| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| J2704 |
Injection, propofol, 10 mg |
951 |
876 |
$35.05 |
| J7040 |
Infusion, normal saline solution, sterile (500 ml = 1 unit) |
272 |
267 |
$0.00 |
| J7120 |
Ringers lactate infusion, up to 1000 cc |
465 |
461 |
$0.00 |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
587 |
533 |
$0.00 |
| J0134 |
Injection, acetaminophen (fresenius kabi), not therapeutically equivalent to j0131, 10 mg |
57 |
55 |
$0.00 |
| J2001 |
Injection, lidocaine hcl for intravenous infusion, 10 mg |
487 |
482 |
$0.00 |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
589 |
523 |
$0.00 |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
556 |
546 |
$0.00 |
| J0131 |
Injection, acetaminophen, not otherwise specified,10 mg |
278 |
274 |
$0.00 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
281 |
278 |
$0.00 |
| J0690 |
Injection, cefazolin sodium, 500 mg |
82 |
63 |
$0.00 |
| J1170 |
Injection, hydromorphone, up to 4 mg |
44 |
42 |
$0.00 |
| J3490 |
Unclassified drugs |
117 |
55 |
$0.00 |