| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
|
8,957 |
7,352 |
$539K |
| A4550 |
Surgical trays |
1,159 |
718 |
$35K |
| 99152 |
|
2,365 |
1,590 |
$32K |
| 80305 |
|
3,130 |
2,582 |
$27K |
| 99213 |
|
755 |
433 |
$21K |
| 20552 |
|
671 |
362 |
$10K |
| 99153 |
Mod sedat endo service >5yrs |
484 |
292 |
$6K |
| 96372 |
|
323 |
254 |
$3K |
| J3490 |
Drugs unclassified injection |
1,579 |
490 |
$2K |
| J2704 |
Inj, propofol, 10 mg |
2,572 |
1,594 |
$1K |
| J0702 |
Betamethasone acet&sod phosp |
92 |
65 |
$930.99 |
| S0020 |
Injection, bupivicaine hydro |
1,229 |
553 |
$438.78 |
| J1885 |
Ketorolac tromethamine inj |
346 |
277 |
$408.15 |
| J2250 |
Inj midazolam hydrochloride |
2,364 |
1,549 |
$395.52 |
| Q9966 |
Locm 200-299mg/ml iodine,1ml |
939 |
668 |
$331.29 |
| 90471 |
|
24 |
15 |
$308.32 |
| 90756 |
|
32 |
16 |
$281.48 |
| J1100 |
Dexamethasone sodium phos |
239 |
175 |
$199.18 |
| H0049 |
Alcohol/drug screening |
17 |
17 |
$183.77 |
| G0396 |
Alcohol/subs interv 15-30mn |
21 |
13 |
$109.36 |
| J3360 |
Diazepam injection |
64 |
32 |
$97.74 |
| J2360 |
Orphenadrine injection |
30 |
14 |
$13.36 |
| J3010 |
Fentanyl citrate injection |
47 |
31 |
$12.21 |
| J2001 |
Lidocaine injection |
660 |
365 |
$5.83 |
| A4216 |
Sterile water/saline, 10 ml |
871 |
469 |
$0.20 |