| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 43239 |
|
85 |
83 |
$13K |
| J2704 |
Injection, propofol, 10 mg |
2,280 |
1,484 |
$5.02 |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
1,312 |
1,028 |
$2.07 |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
1,161 |
878 |
$2.00 |
| J3490 |
Unclassified drugs |
1,408 |
1,107 |
$1.03 |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
1,207 |
1,104 |
$1.02 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
935 |
855 |
$0.58 |
| 82657 |
|
31 |
27 |
$0.00 |
| J1170 |
Injection, hydromorphone, up to 4 mg |
40 |
38 |
$0.00 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
420 |
359 |
$0.00 |
| J0690 |
Injection, cefazolin sodium, 500 mg |
385 |
355 |
$0.00 |
| 88305 |
|
105 |
100 |
$0.00 |
| J0688 |
Injection, cefazolin sodium (hikma), not therapeutically equivalent to j0690, 500 mg |
99 |
94 |
$0.00 |
| J3475 |
Injection, magnesium sulfate, per 500 mg |
45 |
44 |
$0.00 |
| J0665 |
Injection, bupivicaine, not otherwise specified, 0.5 mg |
68 |
63 |
$0.00 |
| 88312 |
|
70 |
66 |
$0.00 |
| J2710 |
Injection, neostigmine methylsulfate, up to 0.5 mg |
24 |
24 |
$0.00 |
| J1596 |
Injection, glycopyrrolate, 0.1 mg |
44 |
43 |
$0.00 |