| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
29 |
28 |
$324.80 |
| J3490 |
Unclassified drugs |
2,515 |
1,344 |
$140.17 |
| J2704 |
Injection, propofol, 10 mg |
2,699 |
2,550 |
$0.50 |
| J7120 |
Ringers lactate infusion, up to 1000 cc |
2,526 |
2,409 |
$0.19 |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
1,989 |
1,781 |
$0.06 |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
1,952 |
1,814 |
$0.04 |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
2,073 |
1,803 |
$0.02 |
| J7999 |
Compounded drug, not otherwise classified |
624 |
312 |
$0.00 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
1,142 |
1,105 |
$0.00 |
| J1170 |
Injection, hydromorphone, up to 4 mg |
757 |
553 |
$0.00 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
322 |
279 |
$0.00 |
| J2001 |
Injection, lidocaine hcl for intravenous infusion, 10 mg |
57 |
55 |
$0.00 |
| J0690 |
Injection, cefazolin sodium, 500 mg |
943 |
751 |
$0.00 |
| J0131 |
Injection, acetaminophen, not otherwise specified,10 mg |
622 |
590 |
$0.00 |
| J1596 |
Injection, glycopyrrolate, 0.1 mg |
176 |
173 |
$0.00 |
| J0665 |
Injection, bupivicaine, not otherwise specified, 0.5 mg |
360 |
324 |
$0.00 |
| J1171 |
Injection, hydromorphone, 0.1 mg |
107 |
68 |
$0.00 |
| J7030 |
Infusion, normal saline solution , 1000 cc |
78 |
78 |
$0.00 |
| J1644 |
Injection, heparin sodium, per 1000 units |
58 |
38 |
$0.00 |