| Code | Description | Claims | Beneficiaries | Total Paid |
| 99214 |
|
34,676 |
33,331 |
$2.26M |
| 99284 |
|
24,722 |
24,398 |
$2.24M |
| 77067 |
|
16,292 |
11,964 |
$686K |
| 91320 |
|
4,398 |
4,395 |
$677K |
| 99213 |
|
46,244 |
43,985 |
$593K |
| 93306 |
|
3,507 |
2,662 |
$485K |
| 92012 |
|
7,231 |
7,069 |
$389K |
| 88305 |
|
13,827 |
8,896 |
$288K |
| 90662 |
|
2,501 |
2,494 |
$274K |
| 90471 |
|
49,363 |
48,828 |
$265K |
| 90480 |
|
5,407 |
5,395 |
$264K |
| 96365 |
|
3,545 |
3,297 |
$231K |
| 99212 |
|
13,161 |
12,646 |
$167K |
| 92015 |
|
18,158 |
18,070 |
$159K |
| 99283 |
|
4,267 |
4,200 |
$132K |
| 74177 |
|
1,445 |
1,408 |
$122K |
| 0001A |
|
2,780 |
2,777 |
$107K |
| 0002A |
|
2,709 |
2,706 |
$106K |
| 96413 |
|
534 |
401 |
$101K |
| 99285 |
|
944 |
920 |
$97K |
| 97110 |
|
5,031 |
3,606 |
$91K |
| 92014 |
|
1,456 |
1,448 |
$78K |
| 70450 |
|
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 |
|
11,813 |
10,975 |
$66K |
| 93970 |
|
230 |
211 |
$53K |
| 0124A |
|
1,642 |
1,639 |
$52K |
| 99204 |
|
408 |
404 |
$42K |
| 0134A |
|
1,098 |
1,098 |
$39K |
| 62322 |
|
158 |
158 |
$39K |
| 67028 |
|
149 |
145 |
$38K |
| 99442 |
|
613 |
571 |
$37K |
| 77080 |
|
2,558 |
2,507 |
$36K |
| 90837 |
|
1,559 |
1,156 |
$36K |
| 0004A |
|
783 |
783 |
$31K |
| 71046 |
|
5,256 |
4,666 |
$31K |
| 0054A |
|
711 |
711 |
$30K |
| 92002 |
|
1,292 |
1,289 |
$29K |
| 92004 |
|
723 |
723 |
$26K |
| 90834 |
|
3,121 |
2,435 |
$25K |
| 90750 |
|
336 |
336 |
$24K |
| 93880 |
|
54 |
51 |
$19K |
| 99391 |
|
1,841 |
1,650 |
$18K |
| 0071A |
|
450 |
450 |
$18K |
| 93296 |
|
251 |
251 |
$17K |
| 96374 |
|
924 |
726 |
$16K |
| 93294 |
|
188 |
188 |
$16K |
| G0400 |
Home sleep test/type 4 porta |
422 |
421 |
$16K |
| 99443 |
|
179 |
139 |
$16K |
| 77066 |
Tomosynthesis, mammo |
191 |
169 |
$16K |
| 20610 |
|
243 |
227 |
$16K |
| 0072A |
|
363 |
363 |
$14K |
| J7030 |
Normal saline solution infus |
7,004 |
4,629 |
$13K |
| 99441 |
|
1,587 |
1,502 |
$13K |
| 11055 |
|
116 |
111 |
$13K |
| 77065 |
Tomosynthesis, mammo |
148 |
139 |
$13K |
| 78452 |
|
140 |
140 |
$13K |
| 74176 |
|
206 |
194 |
$12K |
| 99392 |
|
2,029 |
1,965 |
$12K |
| 93010 |
|
2,602 |
2,559 |
$12K |
| 90472 |
|
6,599 |
6,456 |
$11K |
| 99215 |
Prolong outpt/office vis |
1,389 |
1,284 |
$10K |
| 92551 |
|
6,624 |
6,615 |
$10K |
| 76705 |
|
752 |
681 |
$10K |
| 97161 |
|
517 |
509 |
$10K |
| 99202 |
|
1,336 |
1,313 |
$9K |
| 92567 |
|
703 |
697 |
$9K |
| 83921 |
|
321 |
320 |
$8K |
| 96372 |
|
1,630 |
1,061 |
$8K |
| 90656 |
|
1,798 |
1,789 |
$8K |
| 77063 |
|
275 |
275 |
$8K |
| 92557 |
|
303 |
302 |
$8K |
| 99393 |
|
1,218 |
1,215 |
$8K |
| 11721 |
|
141 |
141 |
$8K |
| 99203 |
|
1,151 |
1,122 |
$8K |
| 90677 |
|
167 |
167 |
$8K |
| 90674 |
|
596 |
596 |
$8K |
| 92523 |
|
158 |
155 |
$7K |
| 90853 |
|
719 |
295 |
$7K |
| 90694 |
|
63 |
63 |
$6K |
| 0031A |
|
147 |
147 |
$6K |
| 99220 |
|
30 |
30 |
$6K |
| 76856 |
|
772 |
679 |
$5K |
| 76813 |
|
219 |
219 |
$5K |
| 73721 |
|
135 |
125 |
$5K |
| 76830 |
|
660 |
582 |
$5K |
| 90679 |
|
28 |
28 |
$5K |
| 97535 |
|
231 |
197 |
$4K |
| 73562 |
|
750 |
620 |
$4K |
| 90670 |
|
1,116 |
1,018 |
$4K |
| 76816 |
|
341 |
331 |
$4K |
| 99282 |
|
448 |
434 |
$3K |
| 73030 |
|
535 |
422 |
$3K |
| 73630 |
|
809 |
632 |
$3K |
| 62323 |
|
25 |
25 |
$3K |
| G2012 |
Brief check in by md/qhp |
10,803 |
10,628 |
$3K |
| J3301 |
Triamcinolone acet inj nos |
586 |
508 |
$3K |
| 85025 |
|
3,150 |
2,944 |
$3K |
| 97597 |
|
29 |
24 |
$3K |
| 72100 |
|
364 |
304 |
$3K |
| 97140 |
|
390 |
264 |
$3K |
| 73221 |
|
17 |
16 |
$2K |
| J1756 |
Iron sucrose injection |
75 |
66 |
$2K |
| 90715 |
|
600 |
597 |
$2K |
| 91319 |
|
84 |
83 |
$2K |
| 85027 |
|
4,529 |
4,482 |
$2K |
| 99394 |
|
691 |
688 |
$2K |
| 99232 |
|
97 |
55 |
$2K |
| 20611 |
|
13 |
13 |
$2K |
| 99211 |
|
2,484 |
2,427 |
$2K |
| 0154A |
|
47 |
47 |
$2K |
| 94729 |
|
14 |
14 |
$2K |
| 92134 |
|
145 |
86 |
$2K |
| 94726 |
|
14 |
14 |
$2K |
| 99281 |
|
199 |
197 |
$1K |
| 76536 |
|
146 |
110 |
$1K |
| 76811 |
|
27 |
26 |
$1K |
| J7999 |
Compounded drug, noc |
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 |
Obtaining screen pap smear |
73 |
73 |
$751.51 |
| 97162 |
|
12 |
12 |
$716.00 |
| 97530 |
|
161 |
132 |
$680.00 |
| 94640 |
|
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 |
|
62 |
62 |
$428.70 |
| 99308 |
|
112 |
92 |
$418.31 |
| 99177 |
|
350 |
349 |
$416.00 |
| 90651 |
|
522 |
521 |
$407.49 |
| 99309 |
|
471 |
301 |
$407.32 |
| 86359 |
|
12 |
12 |
$380.00 |
| 88342 |
|
93 |
54 |
$360.00 |
| J3475 |
Inj magnesium sulfate |
336 |
335 |
$330.71 |
| 90633 |
|
509 |
465 |
$252.00 |
| J0702 |
Betamethasone acet&sod phosp |
14 |
14 |
$242.00 |
| 93005 |
|
511 |
497 |
$241.00 |
| 96366 |
|
122 |
51 |
$227.06 |
| 99385 |
|
53 |
52 |
$225.92 |
| 82565 |
|
3,574 |
3,446 |
$178.32 |
| 12001 |
|
17 |
17 |
$174.78 |
| 87880 |
|
824 |
788 |
$166.92 |
| 73502 |
|
111 |
70 |
$159.59 |
| 76805 |
|
185 |
113 |
$148.02 |
| 81002 |
|
878 |
806 |
$142.13 |
| 99417 |
Prolong home eval add 15m |
15 |
13 |
$140.00 |
| J1885 |
Ketorolac tromethamine inj |
622 |
428 |
$128.67 |
| 99291 |
|
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 |
|
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 |
Vitamin b12 injection |
118 |
58 |
$14.26 |
| 99051 |
|
10,939 |
10,861 |
$11.20 |
| 73110 |
|
233 |
117 |
$8.46 |
| J2405 |
Ondansetron hcl injection |
198 |
100 |
$6.72 |
| 87081 |
|
828 |
822 |
$5.68 |
| 81025 |
|
555 |
515 |
$2.77 |
| G9920 |
Scrning perf and negative |
1,049 |
1,049 |
$0.02 |
| 1036F |
|
7,489 |
7,291 |
$0.00 |
| 84443 |
|
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 |
|
1,341 |
1,264 |
$0.00 |
| 82040 |
|
222 |
218 |
$0.00 |
| 86780 |
|
691 |
673 |
$0.00 |
| 82306 |
|
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 non-comp unit |
274 |
133 |
$0.00 |
| 58100 |
|
19 |
18 |
$0.00 |
| 83550 |
|
475 |
474 |
$0.00 |
| G0145 |
Scr c/v cyto,thinlayer,rescr |
574 |
574 |
$0.00 |
| 86140 |
|
202 |
198 |
$0.00 |
| 84484 |
|
48 |
47 |
$0.00 |
| 97112 |
|
18 |
17 |
$0.00 |
| 83036 |
|
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 |
Meperidine hydrochl /100 mg |
65 |
34 |
$0.00 |
| 86317 |
|
137 |
109 |
$0.00 |
| 88304 |
|
99 |
74 |
$0.00 |
| 45380 |
|
73 |
60 |
$0.00 |
| 3044F |
|
800 |
795 |
$0.00 |
| 87389 |
|
754 |
749 |
$0.00 |
| L1810 |
Ko elastic with joints |
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 |
Fentanyl citrate injection |
108 |
58 |
$0.00 |
| 82550 |
|
50 |
47 |
$0.00 |
| 71101 |
|
60 |
34 |
$0.00 |
| 82746 |
|
139 |
139 |
$0.00 |
| J7644 |
Ipratropium bromide non-comp |
78 |
39 |
$0.00 |
| 92507 |
|
41 |
24 |
$0.00 |
| 84480 |
|
76 |
75 |
$0.00 |
| 86803 |
|
434 |
429 |
$0.00 |
| 76815 |
|
48 |
44 |
$0.00 |
| 86592 |
|
17 |
16 |
$0.00 |
| J2250 |
Inj midazolam hydrochloride |
173 |
92 |
$0.00 |
| 90732 |
|
98 |
97 |
$0.00 |
| 82962 |
|
83 |
78 |
$0.00 |
| 72148 |
|
63 |
54 |
$0.00 |
| 82043 |
|
662 |
658 |
$0.00 |
| 99205 |
Prolong outpt/office vis |
46 |
44 |
$0.00 |
| J1100 |
Dexamethasone sodium phos |
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 |
Screen cerv/vag thin layer |
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 |
Ceftriaxone sodium injection |
94 |
60 |
$0.00 |
| 76870 |
|
48 |
32 |
$0.00 |
| 83880 |
|
12 |
12 |
$0.00 |
| 70491 |
|
15 |
12 |
$0.00 |
| 45378 |
|
63 |
49 |
$0.00 |
| 31231 |
|
31 |
30 |
$0.00 |
| 94761 |
|
20 |
15 |
$0.00 |
| D1206 |
|
164 |
147 |
$0.00 |
| 58300 |
|
40 |
38 |
$0.00 |
| 97010 |
|
60 |
42 |
$0.00 |
| 90847 |
|
29 |
29 |
$0.00 |
| 71260 |
|
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 |
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 |
|
370 |
370 |
$0.00 |
| 80197 |
|
34 |
29 |
$0.00 |
| 76700 |
|
45 |
25 |
$0.00 |
| 17000 |
|
14 |
14 |
$0.00 |
| 86160 |
|
17 |
14 |
$0.00 |
| 96415 |
|
35 |
13 |
$0.00 |
| J7298 |
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 |
135 |
79 |
$0.00 |
| 70553 |
|
51 |
43 |
$0.00 |
| 87186 |
|
418 |
398 |
$0.00 |
| 87185 |
|
15 |
13 |
$0.00 |
| 90710 |
|
141 |
141 |
$0.00 |
| 78815 |
|
30 |
30 |
$0.00 |
| 84550 |
|
125 |
125 |
$0.00 |
| 90681 |
|
256 |
218 |
$0.00 |
| 90791 |
|
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 |
|
2,511 |
2,501 |
$0.00 |
| 87491 |
|
1,342 |
1,267 |
$0.00 |
| G0101 |
Ca screen;pelvic/breast exam |
15 |
15 |
$0.00 |
| 88175 |
|
52 |
48 |
$0.00 |
| 97150 |
|
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 |
Diphenhydramine hcl injectio |
72 |
18 |
$0.00 |
| 85014 |
|
228 |
217 |
$0.00 |
| J1071 |
Inj testosterone cypionate |
95 |
31 |
$0.00 |
| 90832 |
|
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 |
Screen c/v thin layer by md |
54 |
54 |
$0.00 |
| 93015 |
|
12 |
12 |
$0.00 |
| 86735 |
|
33 |
32 |
$0.00 |
| 70551 |
|
45 |
40 |
$0.00 |
| 11100 |
|
52 |
51 |
$0.00 |
| 86003 |
|
325 |
213 |
$0.00 |
| 80307 |
|
486 |
265 |
$0.00 |
| 84403 |
|
146 |
143 |
$0.00 |
| J2930 |
Methylprednisolone injection |
107 |
46 |
$0.00 |
| 73080 |
|
103 |
61 |
$0.00 |
| 84702 |
|
214 |
204 |
$0.00 |
| 83970 |
|
100 |
100 |
$0.00 |
| 99395 |
|
217 |
217 |
$0.00 |
| 92579 |
|
23 |
21 |
$0.00 |
| 82465 |
|
94 |
94 |
$0.00 |
| 93303 |
|
46 |
35 |
$0.00 |
| 73140 |
|
257 |
141 |
$0.00 |
| 92550 |
|
35 |
35 |
$0.00 |
| 90691 |
|
13 |
13 |
$0.00 |
| J1050 |
Medroxyprogesterone acetate |
146 |
77 |
$0.00 |
| 82248 |
|
56 |
48 |
$0.00 |
| 85046 |
|
12 |
12 |
$0.00 |
| 72070 |
|
58 |
33 |
$0.00 |
| L3260 |
Ambulatory surgical boot eac |
12 |
12 |
$0.00 |
| 31575 |
|
13 |
13 |
$0.00 |
| 87804 |
|
56 |
52 |
$0.00 |
| 81220 |
|
17 |
17 |
$0.00 |
| 90746 |
|
14 |
13 |
$0.00 |
| 20552 |
|
33 |
30 |
$0.00 |
| 99219 |
|
63 |
60 |
$0.00 |
| 99396 |
|
146 |
145 |
$0.00 |
| 43239 |
|
66 |
49 |
$0.00 |
| 99225 |
|
34 |
24 |
$0.00 |
| L1902 |
Afo ankle gauntlet pre ots |
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 |
Who cock-up nonmolde pre ots |
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 |
27 |
22 |
$0.00 |
| 00840 |
|
23 |
12 |
$0.00 |
| 26720 |
|
13 |
13 |
$0.00 |