| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 36415 |
Collection of venous blood by venipuncture |
389 |
382 |
$38K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
486 |
481 |
$19K |
| 29848 |
|
25 |
24 |
$10K |
| D2930 |
Prefabricated stainless steel crown - primary tooth |
37 |
37 |
$9K |
| 66984 |
Extracapsular cataract removal with insertion of intraocular lens prosthesis |
42 |
41 |
$5K |
| 81025 |
|
25 |
24 |
$2K |
| 76000 |
|
131 |
128 |
$357.48 |
| J7120 |
Ringers lactate infusion, up to 1000 cc |
4,257 |
4,139 |
$211.45 |
| 86850 |
|
56 |
56 |
$69.61 |
| J0690 |
Injection, cefazolin sodium, 500 mg |
932 |
904 |
$39.26 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
251 |
251 |
$7.39 |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
1,241 |
1,199 |
$0.00 |
| J7030 |
Infusion, normal saline solution , 1000 cc |
14 |
14 |
$0.00 |
| 86900 |
|
56 |
56 |
$0.00 |
| J0665 |
Injection, bupivicaine, not otherwise specified, 0.5 mg |
484 |
334 |
$0.00 |
| J0735 |
Injection, clonidine hydrochloride, 1 mg |
13 |
13 |
$0.00 |
| D1120 |
Prophylaxis - child |
24 |
24 |
$0.00 |
| 86901 |
|
56 |
56 |
$0.00 |
| J2001 |
Injection, lidocaine hcl for intravenous infusion, 10 mg |
650 |
630 |
$0.00 |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
2,971 |
2,773 |
$0.00 |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
3,260 |
3,165 |
$0.00 |
| J3490 |
Unclassified drugs |
1,624 |
1,422 |
$0.00 |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
81 |
79 |
$0.00 |
| 80048 |
Basic metabolic panel (calcium, ionized) |
105 |
102 |
$0.00 |
| V2632 |
Posterior chamber intraocular lens |
70 |
67 |
$0.00 |
| 64721 |
|
29 |
28 |
$0.00 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
582 |
574 |
$0.00 |
| 85027 |
|
79 |
79 |
$0.00 |
| J2795 |
Injection, ropivacaine hydrochloride, 1 mg |
56 |
56 |
$0.00 |
| J2003 |
Injection, lidocaine hydrochloride, 1 mg |
45 |
41 |
$0.00 |