| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 66984 |
|
394 |
258 |
$470K |
| 69436 |
|
13 |
13 |
$12K |
| J2405 |
Ondansetron hcl injection |
1,122 |
1,003 |
$0.00 |
| J1596 |
Inj, glycopyrrolate, 0.1 mg |
185 |
182 |
$0.00 |
| J2710 |
Neostigmine methylslfte inj |
38 |
38 |
$0.00 |
| J0665 |
Inj, bupivacaine, nos, 0.5mg |
298 |
279 |
$0.00 |
| V2630 |
Anter chamber intraocul lens |
167 |
114 |
$0.00 |
| J0688 |
Inj cefazolin sodium, hikma |
15 |
15 |
$0.00 |
| J3490 |
Drugs unclassified injection |
1,239 |
1,060 |
$0.00 |
| J2250 |
Inj midazolam hydrochloride |
1,335 |
1,187 |
$0.00 |
| J3010 |
Fentanyl citrate injection |
1,358 |
1,094 |
$0.00 |
| J2704 |
Inj, propofol, 10 mg |
2,161 |
1,789 |
$0.00 |
| J1885 |
Ketorolac tromethamine inj |
405 |
338 |
$0.00 |
| J1100 |
Dexamethasone sodium phos |
979 |
916 |
$0.00 |
| J0690 |
Cefazolin sodium injection |
374 |
324 |
$0.00 |