| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 69436 |
|
4,045 |
4,045 |
$2.54M |
| 42820 |
|
651 |
651 |
$2.48M |
| 42830 |
|
194 |
194 |
$209K |
| 95810 |
|
383 |
382 |
$127K |
| 64483 |
|
149 |
147 |
$55K |
| 95811 |
|
54 |
54 |
$18K |
| U0004 |
Cov-19 test non-cdc hgh thru |
152 |
151 |
$15K |
| 43239 |
|
12 |
12 |
$7K |
| G0260 |
Inj for sacroiliac jt anesth |
12 |
12 |
$2K |
| J0665 |
Inj, bupivacaine, nos, 0.5mg |
181 |
164 |
$90.36 |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
305 |
295 |
$41.89 |
| J2250 |
Inj midazolam hydrochloride |
112 |
111 |
$8.27 |
| J7050 |
Normal saline solution infus |
135 |
135 |
$0.00 |
| J1885 |
Ketorolac tromethamine inj |
1,992 |
1,991 |
$0.00 |
| J1100 |
Dexamethasone sodium phos |
27 |
27 |
$0.00 |
| J7120 |
Ringers lactate infusion |
829 |
826 |
$0.00 |