| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 41899 |
Unlisted procedure, dentoalveolar structures |
10,289 |
9,926 |
$3.69M |
| G0330 |
Facility services for dental rehabilitation procedure(s) performed on a patient who requires monitored anesthesia (e.g., general, intravenous sedation (monitored anesthesia care) and use of an operating room |
1,302 |
1,302 |
$1.54M |
| 0490 |
|
11,322 |
5,693 |
$752K |
| A4649 |
Surgical supply; miscellaneous |
6,201 |
6,110 |
$735K |
| 00170 |
Anesthesia for intraoral procedures, including biopsy |
3,436 |
3,339 |
$356K |
| 0760 |
|
5,546 |
5,441 |
$122K |
| 0710 |
|
5,710 |
5,594 |
$96K |
| J7120 |
Ringers lactate infusion, up to 1000 cc |
7,149 |
6,952 |
$19K |
| G0378 |
Hospital observation service, per hour |
767 |
746 |
$2K |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
194 |
183 |
$2K |
| J3490 |
Unclassified drugs |
267 |
148 |
$1K |
| Z7506 |
|
12 |
12 |
$1K |
| Z7514 |
|
24 |
24 |
$863.86 |
| 0279 |
|
80 |
80 |
$802.66 |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
173 |
142 |
$483.19 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
144 |
138 |
$433.92 |
| 0271 |
|
29 |
29 |
$291.43 |
| Z7500 |
|
12 |
12 |
$257.28 |
| Z7512 |
|
12 |
12 |
$197.04 |
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
695 |
677 |
$0.00 |
| 99217 |
|
85 |
85 |
$0.00 |
| 99238 |
Hospital discharge day management, 30 minutes or less |
585 |
585 |
$0.00 |
| 99218 |
|
85 |
85 |
$0.00 |
| 99221 |
|
585 |
585 |
$0.00 |