| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| C1713 |
Anchor/screw bn/bn,tis/bn |
146 |
142 |
$300K |
| T1015 |
Clinic service |
2,283 |
452 |
$92K |
| J0690 |
Cefazolin sodium injection |
1,943 |
1,305 |
$1K |
| 77067 |
|
13 |
13 |
$1K |
| 76942 |
|
118 |
113 |
$997.92 |
| J2704 |
Inj, propofol, 10 mg |
1,936 |
1,738 |
$937.24 |
| J1100 |
Dexamethasone sodium phos |
1,815 |
1,502 |
$399.18 |
| J3010 |
Fentanyl citrate injection |
1,717 |
1,343 |
$390.86 |
| 77063 |
|
13 |
13 |
$314.79 |
| J1630 |
Haloperidol injection |
788 |
741 |
$272.07 |
| J2250 |
Inj midazolam hydrochloride |
1,566 |
1,422 |
$222.68 |
| J2405 |
Ondansetron hcl injection |
1,852 |
1,655 |
$190.35 |
| J3370 |
Vancomycin hcl injection |
197 |
110 |
$108.50 |
| J1885 |
Ketorolac tromethamine inj |
317 |
296 |
$38.31 |
| 82947 |
|
30 |
27 |
$32.20 |
| J7120 |
Ringers lactate infusion |
242 |
235 |
$0.00 |
| J0665 |
Inj, bupivacaine, nos, 0.5mg |
120 |
115 |
$0.00 |
| J3590 |
Unclassified biologics |
14 |
13 |
$0.00 |
| J2795 |
Ropivacaine hcl injection |
14 |
12 |
$0.00 |
| J1170 |
Hydromorphone injection |
14 |
13 |
$0.00 |