| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 66984 |
|
586 |
557 |
$373K |
| 67113 |
|
44 |
43 |
$25K |
| 66982 |
|
14 |
13 |
$10K |
| OP250 |
|
202 |
70 |
$4K |
| 92018 |
|
26 |
26 |
$1K |
| J7040 |
Normal saline solution infus |
316 |
310 |
$188.70 |
| 92134 |
|
12 |
12 |
$128.64 |
| V2632 |
Post chmbr intraocular lens |
285 |
270 |
$122.25 |
| J3010 |
Fentanyl citrate injection |
295 |
282 |
$48.77 |
| J2250 |
Inj midazolam hydrochloride |
271 |
265 |
$41.77 |
| S9061 |
Medical supplies and equipme |
57 |
56 |
$33.50 |
| J2405 |
Ondansetron hcl injection |
294 |
284 |
$30.71 |
| J1100 |
Dexamethasone sodium phos |
151 |
148 |
$24.49 |
| J2704 |
Inj, propofol, 10 mg |
115 |
114 |
$23.90 |
| J0665 |
Inj, bupivacaine, nos, 0.5mg |
29 |
29 |
$1.70 |
| OP270 |
|
48 |
46 |
$0.00 |
| J2001 |
Lidocaine injection |
88 |
71 |
$0.00 |
| J2003 |
Inj, lidocaine hcl, 1 mg |
29 |
25 |
$0.00 |
| J1885 |
Ketorolac tromethamine inj |
13 |
13 |
$0.00 |
| L8610 |
Ocular implant |
64 |
56 |
$0.00 |
| G8907 |
Pt doc no events on discharg |
59 |
59 |
$0.00 |
| G8918 |
Pt w/o preop order iv ab pro |
59 |
59 |
$0.00 |