| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 90378 |
|
3,057 |
2,241 |
$8.39M |
| J2357 |
Injection, omalizumab, 5 mg |
2,782 |
2,100 |
$6.83M |
| J1726 |
Injection, hydroxyprogesterone caproate, (makena), 10 mg |
1,674 |
1,100 |
$3.77M |
| J3285 |
Injection, treprostinil, 1 mg |
1,906 |
832 |
$3.52M |
| J7298 |
Levonorgestrel-releasing intrauterine contraceptive system (mirena), 52 mg |
2,617 |
2,570 |
$2.57M |
| J3357 |
Ustekinumab, for subcutaneous injection, 1 mg |
154 |
129 |
$2.12M |
| J7307 |
Etonogestrel (contraceptive) implant system, including implant and supplies |
2,055 |
1,662 |
$1.64M |
| J2182 |
Injection, mepolizumab, 1 mg |
446 |
406 |
$1.28M |
| J0585 |
Injection, onabotulinumtoxina, 1 unit |
971 |
918 |
$1.14M |
| J1559 |
Injection, immune globulin (hizentra), 100 mg |
390 |
226 |
$959K |
| J1950 |
Injection, leuprolide acetate (for depot suspension), per 3.75 mg |
197 |
178 |
$504K |
| J0517 |
Injection, benralizumab, 1 mg |
103 |
100 |
$458K |
| A4222 |
Infusion supplies for external drug infusion pump, per cassette or bag (list drugs separately) |
1,580 |
1,007 |
$400K |
| 99601 |
|
755 |
453 |
$155K |
| J3590 |
Unclassified biologics |
30 |
24 |
$70K |
| J7321 |
Hyaluronan or derivative, hyalgan, supartz or visco-3, for intra-articular injection, per dose |
153 |
84 |
$56K |
| J7296 |
Levonorgestrel-releasing intrauterine contraceptive system, (kyleena), 19.5 mg |
59 |
56 |
$51K |
| J7318 |
Hyaluronan or derivative, durolane, for intra-articular injection, 1 mg |
37 |
27 |
$36K |
| J7326 |
Hyaluronan or derivative, gel-one, for intra-articular injection, per dose |
35 |
28 |
$31K |
| 99602 |
Nursing care in home rn |
117 |
66 |
$26K |
| J3490 |
Unclassified drugs |
82 |
67 |
$25K |
| A4221 |
Supplies for maintenance of non-insulin drug infusion catheter, per week (list drugs separately) |
1,244 |
784 |
$19K |
| K0455 |
Infusion pump used for uninterrupted parenteral administration of medication, (e.g., epoprostenol or treprostinol) |
529 |
414 |
$14K |
| S9379 |
Home infusion therapy, infusion therapy, not otherwise classified; administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem |
77 |
70 |
$3K |
| J7507 |
Tacrolimus, immediate release, oral, 1 mg |
620 |
429 |
$3K |
| J7518 |
Mycophenolic acid, oral, 180 mg |
56 |
40 |
$2K |
| E0781 |
Ambulatory infusion pump, single or multiple channels, electric or battery operated, with administrative equipment, worn by patient |
108 |
61 |
$2K |
| Q0512 |
Pharmacy supply fee for oral anti-cancer, oral anti-emetic or immunosuppressive drug(s); for a subsequent prescription in a 30-day period |
769 |
360 |
$878.72 |
| Q0511 |
Pharmacy supply fee for oral anti-cancer, oral anti-emetic or immunosuppressive drug(s); for the first prescription in a 30-day period |
45 |
38 |
$145.13 |
| J0171 |
Injection, adrenalin, epinephrine, 0.1 mg |
16 |
16 |
$10.08 |