| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| J1100 |
Dexamethasone sodium phos |
289 |
217 |
$0.00 |
| J2704 |
Inj, propofol, 10 mg |
769 |
533 |
$0.00 |
| J3010 |
Fentanyl citrate injection |
785 |
521 |
$0.00 |
| J0690 |
Cefazolin sodium injection |
210 |
160 |
$0.00 |
| J1885 |
Ketorolac tromethamine inj |
14 |
12 |
$0.00 |
| J2250 |
Inj midazolam hydrochloride |
650 |
548 |
$0.00 |
| J1170 |
Hydromorphone injection |
20 |
14 |
$0.00 |
| J0131 |
Inj, acetaminophen (nos) |
53 |
52 |
$0.00 |
| J2405 |
Ondansetron hcl injection |
404 |
334 |
$0.00 |
| J0665 |
Inj, bupivacaine, nos, 0.5mg |
26 |
26 |
$0.00 |
| J1171 |
Inj, hydromorphone, 0.1 mg |
35 |
25 |
$0.00 |