| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 8888888 |
|
7,148 |
2,033 |
$4.32M |
| 97110 |
|
2,577 |
1,544 |
$89K |
| 72148 |
|
282 |
271 |
$46K |
| J2405 |
Ondansetron hcl injection |
1,307 |
1,133 |
$20K |
| J3010 |
Fentanyl citrate injection |
1,527 |
1,171 |
$19K |
| J2704 |
Inj, propofol, 10 mg |
1,543 |
1,301 |
$17K |
| J1885 |
Ketorolac tromethamine inj |
759 |
618 |
$13K |
| 97161 |
|
146 |
144 |
$12K |
| J1100 |
Dexamethasone sodium phos |
1,155 |
1,085 |
$12K |
| J0690 |
Cefazolin sodium injection |
1,202 |
980 |
$11K |
| 97140 |
|
712 |
434 |
$10K |
| J7120 |
Ringers lactate infusion |
329 |
314 |
$9K |
| 0031A |
|
341 |
317 |
$9K |
| 73721 |
|
44 |
41 |
$8K |
| 97162 |
|
61 |
59 |
$7K |
| 0011A |
|
193 |
176 |
$5K |
| J2250 |
Inj midazolam hydrochloride |
904 |
848 |
$4K |
| 72141 |
|
44 |
44 |
$4K |
| 0012A |
|
144 |
142 |
$4K |
| 97113 |
|
89 |
39 |
$4K |
| 70553 |
|
14 |
13 |
$3K |
| 97112 |
|
50 |
36 |
$2K |
| 76856 |
|
12 |
12 |
$2K |
| 97163 |
|
13 |
13 |
$2K |
| A9585 |
Gadobutrol injection |
271 |
249 |
$1K |
| 82565 |
|
112 |
105 |
$1K |
| 97165 |
|
28 |
27 |
$1K |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
496 |
469 |
$1K |
| 91301 |
|
27 |
26 |
$520.37 |
| 97116 |
|
34 |
26 |
$263.68 |
| Q9963 |
Hocm 350-399mg/ml iodine,1ml |
12 |
12 |
$94.39 |
| J1170 |
Hydromorphone injection |
542 |
442 |
$0.00 |
| 71260 |
|
26 |
25 |
$0.00 |
| J1630 |
Haloperidol injection |
14 |
13 |
$0.00 |
| J3475 |
Inj magnesium sulfate |
353 |
337 |
$0.00 |
| C1713 |
Anchor/screw bn/bn,tis/bn |
211 |
197 |
$0.00 |
| 74177 |
|
58 |
54 |
$0.00 |