| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 88305 |
|
62 |
62 |
$891.00 |
| J3490 |
Drugs unclassified injection |
1,211 |
646 |
$55.37 |
| J2704 |
Inj, propofol, 10 mg |
1,051 |
922 |
$1.02 |
| J3010 |
Fentanyl citrate injection |
1,791 |
1,555 |
$0.44 |
| J7120 |
Ringers lactate infusion |
1,160 |
935 |
$0.31 |
| J2405 |
Ondansetron hcl injection |
1,923 |
1,762 |
$0.30 |
| J2250 |
Inj midazolam hydrochloride |
1,898 |
1,765 |
$0.18 |
| J1100 |
Dexamethasone sodium phos |
668 |
655 |
$0.00 |
| J7999 |
Compounded drug, noc |
1,194 |
529 |
$0.00 |
| J2795 |
Ropivacaine hcl injection |
376 |
356 |
$0.00 |
| J1170 |
Hydromorphone injection |
629 |
387 |
$0.00 |
| J7050 |
Normal saline solution infus |
381 |
350 |
$0.00 |
| J2001 |
Lidocaine injection |
1,169 |
1,148 |
$0.00 |
| J0690 |
Cefazolin sodium injection |
1,182 |
1,041 |
$0.00 |
| J0131 |
Inj, acetaminophen (nos) |
839 |
792 |
$0.00 |
| J1885 |
Ketorolac tromethamine inj |
445 |
420 |
$0.00 |
| J2003 |
Inj, lidocaine hcl, 1 mg |
24 |
24 |
$0.00 |
| J8501 |
Oral aprepitant |
14 |
14 |
$0.00 |
| J7040 |
Normal saline solution infus |
271 |
267 |
$0.00 |
| J0665 |
Inj, bupivacaine, nos, 0.5mg |
234 |
222 |
$0.00 |
| J1171 |
Inj, hydromorphone, 0.1 mg |
104 |
59 |
$0.00 |
| J7030 |
Normal saline solution infus |
517 |
507 |
$0.00 |
| J1596 |
Inj, glycopyrrolate, 0.1 mg |
25 |
25 |
$0.00 |
| J1644 |
Inj heparin sodium per 1000u |
91 |
75 |
$0.00 |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
13 |
13 |
$0.00 |