| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 36215 |
|
1,555 |
1,358 |
$198K |
| 36902 |
|
2,154 |
2,090 |
$176K |
| 36901 |
|
250 |
243 |
$25K |
| 75710 |
|
1,601 |
1,407 |
$21K |
| 36907 |
|
346 |
329 |
$12K |
| 99152 |
|
3,744 |
3,372 |
$11K |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
1,331 |
1,226 |
$2K |
| J2997 |
Injection, alteplase recombinant, 1 mg |
15 |
12 |
$561.15 |
| 99153 |
Mod sedat endo service >5yrs |
413 |
371 |
$559.96 |
| 77001 |
|
16 |
14 |
$136.32 |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
1,572 |
1,455 |
$6.19 |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
5,987 |
3,621 |
$0.00 |
| J1644 |
Injection, heparin sodium, per 1000 units |
48 |
40 |
$0.00 |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
1,642 |
1,513 |
$0.00 |
| J1170 |
Injection, hydromorphone, up to 4 mg |
37 |
35 |
$0.00 |