075 19 17 $0.00
88307 17 13 $0.00
73660 72 40 $0.00
64615 14 12 $0.00
73564 182 96 $0.00
85730 13 12 $0.00
G0123 Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, screening by cytotechnologist under physician supervision 53 53 $0.00
86695 18 18 $0.00
83002 40 40 $0.00
96127 57 56 $0.00
70486 37 31 $0.00
74022 18 12 $0.00
86376 35 35 $0.00
J0696 Injection, ceftriaxone sodium, per 250 mg 94 60 $0.00
76870 48 32 $0.00
83880 12 12 $0.00
70491 15 12 $0.00
45378 Colonoscopy, flexible; diagnostic, including collection of specimen(s) 63 49 $0.00
31231 31 30 $0.00
94761 20 15 $0.00
D1206 Topical application of fluoride varnish 164 147 $0.00
58300 40 38 $0.00
97010 60 42 $0.00
90847 Family psychotherapy with the patient present, 50 minutes 29 29 $0.00
71260 Computed tomography, thorax, diagnostic; with contrast material 42 33 $0.00
87517 15 15 $0.00
83690 119 116 $0.00
87536 19 19 $0.00
11900 19 14 $0.00
J7060 5% dextrose/water (500 ml = 1 unit) 198 21 $0.00
99024 39 26 $0.00
85379 21 21 $0.00
90744 19 19 $0.00
86901 42 42 $0.00
87624 Infectious agent detection by nucleic acid; human papillomavirus (HPV), high-risk types 370 370 $0.00
80197 34 29 $0.00
76700 Ultrasound, abdominal, real time with image documentation; complete 45 25 $0.00
17000 14 14 $0.00
86160 17 14 $0.00
96415 35 13 $0.00
J7298 Levonorgestrel-releasing intrauterine contraceptive system (mirena), 52 mg 16 14 $0.00
87040 22 17 $0.00
83605 29 22 $0.00
85610 199 182 $0.00
84146 48 48 $0.00
84520 840 801 $0.00
90661 2,917 2,896 $0.00
84100 125 121 $0.00
90672 94 94 $0.00
J7120 Ringers lactate infusion, up to 1000 cc 135 79 $0.00
70553 Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences 51 43 $0.00
87186 418 398 $0.00
87185 15 13 $0.00
90710 141 141 $0.00
78815 Positron emission tomography (PET) for limited area imaging 30 30 $0.00
84550 125 125 $0.00
90681 256 218 $0.00
90791 Psychiatric diagnostic evaluation 281 279 $0.00
83540 491 491 $0.00
86480 39 39 $0.00
90700 240 218 $0.00
12011 12 12 $0.00
86696 18 18 $0.00
86038 50 50 $0.00
80061 Lipid panel 2,511 2,501 $0.00
87491 Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe 1,342 1,267 $0.00
G0101 Cervical or vaginal cancer screening; pelvic and clinical breast examination 15 15 $0.00
88175 Cytopathology, cervical or vaginal, any reporting system; collected in preservative fluid, automated thin layer 52 48 $0.00
97150 Therapeutic procedure(s), group (2 or more individuals) 195 76 $0.00
82310 402 394 $0.00
82274 560 558 $0.00
90734 414 413 $0.00
86787 131 130 $0.00
88312 41 19 $0.00
90713 43 41 $0.00
98968 19 17 $0.00
83718 62 62 $0.00
86336 79 79 $0.00
J1200 Injection, diphenhydramine hcl, up to 50 mg 72 18 $0.00
85014 228 217 $0.00
J1071 Injection, testosterone cypionate, 1 mg 95 31 $0.00
90832 Psychotherapy, 30 minutes with patient 69 69 $0.00
90756 93 88 $0.00
73070 55 33 $0.00
83655 479 460 $0.00
83721 146 145 $0.00
11750 33 33 $0.00
71250 33 25 $0.00
86900 42 42 $0.00
72141 18 15 $0.00
92133 23 13 $0.00
84439 634 624 $0.00
G0124 Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, requiring interpretation by physician 54 54 $0.00
93015 12 12 $0.00
86735 33 32 $0.00
70551 Magnetic resonance imaging, brain; without contrast material 45 40 $0.00
11100 52 51 $0.00
86003 325 213 $0.00
80307 Drug test(s), presumptive, any number of drug classes; immunoassay 486 265 $0.00
84403 146 143 $0.00
J2930 Injection, methylprednisolone sodium succinate, up to 125 mg 107 46 $0.00
73080 103 61 $0.00
84702 214 204 $0.00
83970 100 100 $0.00
99395 Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years 217 217 $0.00
92579 23 21 $0.00
82465 94 94 $0.00
93303 Transthoracic echocardiography for congenital cardiac anomalies, follow-up or limited study 46 35 $0.00
73140 257 141 $0.00
92550 35 35 $0.00
90691 13 13 $0.00
J1050 Injection, medroxyprogesterone acetate, 1 mg 146 77 $0.00
82248 56 48 $0.00
85046 12 12 $0.00
72070 58 33 $0.00
L3260 Surgical boot/shoe, each 12 12 $0.00
31575 13 13 $0.00
87804 Infectious agent antigen detection by immunoassay; Influenza, each type 56 52 $0.00
81220 CFTR (cystic fibrosis transmembrane conductance regulator) gene analysis; common variants 17 17 $0.00
90746 14 13 $0.00
20552 33 30 $0.00
99219 63 60 $0.00
99396 Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years 146 145 $0.00
43239 Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple 66 49 $0.00
99225 34 24 $0.00
L1902 Ankle orthosis, ankle gauntlet or similar, with or without joints, prefabricated, off-the-shelf 15 15 $0.00
76642 66 36 $0.00
86765 34 33 $0.00
17110 133 124 $0.00
84163 43 43 $0.00
86677 43 43 $0.00
90707 243 209 $0.00
84165 21 18 $0.00
43235 43 33 $0.00
73100 73 41 $0.00
86708 16 16 $0.00
L3908 Wrist hand orthosis, wrist extension control cock-up, non molded, prefabricated, off-the-shelf 21 20 $0.00
90658 17 17 $0.00
76857 22 13 $0.00
86431 65 65 $0.00
86709 13 13 $0.00
96101 17 15 $0.00
73000 22 12 $0.00
76881 20 12 $0.00
J0585 Injection, onabotulinumtoxina, 1 unit 27 22 $0.00
00840 23 12 $0.00
26720 13 13 $0.00