| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
24 |
24 |
$326.70 |
| J3490 |
Unclassified drugs |
749 |
526 |
$0.00 |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
1,287 |
1,254 |
$0.00 |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
1,215 |
1,095 |
$0.00 |
| J0690 |
Injection, cefazolin sodium, 500 mg |
611 |
514 |
$0.00 |
| J1170 |
Injection, hydromorphone, up to 4 mg |
445 |
268 |
$0.00 |
| J2001 |
Injection, lidocaine hcl for intravenous infusion, 10 mg |
161 |
158 |
$0.00 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
745 |
715 |
$0.00 |
| J0131 |
Injection, acetaminophen, not otherwise specified,10 mg |
831 |
816 |
$0.00 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
286 |
248 |
$0.00 |
| J2704 |
Injection, propofol, 10 mg |
21 |
14 |
$0.00 |
| J1596 |
Injection, glycopyrrolate, 0.1 mg |
223 |
222 |
$0.00 |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
1,510 |
1,376 |
$0.00 |
| J0665 |
Injection, bupivicaine, not otherwise specified, 0.5 mg |
304 |
300 |
$0.00 |
| J3473 |
Injection, hyaluronidase, recombinant, 1 usp unit |
102 |
102 |
$0.00 |
| J1171 |
Injection, hydromorphone, 0.1 mg |
73 |
45 |
$0.00 |
| J1644 |
Injection, heparin sodium, per 1000 units |
19 |
12 |
$0.00 |