| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 69436 |
Tympanostomy (requiring insertion of ventilating tube), general anesthesia |
413 |
337 |
$447K |
| 42820 |
Tonsillectomy and adenoidectomy; younger than age 12 |
80 |
68 |
$289K |
| 88304 |
|
610 |
332 |
$19K |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
268 |
176 |
$6K |
| 43239 |
Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple |
14 |
12 |
$2K |
| J0461 |
Injection, atropine sulfate, 0.01 mg |
547 |
416 |
$42.24 |
| 82948 |
|
26 |
25 |
$36.68 |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
946 |
695 |
$25.43 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
675 |
520 |
$16.74 |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
677 |
523 |
$6.55 |
| J0690 |
Injection, cefazolin sodium, 500 mg |
159 |
116 |
$0.00 |
| J0330 |
Injection, succinylcholine chloride, up to 20 mg |
136 |
111 |
$0.00 |
| J1030 |
Injection, methylprednisolone acetate, 40 mg |
18 |
14 |
$0.00 |
| J3490 |
Unclassified drugs |
2,741 |
753 |
$0.00 |
| J2175 |
Injection, meperidine hydrochloride, per 100 mg |
61 |
50 |
$0.00 |
| J2704 |
Injection, propofol, 10 mg |
530 |
458 |
$0.00 |
| 36416 |
|
26 |
25 |
$0.00 |
| J2001 |
Injection, lidocaine hcl for intravenous infusion, 10 mg |
19 |
12 |
$0.00 |
| J2003 |
Injection, lidocaine hydrochloride, 1 mg |
30 |
19 |
$0.00 |
| J1040 |
Injection, methylprednisolone acetate, 80 mg |
14 |
13 |
$0.00 |
| J0171 |
Injection, adrenalin, epinephrine, 0.1 mg |
63 |
47 |
$0.00 |
| J2004 |
Injection, lidocaine hcl with epinephrine, 1 mg |
13 |
13 |
$0.00 |