| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
143 |
138 |
$3K |
| 43239 |
Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple |
12 |
12 |
$1K |
| J7120 |
Ringers lactate infusion, up to 1000 cc |
545 |
510 |
$320.20 |
| J2704 |
Injection, propofol, 10 mg |
595 |
557 |
$196.10 |
| 88312 |
|
13 |
13 |
$122.28 |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
86 |
83 |
$13.33 |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
36 |
36 |
$2.86 |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
135 |
92 |
$2.56 |