| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 43239 |
|
165 |
158 |
$90K |
| 45380 |
|
28 |
27 |
$23K |
| J3490 |
Drugs unclassified injection |
11,703 |
4,720 |
$6K |
| 96365 |
|
88 |
63 |
$3K |
| C9399 |
Unclassified drugs or biolog |
124 |
92 |
$2K |
| 88305 |
|
600 |
566 |
$2K |
| 85025 |
|
292 |
208 |
$837.52 |
| C1769 |
Guide wire |
12 |
12 |
$697.74 |
| 88342 |
|
93 |
86 |
$674.70 |
| 80048 |
|
261 |
188 |
$662.17 |
| J7999 |
Compounded drug, noc |
3,798 |
1,723 |
$538.85 |
| 93005 |
|
130 |
120 |
$321.36 |
| 83735 |
|
132 |
96 |
$298.30 |
| 76942 |
|
26 |
25 |
$282.87 |
| 99152 |
|
72 |
68 |
$273.54 |
| J2704 |
Inj, propofol, 10 mg |
4,685 |
3,343 |
$261.61 |
| 85610 |
|
247 |
198 |
$258.88 |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
625 |
584 |
$238.85 |
| 82962 |
|
367 |
254 |
$203.78 |
| 99153 |
Mod sedat endo service >5yrs |
59 |
51 |
$177.92 |
| J1170 |
Hydromorphone injection |
3,859 |
1,841 |
$177.32 |
| J0690 |
Cefazolin sodium injection |
3,960 |
2,749 |
$171.45 |
| 88341 |
|
13 |
12 |
$136.95 |
| J1644 |
Inj heparin sodium per 1000u |
1,563 |
1,086 |
$134.64 |
| J3010 |
Fentanyl citrate injection |
6,269 |
5,328 |
$126.95 |
| 84100 |
|
50 |
38 |
$97.47 |
| J2250 |
Inj midazolam hydrochloride |
7,274 |
6,157 |
$91.04 |
| J0131 |
Inj, acetaminophen (nos) |
2,417 |
2,148 |
$78.64 |
| S0020 |
Injection, bupivicaine hydro |
180 |
123 |
$62.22 |
| J1100 |
Dexamethasone sodium phos |
2,455 |
2,110 |
$43.71 |
| 82565 |
|
25 |
17 |
$43.45 |
| 85730 |
|
49 |
47 |
$30.46 |
| J2405 |
Ondansetron hcl injection |
5,774 |
4,684 |
$26.62 |
| J2795 |
Ropivacaine hcl injection |
354 |
334 |
$12.00 |
| J2001 |
Lidocaine injection |
76 |
44 |
$0.01 |
| J0330 |
Succinycholine chloride inj |
51 |
37 |
$0.00 |
| J7050 |
Normal saline solution infus |
571 |
376 |
$0.00 |
| J1885 |
Ketorolac tromethamine inj |
608 |
498 |
$0.00 |
| J8501 |
Oral aprepitant |
15 |
14 |
$0.00 |
| Q9965 |
Locm 100-199mg/ml iodine,1ml |
14 |
13 |
$0.00 |
| J1630 |
Haloperidol injection |
39 |
39 |
$0.00 |
| J1171 |
Inj, hydromorphone, 0.1 mg |
233 |
147 |
$0.00 |
| J0171 |
Adrenalin epinephrine inject |
95 |
90 |
$0.00 |
| J7030 |
Normal saline solution infus |
106 |
101 |
$0.00 |
| J3475 |
Inj magnesium sulfate |
226 |
216 |
$0.00 |
| J0665 |
Inj, bupivacaine, nos, 0.5mg |
861 |
793 |
$0.00 |
| J1200 |
Diphenhydramine hcl injectio |
145 |
117 |
$0.00 |
| J1756 |
Iron sucrose injection |
48 |
24 |
$0.00 |
| J1596 |
Inj, glycopyrrolate, 0.1 mg |
308 |
306 |
$0.00 |
| J3370 |
Vancomycin hcl injection |
39 |
34 |
$0.00 |
| J0780 |
Prochlorperazine injection |
27 |
26 |
$0.00 |