| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 01930 |
|
539 |
398 |
$69K |
| 01967 |
Neuraxial labor analgesia/anesthesia for planned vaginal delivery |
61 |
55 |
$23K |
| A4649 |
Surgical supply; miscellaneous |
823 |
557 |
$8K |
| A4222 |
Infusion supplies for external drug infusion pump, per cassette or bag (list drugs separately) |
762 |
553 |
$7K |
| 00910 |
|
85 |
85 |
$7K |
| J3490 |
Unclassified drugs |
460 |
290 |
$4K |
| E0445 |
Oximeter device for measuring blood oxygen levels non-invasively |
557 |
346 |
$3K |
| E1399 |
Durable medical equipment, miscellaneous |
1,380 |
346 |
$3K |
| E0485 |
Oral device/appliance used to reduce upper airway collapsibility, adjustable or non-adjustable, prefabricated, includes fitting and adjustment |
237 |
154 |
$611.68 |
| E1353 |
Regulator |
489 |
302 |
$593.22 |
| J7030 |
Infusion, normal saline solution , 1000 cc |
764 |
561 |
$450.99 |
| A4615 |
Cannula, nasal |
803 |
567 |
$157.62 |
| E1354 |
Oxygen accessory, wheeled cart for portable cylinder or portable concentrator, any type, replacement only, each |
561 |
347 |
$116.48 |
| J1094 |
Injection, dexamethasone acetate, 1 mg |
206 |
148 |
$110.17 |
| J2704 |
Injection, propofol, 10 mg |
230 |
166 |
$105.51 |
| A4670 |
Automatic blood pressure monitor |
197 |
153 |
$75.05 |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
662 |
478 |
$63.67 |
| J7643 |
Glycopyrrolate, inhalation solution, compounded product, administered through dme, unit dose form, per milligram |
325 |
226 |
$44.75 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
168 |
111 |
$41.19 |
| A4213 |
Syringe, sterile, 20 cc or greater, each |
1,071 |
572 |
$26.25 |
| A4207 |
Syringe with needle, sterile 2 cc, each |
1,076 |
574 |
$17.17 |
| J2001 |
Injection, lidocaine hcl for intravenous infusion, 10 mg |
480 |
316 |
$13.52 |
| R0076 |
Transportation of portable ekg to facility or location, per patient |
556 |
334 |
$0.00 |
| 99070 |
|
968 |
474 |
$0.00 |