| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 01992 |
|
6,633 |
5,704 |
$439K |
| 01936 |
|
10,425 |
8,084 |
$338K |
| 01320 |
|
591 |
427 |
$11K |
| E0600 |
Respiratory suction pump, home model, portable or stationary, electric |
10,809 |
7,486 |
$8K |
| 01991 |
|
465 |
368 |
$6K |
| J7040 |
Infusion, normal saline solution, sterile (500 ml = 1 unit) |
13,491 |
9,923 |
$3K |
| J1810 |
Injection, droperidol and fentanyl citrate, up to 2 ml ampule |
2,550 |
1,890 |
$2K |
| J2704 |
Injection, propofol, 10 mg |
11,604 |
8,097 |
$990.90 |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
2,004 |
1,490 |
$93.67 |
| J2001 |
Injection, lidocaine hcl for intravenous infusion, 10 mg |
3,924 |
3,054 |
$41.16 |
| 01938 |
|
23 |
14 |
$39.02 |
| A4208 |
Syringe with needle, sterile 3 cc, each |
10,898 |
7,614 |
$20.14 |
| 01250 |
|
18 |
17 |
$18.69 |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
20 |
14 |
$0.80 |
| E1399 |
Durable medical equipment, miscellaneous |
142 |
103 |
$0.00 |
| A4615 |
Cannula, nasal |
88 |
64 |
$0.00 |