| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99284 |
|
46,277 |
35,401 |
$9.63M |
| 74177 |
|
13,047 |
10,190 |
$7.67M |
| 99285 |
|
26,412 |
17,685 |
$7.18M |
| 99283 |
|
43,806 |
37,835 |
$6.22M |
| 74176 |
|
6,213 |
4,791 |
$3.32M |
| 70450 |
|
11,065 |
8,353 |
$2.99M |
| 93306 |
|
7,799 |
6,551 |
$2.90M |
| 93005 |
|
33,937 |
25,219 |
$1.80M |
| 78452 |
|
7,606 |
3,015 |
$1.64M |
| G0378 |
Hospital observation per hr |
5,876 |
4,072 |
$1.50M |
| C1713 |
Anchor/screw bn/bn,tis/bn |
1,697 |
1,327 |
$958K |
| 71045 |
|
31,307 |
21,518 |
$915K |
| 96361 |
|
31,060 |
12,036 |
$915K |
| 96374 |
|
51,427 |
24,257 |
$896K |
| 72125 |
|
3,483 |
2,968 |
$877K |
| 76705 |
|
3,860 |
3,437 |
$869K |
| 96365 |
|
27,190 |
9,950 |
$859K |
| 71046 |
|
18,472 |
14,077 |
$823K |
| 87633 |
|
2,270 |
2,155 |
$804K |
| 80053 |
|
81,465 |
60,664 |
$803K |
| 72148 |
|
2,703 |
2,375 |
$775K |
| 71260 |
|
3,293 |
2,362 |
$758K |
| 97110 |
|
30,254 |
5,393 |
$750K |
| 96375 |
|
22,952 |
17,767 |
$684K |
| 95810 |
|
1,858 |
1,584 |
$683K |
| 36415 |
|
153,281 |
73,307 |
$678K |
| 70551 |
|
2,240 |
1,893 |
$675K |
| 72131 |
|
2,644 |
2,174 |
$667K |
| 85025 |
|
86,606 |
67,587 |
$649K |
| 97112 |
|
22,330 |
4,693 |
$644K |
| 0202U |
|
2,038 |
1,732 |
$633K |
| 43239 |
|
1,679 |
1,081 |
$595K |
| 73721 |
|
2,074 |
1,857 |
$581K |
| 96413 |
|
2,821 |
1,250 |
$563K |
| 70553 |
|
1,849 |
1,412 |
$556K |
| 73630 |
|
7,292 |
6,115 |
$546K |
| 71275 |
|
2,528 |
1,852 |
$546K |
| 93017 |
|
3,677 |
3,102 |
$525K |
| 97140 |
|
18,367 |
4,389 |
$512K |
| 99282 |
|
7,098 |
6,470 |
$507K |
| 69436 |
|
388 |
352 |
$504K |
| 71250 |
|
2,408 |
1,946 |
$437K |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
14,658 |
12,696 |
$437K |
| 76700 |
|
1,716 |
1,522 |
$432K |
| 73610 |
|
5,741 |
4,667 |
$404K |
| 70486 |
|
1,538 |
1,378 |
$398K |
| 80307 |
|
8,358 |
6,375 |
$392K |
| U0003 |
Cov-19 amp prb hgh thruput |
6,048 |
5,206 |
$355K |
| 96372 |
|
22,801 |
11,345 |
$314K |
| 97530 |
|
15,293 |
3,693 |
$302K |
| 0240U |
|
5,541 |
4,163 |
$299K |
| 84484 |
|
25,251 |
18,957 |
$296K |
| 72100 |
|
4,638 |
3,973 |
$287K |
| 72141 |
|
1,043 |
885 |
$282K |
| G0480 |
Drug test def 1-7 classes |
3,598 |
2,824 |
$279K |
| 96366 |
|
3,947 |
2,466 |
$276K |
| 96360 |
|
10,899 |
4,430 |
$266K |
| 73130 |
|
4,277 |
3,587 |
$261K |
| 74018 |
|
3,348 |
3,007 |
$248K |
| 76536 |
|
2,076 |
1,803 |
$243K |
| 93971 |
|
2,080 |
1,796 |
$241K |
| 73564 |
|
3,173 |
2,603 |
$237K |
| 72110 |
|
2,217 |
1,926 |
$235K |
| 94060 |
|
3,470 |
1,981 |
$229K |
| 73030 |
|
4,105 |
3,358 |
$219K |
| 71271 |
|
833 |
744 |
$216K |
| 11042 |
|
3,952 |
1,489 |
$199K |
| J2785 |
Regadenoson injection |
1,885 |
1,615 |
$189K |
| 0241U |
|
2,810 |
1,965 |
$189K |
| G0463 |
Hospital outpt clinic visit |
14,693 |
9,748 |
$188K |
| 87804 |
|
7,529 |
6,171 |
$183K |
| 82553 |
|
17,236 |
12,132 |
$179K |
| U0002 |
Covid-19 lab test non-cdc |
6,655 |
3,943 |
$173K |
| 96367 |
|
4,159 |
1,574 |
$172K |
| A9502 |
Tc99m tetrofosmin |
2,479 |
2,003 |
$169K |
| 72128 |
|
857 |
702 |
$154K |
| 83880 |
|
5,359 |
4,501 |
$151K |
| 84443 |
|
10,258 |
9,242 |
$149K |
| 76775 |
|
1,296 |
1,072 |
$148K |
| 72050 |
|
1,489 |
1,211 |
$147K |
| 73221 |
|
501 |
452 |
$140K |
| 96376 |
|
6,507 |
4,306 |
$137K |
| 87880 |
|
9,439 |
8,681 |
$135K |
| 83874 |
|
11,588 |
8,959 |
$133K |
| 11043 |
|
1,046 |
471 |
$128K |
| 83690 |
|
21,370 |
18,380 |
$127K |
| 84145 |
|
5,925 |
5,168 |
$124K |
| 73110 |
|
2,208 |
1,819 |
$121K |
| 72040 |
|
1,969 |
1,626 |
$118K |
| 87507 |
|
398 |
370 |
$114K |
| 81001 |
|
40,911 |
34,660 |
$114K |
| 76641 |
|
652 |
480 |
$112K |
| 77067 |
|
1,979 |
1,877 |
$111K |
| 82550 |
|
18,648 |
13,289 |
$109K |
| 73562 |
|
1,635 |
1,344 |
$103K |
| 94640 |
|
2,987 |
2,007 |
$102K |
| 73502 |
|
2,318 |
1,890 |
$101K |
| 80048 |
|
14,893 |
9,875 |
$100K |
| 83605 |
|
10,122 |
8,411 |
$99K |
| 87086 |
|
14,266 |
12,249 |
$98K |
| 82306 |
|
4,281 |
3,807 |
$96K |
| 73590 |
|
1,767 |
1,450 |
$96K |
| 84703 |
|
13,977 |
12,148 |
$94K |
| 73080 |
|
1,422 |
1,187 |
$93K |
| 73700 |
|
622 |
540 |
$89K |
| 12001 |
|
1,136 |
1,025 |
$88K |
| 87040 |
|
7,256 |
5,693 |
$87K |
| 72070 |
|
1,422 |
1,206 |
$84K |
| 73090 |
|
1,466 |
1,180 |
$84K |
| 93225 |
|
1,265 |
1,079 |
$82K |
| J0696 |
Ceftriaxone sodium injection |
7,142 |
5,209 |
$78K |
| G0297 |
Ldct for lung ca screen |
361 |
334 |
$76K |
| 93880 |
|
257 |
208 |
$72K |
| 80061 |
|
6,474 |
5,146 |
$67K |
| 94664 |
|
2,952 |
2,497 |
$62K |
| 93970 |
|
258 |
233 |
$59K |
| 85379 |
|
6,653 |
6,051 |
$58K |
| 87651 |
|
1,858 |
1,760 |
$55K |
| C1776 |
Joint device (implantable) |
50 |
42 |
$55K |
| 93925 |
|
310 |
274 |
$54K |
| 94726 |
|
1,409 |
1,290 |
$53K |
| 70498 |
|
196 |
161 |
$52K |
| 82728 |
|
4,478 |
4,002 |
$52K |
| 84439 |
|
6,301 |
5,610 |
$51K |
| 36600 |
|
3,008 |
1,978 |
$51K |
| 87081 |
|
8,488 |
7,904 |
$51K |
| 80074 |
|
1,367 |
1,234 |
$51K |
| 83735 |
|
8,691 |
6,612 |
$47K |
| 45380 |
|
190 |
152 |
$47K |
| 76000 |
|
1,742 |
1,437 |
$46K |
| 86140 |
|
10,292 |
8,821 |
$46K |
| Q9962 |
Hocm 300-349mg/ml iodine,1ml |
1,794 |
1,577 |
$46K |
| 84702 |
|
3,479 |
2,742 |
$45K |
| J1885 |
Ketorolac tromethamine inj |
17,848 |
14,981 |
$45K |
| 97162 |
|
1,916 |
1,090 |
$45K |
| 85027 |
|
6,912 |
5,426 |
$45K |
| 87077 |
|
6,542 |
4,911 |
$44K |
| 87635 |
|
1,085 |
976 |
$44K |
| 70496 |
|
226 |
178 |
$43K |
| 87186 |
|
5,110 |
4,430 |
$43K |
| 97161 |
|
2,245 |
1,222 |
$43K |
| Q9963 |
Hocm 350-399mg/ml iodine,1ml |
1,688 |
1,485 |
$41K |
| 94010 |
|
1,318 |
1,003 |
$40K |
| J7030 |
Normal saline solution infus |
21,642 |
16,030 |
$40K |
| A9577 |
Inj multihance |
1,659 |
1,410 |
$39K |
| 82607 |
|
3,208 |
2,811 |
$38K |
| J0690 |
Cefazolin sodium injection |
5,427 |
3,743 |
$38K |
| 82803 |
|
2,013 |
1,614 |
$38K |
| 90715 |
|
1,729 |
1,561 |
$37K |
| J1756 |
Iron sucrose injection |
743 |
299 |
$37K |
| J2795 |
Ropivacaine hcl injection |
3,344 |
2,462 |
$36K |
| 85610 |
|
9,657 |
7,936 |
$35K |
| 88305 |
|
499 |
414 |
$35K |
| 83036 |
|
4,751 |
4,270 |
$33K |
| J2704 |
Inj, propofol, 10 mg |
9,520 |
7,071 |
$33K |
| 82805 |
|
645 |
468 |
$32K |
| 87491 |
|
1,030 |
944 |
$31K |
| 87070 |
|
5,485 |
3,399 |
$31K |
| 87591 |
|
991 |
933 |
$31K |
| J2405 |
Ondansetron hcl injection |
27,235 |
20,176 |
$30K |
| 76830 |
|
194 |
176 |
$30K |
| 10060 |
|
433 |
375 |
$29K |
| 85730 |
|
6,331 |
5,383 |
$29K |
| 76870 |
|
180 |
166 |
$29K |
| 45385 |
|
79 |
65 |
$28K |
| M0243 |
Casirivi and imdevi inj |
274 |
259 |
$27K |
| 93226 |
|
451 |
409 |
$27K |
| J1100 |
Dexamethasone sodium phos |
12,188 |
9,035 |
$27K |
| 59025 |
|
508 |
409 |
$26K |
| 81025 |
|
3,667 |
3,155 |
$26K |
| 77080 |
|
458 |
381 |
$26K |
| 83550 |
|
3,465 |
3,204 |
$25K |
| 85652 |
|
7,738 |
5,664 |
$24K |
| 73718 |
|
96 |
81 |
$23K |
| 82962 |
|
7,559 |
3,531 |
$23K |
| J3370 |
Vancomycin hcl injection |
2,822 |
1,641 |
$22K |
| J2270 |
Morphine sulfate injection |
11,133 |
7,571 |
$22K |
| 29125 |
|
517 |
460 |
$22K |
| 94729 |
|
1,446 |
1,367 |
$22K |
| 99291 |
|
124 |
77 |
$21K |
| C1788 |
Port, indwelling, imp |
369 |
160 |
$21K |
| 83540 |
|
3,762 |
3,477 |
$21K |
| 72072 |
|
947 |
802 |
$21K |
| 87420 |
|
1,542 |
1,445 |
$20K |
| 77063 |
|
1,470 |
1,215 |
$20K |
| 80050 |
|
645 |
550 |
$20K |
| C1769 |
Guide wire |
406 |
303 |
$19K |
| 93270 |
|
1,042 |
910 |
$19K |
| 90471 |
|
2,240 |
1,963 |
$19K |
| J2930 |
Methylprednisolone injection |
2,910 |
2,274 |
$19K |
| 82150 |
|
3,131 |
2,739 |
$19K |
| 93798 |
|
872 |
179 |
$19K |
| 86850 |
|
2,389 |
1,750 |
$18K |
| J3010 |
Fentanyl citrate injection |
10,250 |
6,830 |
$18K |
| 93303 |
|
105 |
99 |
$18K |
| J1170 |
Hydromorphone injection |
5,925 |
3,333 |
$18K |
| 83615 |
|
2,236 |
1,968 |
$16K |
| A9579 |
Gad-base mr contrast nos,1ml |
475 |
448 |
$16K |
| 87798 |
|
470 |
432 |
$16K |
| 45378 |
|
69 |
45 |
$16K |
| 12002 |
|
135 |
112 |
$15K |
| 87486 |
|
453 |
414 |
$15K |
| 97165 |
|
417 |
349 |
$15K |
| 87581 |
|
449 |
414 |
$15K |
| J2469 |
Palonosetron hcl |
107 |
65 |
$14K |
| 84112 |
|
158 |
142 |
$14K |
| J7120 |
Ringers lactate infusion |
8,367 |
6,204 |
$14K |
| 96415 |
|
146 |
88 |
$14K |
| 36591 |
|
738 |
376 |
$14K |
| 70491 |
|
57 |
37 |
$13K |
| 87205 |
|
3,265 |
2,836 |
$13K |
| J2250 |
Inj midazolam hydrochloride |
8,820 |
6,663 |
$13K |
| 64721 |
|
33 |
12 |
$12K |
| 54160 |
|
40 |
39 |
$12K |
| 73060 |
|
221 |
172 |
$12K |
| 83516 |
|
638 |
451 |
$12K |
| 82731 |
|
175 |
157 |
$11K |
| C9113 |
Inj pantoprazole sodium, via |
2,321 |
1,724 |
$11K |
| 94760 |
|
1,524 |
941 |
$11K |
| 99281 |
|
407 |
369 |
$11K |
| 78227 |
|
105 |
69 |
$10K |
| 82746 |
|
846 |
760 |
$10K |
| 74178 |
|
16 |
12 |
$10K |
| 81003 |
|
4,558 |
4,015 |
$9K |
| J0171 |
Adrenalin epinephrine inject |
917 |
667 |
$9K |
| 82565 |
|
1,170 |
960 |
$9K |
| 73560 |
|
136 |
112 |
$8K |
| 84100 |
|
2,147 |
1,616 |
$8K |
| J7040 |
Normal saline solution infus |
5,054 |
2,585 |
$8K |
| J1650 |
Inj enoxaparin sodium |
1,878 |
964 |
$8K |
| 76817 |
|
74 |
67 |
$8K |
| 80320 |
|
257 |
215 |
$8K |
| 82570 |
|
1,891 |
1,672 |
$8K |
| 86900 |
|
3,030 |
2,501 |
$8K |
| 72170 |
|
167 |
135 |
$8K |
| 86901 |
|
2,921 |
2,488 |
$8K |
| 73552 |
|
130 |
116 |
$7K |
| 99212 |
|
404 |
333 |
$7K |
| 82784 |
|
678 |
577 |
$7K |
| 99152 |
|
332 |
273 |
$7K |
| 82140 |
|
572 |
460 |
$7K |
| M0245 |
Bamlan and etesev infusion |
60 |
56 |
$7K |
| C8929 |
Tte w or wo fol wcon,doppler |
13 |
13 |
$7K |
| 83518 |
|
766 |
654 |
$7K |
| 12011 |
|
58 |
49 |
$6K |
| J0897 |
Denosumab injection |
14 |
13 |
$6K |
| 95811 |
|
31 |
26 |
$6K |
| J2543 |
Piperacillin/tazobactam |
521 |
322 |
$6K |
| 83520 |
|
360 |
286 |
$6K |
| M0247 |
Sotrovimab infusion |
51 |
49 |
$6K |
| 86038 |
|
607 |
554 |
$6K |
| J0131 |
Inj, acetaminophen (nos) |
247 |
212 |
$6K |
| 84156 |
|
1,370 |
1,012 |
$6K |
| 96368 |
|
210 |
153 |
$6K |
| 78264 |
|
15 |
13 |
$6K |
| J1644 |
Inj heparin sodium per 1000u |
1,826 |
800 |
$6K |
| 97163 |
|
144 |
131 |
$5K |
| 82948 |
|
1,018 |
502 |
$5K |
| J1200 |
Diphenhydramine hcl injectio |
3,034 |
2,390 |
$5K |
| J1815 |
Insulin injection |
671 |
242 |
$5K |
| 87389 |
|
202 |
188 |
$5K |
| 82947 |
|
1,731 |
968 |
$5K |
| 71111 |
|
70 |
44 |
$5K |
| 80076 |
|
646 |
567 |
$5K |
| J2550 |
Promethazine hcl injection |
3,250 |
2,371 |
$4K |
| 82043 |
|
772 |
563 |
$4K |
| 84550 |
|
1,201 |
1,030 |
$4K |
| 84436 |
|
809 |
745 |
$4K |
| 97597 |
|
201 |
125 |
$4K |
| 45384 |
|
28 |
13 |
$4K |
| M0222 |
Bebtelovimab injection |
27 |
25 |
$4K |
| J0561 |
Penicillin g benzathine inj |
33 |
29 |
$4K |
| A9537 |
Tc99m mebrofenin |
234 |
200 |
$4K |
| 82248 |
|
750 |
557 |
$4K |
| J3490 |
Drugs unclassified injection |
648 |
210 |
$4K |
| 72082 |
|
26 |
26 |
$3K |
| J2710 |
Neostigmine methylslfte inj |
1,546 |
1,181 |
$3K |
| 86200 |
|
297 |
272 |
$3K |
| J1453 |
Fosaprepitant injection |
20 |
12 |
$3K |
| 73200 |
|
12 |
12 |
$3K |
| 84480 |
|
276 |
231 |
$3K |
| 83921 |
|
169 |
160 |
$3K |
| J7050 |
Normal saline solution infus |
1,544 |
1,209 |
$3K |
| J2765 |
Metoclopramide hcl injection |
2,197 |
1,864 |
$3K |
| 64450 |
|
61 |
40 |
$3K |
| 36416 |
|
506 |
393 |
$3K |
| 76770 |
|
17 |
15 |
$3K |
| 86480 |
|
46 |
44 |
$3K |
| 94681 |
|
31 |
26 |
$2K |
| 82009 |
|
646 |
550 |
$2K |
| 86431 |
|
516 |
475 |
$2K |
| 73620 |
|
41 |
37 |
$2K |
| 86403 |
|
235 |
214 |
$2K |
| 73140 |
|
44 |
38 |
$2K |
| J2060 |
Lorazepam injection |
1,348 |
1,003 |
$2K |
| 99153 |
Mod sedat endo service >5yrs |
84 |
63 |
$2K |
| 86003 |
|
28 |
28 |
$2K |
| 78226 |
|
18 |
16 |
$2K |
| 71101 |
|
25 |
25 |
$2K |
| 86920 |
|
64 |
38 |
$2K |
| P9016 |
Rbc leukocytes reduced |
32 |
25 |
$2K |
| 10061 |
|
17 |
14 |
$2K |
| 77065 |
Tomosynthesis, mammo |
64 |
55 |
$2K |
| J3475 |
Inj magnesium sulfate |
496 |
289 |
$2K |
| J2919 |
Inj, methylpred sod succ 5mg |
307 |
223 |
$2K |
| 72020 |
|
55 |
40 |
$1K |
| J2360 |
Orphenadrine injection |
128 |
119 |
$1K |
| J7070 |
D5w infusion |
559 |
249 |
$1K |
| 82247 |
|
307 |
206 |
$1K |
| 86665 |
|
39 |
36 |
$1K |
| 99211 |
|
222 |
168 |
$1K |
| J0689 |
Inj cefazolin sodium, baxter |
258 |
164 |
$1K |
| 72202 |
|
13 |
13 |
$1K |
| 82747 |
|
65 |
61 |
$1K |
| 84238 |
|
37 |
23 |
$1K |
| 80179 |
|
104 |
93 |
$1K |
| 84520 |
|
135 |
119 |
$1K |
| 97116 |
|
64 |
26 |
$1K |
| 87210 |
|
207 |
195 |
$980.17 |
| 86803 |
|
89 |
80 |
$971.14 |
| 36430 |
|
15 |
14 |
$969.84 |
| 90714 |
|
59 |
52 |
$937.68 |
| M0239 |
Bamlanivimab-xxxx infusion |
23 |
22 |
$870.16 |
| J3480 |
Inj potassium chloride |
188 |
115 |
$847.64 |
| A9270 |
Non-covered item or service |
1,611 |
385 |
$841.01 |
| 82272 |
|
225 |
206 |
$788.99 |
| J2001 |
Lidocaine injection |
2,311 |
1,785 |
$772.45 |
| J0780 |
Prochlorperazine injection |
65 |
58 |
$752.87 |
| 0012A |
|
59 |
57 |
$717.06 |
| J2371 |
Inj phenylephrine hcl 20 mcg |
321 |
239 |
$715.77 |
| 87390 |
|
30 |
28 |
$664.67 |
| J1598 |
Inj glycopyrrolate fres kabi |
125 |
99 |
$663.26 |
| 51701 |
|
13 |
13 |
$649.88 |
| 80143 |
|
46 |
44 |
$644.89 |
| 84481 |
|
52 |
47 |
$644.33 |
| 87340 |
|
79 |
73 |
$639.03 |
| 96523 |
|
172 |
110 |
$618.91 |
| 99202 |
|
50 |
46 |
$617.03 |
| J0592 |
Buprenorphine hydrochloride |
118 |
89 |
$610.81 |
| G0279 |
Tomosynthesis, mammo |
77 |
59 |
$571.60 |
| 86160 |
|
31 |
25 |
$570.29 |
| 87522 |
Neg quan hep c or qual rna |
15 |
14 |
$566.90 |
| 86664 |
|
39 |
36 |
$552.47 |
| J1953 |
Levetiracetam injection |
55 |
41 |
$541.09 |
| A9541 |
Tc99m sulfur colloid |
13 |
12 |
$509.62 |
| 73100 |
|
19 |
12 |
$502.97 |
| J1720 |
Hydrocortisone sodium succ i |
34 |
25 |
$475.77 |
| 86663 |
|
39 |
36 |
$473.99 |
| 97166 |
|
28 |
25 |
$465.49 |
| 86704 |
|
47 |
44 |
$449.83 |
| 88304 |
|
14 |
13 |
$431.64 |
| J1171 |
Inj, hydromorphone, 0.1 mg |
88 |
80 |
$421.66 |
| J2470 |
Inj pantoprazole sodium 40mg |
106 |
92 |
$409.37 |
| 73522 |
|
20 |
17 |
$393.15 |
| 99406 |
|
39 |
37 |
$378.88 |
| G0379 |
Direct refer hospital observ |
93 |
81 |
$372.67 |
| J0330 |
Succinycholine chloride inj |
102 |
77 |
$371.89 |
| 84153 |
|
27 |
25 |
$345.78 |
| J1642 |
Inj heparin sodium per 10 u |
594 |
349 |
$343.09 |
| 85018 |
|
208 |
133 |
$324.88 |
| 84132 |
|
56 |
36 |
$318.20 |
| 86780 |
|
25 |
24 |
$314.24 |
| J1596 |
Inj, glycopyrrolate, 0.1 mg |
55 |
47 |
$310.11 |
| J2272 |
Inj, morphine (fresenius) |
357 |
278 |
$307.21 |
| J0665 |
Inj, bupivacaine, nos, 0.5mg |
589 |
498 |
$294.86 |
| 0011A |
|
36 |
35 |
$289.28 |
| 85014 |
|
170 |
109 |
$276.23 |
| J2920 |
Methylprednisolone injection |
122 |
54 |
$267.30 |
| 83525 |
|
26 |
26 |
$232.50 |
| J7060 |
5% dextrose/water |
90 |
57 |
$193.21 |
| 86308 |
|
41 |
40 |
$181.62 |
| 86039 |
|
13 |
12 |
$144.79 |
| J0702 |
Betamethasone acet&sod phosp |
14 |
12 |
$135.56 |
| J2370 |
Phenylephrine hcl injection |
230 |
159 |
$124.82 |
| 81015 |
|
514 |
438 |
$114.56 |
| 82270 |
|
27 |
24 |
$105.24 |
| G8978 |
Mobility current status |
65 |
30 |
$99.73 |
| J2003 |
Inj, lidocaine hcl, 1 mg |
175 |
168 |
$81.71 |
| 89055 |
|
18 |
17 |
$79.71 |
| J1940 |
Furosemide injection |
35 |
25 |
$64.10 |
| J7512 |
Prednisone ir or dr oral 1mg |
77 |
64 |
$21.03 |
| G8979 |
Mobility goal status |
28 |
25 |
$0.00 |