| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 41899 |
Unlisted procedure, dentoalveolar structures |
95 |
71 |
$132K |
| 00170 |
Anesthesia for intraoral procedures, including biopsy |
366 |
361 |
$65K |
| 69436 |
Tympanostomy (requiring insertion of ventilating tube), general anesthesia |
118 |
111 |
$41K |
| 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 |
12 |
12 |
$19K |
| 00126 |
|
41 |
41 |
$4K |
| 99070 |
|
63 |
63 |
$155.80 |
| J7030 |
Infusion, normal saline solution , 1000 cc |
377 |
361 |
$0.00 |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
675 |
631 |
$0.00 |
| J2270 |
Injection, morphine sulfate, up to 10 mg |
167 |
154 |
$0.00 |
| J7040 |
Infusion, normal saline solution, sterile (500 ml = 1 unit) |
15 |
13 |
$0.00 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
637 |
595 |
$0.00 |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
720 |
679 |
$0.00 |
| J2704 |
Injection, propofol, 10 mg |
796 |
743 |
$0.00 |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
14 |
14 |
$0.00 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
18 |
14 |
$0.00 |