| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| J1569 |
Gammagard liquid injection |
1,669 |
537 |
$3.37M |
| Q5103 |
Injection, inflectra |
1,511 |
1,283 |
$2.08M |
| J1745 |
Infliximab not biosimil 10mg |
414 |
329 |
$919K |
| 99601 |
|
12,555 |
7,315 |
$656K |
| 99602 |
Nursing care in home rn |
6,238 |
4,131 |
$382K |
| S9338 |
Hit immunotherapy diem |
2,482 |
1,763 |
$340K |
| S9359 |
Hit anti-tnf per diem |
2,046 |
1,920 |
$180K |
| S9379 |
Hit noc per diem |
1,440 |
599 |
$65K |
| S9542 |
Ht inj noc per diem |
755 |
232 |
$56K |
| S9500 |
Hit antibiotic q24h diem |
48 |
12 |
$21K |
| Q5119 |
Inj ruxience, 10 mg |
13 |
12 |
$20K |
| J3490 |
Drugs unclassified injection |
472 |
176 |
$10K |
| S9357 |
Hit enzyme replace diem |
63 |
24 |
$10K |
| J0171 |
Adrenalin epinephrine inject |
1,096 |
920 |
$7K |
| J1642 |
Inj heparin sodium per 10 u |
3,294 |
1,073 |
$5K |
| S9374 |
Hit hydra 1 liter diem |
32 |
12 |
$4K |
| J2930 |
Methylprednisolone injection |
236 |
177 |
$2K |
| J1200 |
Diphenhydramine hcl injectio |
1,270 |
1,009 |
$2K |
| J2919 |
Inj, methylpred sod succ 5mg |
187 |
135 |
$2K |
| S9494 |
Hit antibiotic total diem |
75 |
65 |
$1K |
| A4221 |
Supp non-insulin inf cath/wk |
49 |
25 |
$399.25 |
| J7050 |
Normal saline solution infus |
147 |
75 |
$109.59 |