| Code | Description | Claims | Beneficiaries | Total Paid |
| 43239 |
Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple |
118 |
111 |
$10K |
| D0120 |
Periodic oral evaluation - established patient |
12 |
12 |
$2K |
| C1769 |
Guide wire |
136 |
125 |
$2K |
| C1894 |
Introducer/sheath, other than guiding, other than intracardiac electrophysiological, non-laser |
94 |
80 |
$2K |
| 43235 |
|
33 |
29 |
$1K |
| 88342 |
|
79 |
72 |
$1K |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
299 |
266 |
$1K |
| C1713 |
Anchor/screw for opposing bone-to-bone or soft tissue-to-bone (implantable) |
15 |
15 |
$754.16 |
| 88313 |
|
14 |
13 |
$568.56 |
| J0330 |
Injection, succinylcholine chloride, up to 20 mg |
336 |
318 |
$514.85 |
| 82962 |
|
551 |
429 |
$435.73 |
| J0690 |
Injection, cefazolin sodium, 500 mg |
1,622 |
1,549 |
$377.28 |
| 88304 |
|
56 |
52 |
$301.52 |
| J1170 |
Injection, hydromorphone, up to 4 mg |
710 |
617 |
$290.29 |
| J2704 |
Injection, propofol, 10 mg |
3,371 |
3,086 |
$251.92 |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
3,621 |
3,293 |
$225.29 |
| 81025 |
|
181 |
179 |
$175.08 |
| 76000 |
|
47 |
47 |
$158.21 |
| 88307 |
|
22 |
18 |
$116.27 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
3,435 |
3,371 |
$114.14 |
| S0020 |
Injection, bupivicaine hydrochloride, 30 ml |
86 |
82 |
$113.42 |
| 80048 |
Basic metabolic panel (calcium, ionized) |
24 |
15 |
$107.60 |
| J2270 |
Injection, morphine sulfate, up to 10 mg |
87 |
81 |
$99.29 |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
4,050 |
3,893 |
$68.74 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
1,381 |
1,346 |
$57.80 |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
3,157 |
3,089 |
$44.47 |
| 36416 |
|
20 |
18 |
$38.50 |
| J2370 |
Injection, phenylephrine hcl, up to 1 ml |
94 |
81 |
$32.23 |
| S0028 |
Injection, famotidine, 20 mg |
42 |
41 |
$31.92 |
| C1729 |
Catheter, drainage |
23 |
22 |
$15.84 |
| J3490 |
Unclassified drugs |
40 |
34 |
$15.77 |
| J1790 |
Injection, droperidol, up to 5 mg |
29 |
28 |
$9.26 |
| 36415 |
Collection of venous blood by venipuncture |
12 |
12 |
$0.00 |
| J0131 |
Injection, acetaminophen, not otherwise specified,10 mg |
48 |
46 |
$0.00 |
| J7050 |
Infusion, normal saline solution, 250 cc |
352 |
319 |
$0.00 |
| J0173 |
Injection, epinephrine (belcher), not therapeutically equivalent to j0171, 0.1 mg |
15 |
12 |
$0.00 |
| J1597 |
Injection, glycopyrrolate (glyrx-pf), 0.1 mg |
57 |
57 |
$0.00 |
| C9399 |
Unclassified drugs or biologicals |
247 |
244 |
$0.00 |
| J2003 |
Injection, lidocaine hydrochloride, 1 mg |
141 |
111 |
$0.00 |
| 90686 |
|
27 |
27 |
$0.00 |
| D7140 |
Extraction, erupted tooth or exposed root |
12 |
12 |
$0.00 |
| J0137 |
Injection, acetaminophen (hikma), not therapeutically equivalent to j0131, 10 mg |
87 |
85 |
$0.00 |
| J0665 |
Injection, bupivicaine, not otherwise specified, 0.5 mg |
665 |
644 |
$0.00 |
| J0134 |
Injection, acetaminophen (fresenius kabi), not therapeutically equivalent to j0131, 10 mg |
275 |
275 |
$0.00 |
| J1644 |
Injection, heparin sodium, per 1000 units |
96 |
78 |
$0.00 |
| J1596 |
Injection, glycopyrrolate, 0.1 mg |
77 |
77 |
$0.00 |
| J0688 |
Injection, cefazolin sodium (hikma), not therapeutically equivalent to j0690, 500 mg |
125 |
124 |
$0.00 |
| J1171 |
Injection, hydromorphone, 0.1 mg |
87 |
87 |
$0.00 |
| J2004 |
Injection, lidocaine hcl with epinephrine, 1 mg |
38 |
38 |
$0.00 |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
13 |
12 |
$0.00 |