| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
62 |
62 |
$891.00 |
| J3490 |
Unclassified drugs |
1,211 |
646 |
$55.37 |
| J2704 |
Injection, propofol, 10 mg |
1,051 |
922 |
$1.02 |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
1,791 |
1,555 |
$0.44 |
| J7120 |
Ringers lactate infusion, up to 1000 cc |
1,160 |
935 |
$0.31 |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
1,923 |
1,762 |
$0.30 |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
1,898 |
1,765 |
$0.18 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
668 |
655 |
$0.00 |
| J7999 |
Compounded drug, not otherwise classified |
1,194 |
529 |
$0.00 |
| J2795 |
Injection, ropivacaine hydrochloride, 1 mg |
376 |
356 |
$0.00 |
| J1170 |
Injection, hydromorphone, up to 4 mg |
629 |
387 |
$0.00 |
| J7050 |
Infusion, normal saline solution, 250 cc |
381 |
350 |
$0.00 |
| J2001 |
Injection, lidocaine hcl for intravenous infusion, 10 mg |
1,169 |
1,148 |
$0.00 |
| J0690 |
Injection, cefazolin sodium, 500 mg |
1,182 |
1,041 |
$0.00 |
| J0131 |
Injection, acetaminophen, not otherwise specified,10 mg |
839 |
792 |
$0.00 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
445 |
420 |
$0.00 |
| J2003 |
Injection, lidocaine hydrochloride, 1 mg |
24 |
24 |
$0.00 |
| J8501 |
Aprepitant, oral, 5 mg |
14 |
14 |
$0.00 |
| J7040 |
Infusion, normal saline solution, sterile (500 ml = 1 unit) |
271 |
267 |
$0.00 |
| J0665 |
Injection, bupivicaine, not otherwise specified, 0.5 mg |
234 |
222 |
$0.00 |
| J1171 |
Injection, hydromorphone, 0.1 mg |
104 |
59 |
$0.00 |
| J7030 |
Infusion, normal saline solution , 1000 cc |
517 |
507 |
$0.00 |
| J1596 |
Injection, glycopyrrolate, 0.1 mg |
25 |
25 |
$0.00 |
| J1644 |
Injection, heparin sodium, per 1000 units |
91 |
75 |
$0.00 |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
13 |
13 |
$0.00 |