| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 88305 |
|
24 |
24 |
$326.70 |
| J3490 |
Drugs unclassified injection |
749 |
526 |
$0.00 |
| J2250 |
Inj midazolam hydrochloride |
1,287 |
1,254 |
$0.00 |
| J3010 |
Fentanyl citrate injection |
1,215 |
1,095 |
$0.00 |
| J0690 |
Cefazolin sodium injection |
611 |
514 |
$0.00 |
| J1170 |
Hydromorphone injection |
445 |
268 |
$0.00 |
| J2001 |
Lidocaine injection |
161 |
158 |
$0.00 |
| J1100 |
Dexamethasone sodium phos |
745 |
715 |
$0.00 |
| J0131 |
Inj, acetaminophen (nos) |
831 |
816 |
$0.00 |
| J1885 |
Ketorolac tromethamine inj |
286 |
248 |
$0.00 |
| J2704 |
Inj, propofol, 10 mg |
21 |
14 |
$0.00 |
| J1596 |
Inj, glycopyrrolate, 0.1 mg |
223 |
222 |
$0.00 |
| J2405 |
Ondansetron hcl injection |
1,510 |
1,376 |
$0.00 |
| J0665 |
Inj, bupivacaine, nos, 0.5mg |
304 |
300 |
$0.00 |
| J3473 |
Hyaluronidase recombinant |
102 |
102 |
$0.00 |
| J1171 |
Inj, hydromorphone, 0.1 mg |
73 |
45 |
$0.00 |
| J1644 |
Inj heparin sodium per 1000u |
19 |
12 |
$0.00 |