| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 43239 |
|
915 |
842 |
$323K |
| 45385 |
|
465 |
424 |
$215K |
| 45380 |
|
601 |
546 |
$190K |
| 66984 |
|
113 |
72 |
$96K |
| 45378 |
|
214 |
201 |
$72K |
| J3490 |
Unclassified drugs |
400 |
167 |
$7K |
| 43235 |
|
15 |
13 |
$4K |
| J7999 |
Compounded drug, not otherwise classified |
36 |
24 |
$391.28 |
| J2704 |
Injection, propofol, 10 mg |
732 |
425 |
$26.90 |
| J0689 |
Injection, cefazolin sodium (baxter), not therapeutically equivalent to j0690, 500 mg |
189 |
138 |
$24.65 |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
800 |
429 |
$9.85 |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
758 |
515 |
$1.52 |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
477 |
315 |
$1.22 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
459 |
315 |
$1.05 |
| J0665 |
Injection, bupivicaine, not otherwise specified, 0.5 mg |
20 |
12 |
$0.21 |
| J2371 |
Injection, phenylephrine hydrochloride, 20 micrograms |
12 |
12 |
$0.00 |
| J2003 |
Injection, lidocaine hydrochloride, 1 mg |
35 |
31 |
$0.00 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
22 |
12 |
$0.00 |
| J2001 |
Injection, lidocaine hcl for intravenous infusion, 10 mg |
57 |
44 |
$0.00 |
| J1170 |
Injection, hydromorphone, up to 4 mg |
26 |
13 |
$0.00 |
| J0690 |
Injection, cefazolin sodium, 500 mg |
23 |
12 |
$0.00 |
| J0171 |
Injection, adrenalin, epinephrine, 0.1 mg |
62 |
37 |
$0.00 |