| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 36902 |
|
93 |
88 |
$8K |
| 99152 |
|
202 |
183 |
$1K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
15 |
15 |
$1K |
| 76801 |
|
12 |
12 |
$974.76 |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
520 |
484 |
$306.39 |
| 76937 |
|
32 |
25 |
$116.34 |
| J3301 |
Injection, triamcinolone acetonide, not otherwise specified, 10 mg |
13 |
13 |
$45.77 |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
118 |
106 |
$18.17 |
| 99153 |
Mod sedat endo service >5yrs |
13 |
13 |
$13.28 |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
125 |
116 |
$0.00 |
| G9500 |
Radiation exposure indices documented in final report for procedure using fluoroscopy |
336 |
276 |
$0.00 |