| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| J3285 |
Treprostinil injection |
2,816 |
1,570 |
$8.92M |
| J7298 |
Mirena, 52 mg |
2,905 |
2,751 |
$2.78M |
| J7307 |
Etonogestrel implant system |
1,701 |
1,663 |
$1.74M |
| J2357 |
Omalizumab injection |
814 |
700 |
$1.52M |
| Z5999 |
|
51 |
50 |
$1.48M |
| 90378 |
|
536 |
439 |
$1.44M |
| S9347 |
Hit longterm infusion diem |
665 |
508 |
$674K |
| J1726 |
Makena, 10 mg |
182 |
156 |
$384K |
| J0135 |
Adalimumab injection |
368 |
336 |
$334K |
| J3590 |
Unclassified biologics |
307 |
285 |
$202K |
| A4222 |
Infusion supplies with pump |
1,131 |
718 |
$125K |
| J1438 |
Etanercept injection |
122 |
118 |
$76K |
| A4221 |
Supp non-insulin inf cath/wk |
1,087 |
685 |
$67K |
| J7192 |
Factor viii recombinant nos |
25 |
12 |
$65K |
| J0585 |
Injection,onabotulinumtoxina |
27 |
27 |
$35K |
| K0455 |
Pump uninterrupted infusion |
703 |
543 |
$16K |
| J7296 |
Kyleena, 19.5 mg |
12 |
12 |
$11K |
| J3490 |
Drugs unclassified injection |
458 |
419 |
$5K |
| S5000 |
Prescription drug, generic |
120 |
88 |
$3K |
| Q0512 |
Px sup fee anti-can sub pres |
400 |
294 |
$452.74 |
| Q0511 |
Sup fee antiem,antica,immuno |
130 |
125 |
$377.69 |
| J7507 |
Tacrolimus imme rel oral 1mg |
51 |
48 |
$326.73 |