| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| J9035 |
Injection, bevacizumab, 10 mg |
366 |
302 |
$2.18M |
| J9271 |
Injection, pembrolizumab, 1 mg |
178 |
143 |
$1.58M |
| J9355 |
Injection, trastuzumab, excludes biosimilar, 10 mg |
47 |
36 |
$199K |
| J9306 |
Injection, pertuzumab, 1 mg |
14 |
12 |
$66K |
| J0640 |
Injection, leucovorin calcium, per 50 mg |
302 |
239 |
$62K |
| Q0081 |
Infusion therapy, using other than chemotherapeutic drugs, per visit |
560 |
409 |
$37K |
| J9190 |
Injection, fluorouracil, 500 mg |
461 |
363 |
$17K |
| J9263 |
Injection, oxaliplatin, 0.5 mg |
63 |
55 |
$11K |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
1,669 |
1,353 |
$9K |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
1,313 |
1,054 |
$8K |
| J1200 |
Injection, diphenhydramine hcl, up to 50 mg |
1,445 |
1,185 |
$2K |
| J9045 |
Injection, carboplatin, 50 mg |
33 |
26 |
$2K |
| J3489 |
Injection, zoledronic acid, 1 mg |
14 |
13 |
$2K |
| S0028 |
Injection, famotidine, 20 mg |
1,004 |
822 |
$1K |
| J3490 |
Unclassified drugs |
72 |
52 |
$123.56 |