| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 90378 |
|
3,057 |
2,241 |
$8.39M |
| J2357 |
Omalizumab injection |
2,782 |
2,100 |
$6.83M |
| J1726 |
Makena, 10 mg |
1,674 |
1,100 |
$3.77M |
| J3285 |
Treprostinil injection |
1,906 |
832 |
$3.52M |
| J7298 |
Mirena, 52 mg |
2,617 |
2,570 |
$2.57M |
| J3357 |
Ustekinumab sub cu inj, 1 mg |
154 |
129 |
$2.12M |
| J7307 |
Etonogestrel implant system |
2,055 |
1,662 |
$1.64M |
| J2182 |
Injection, mepolizumab, 1mg |
446 |
406 |
$1.28M |
| J0585 |
Injection,onabotulinumtoxina |
971 |
918 |
$1.14M |
| J1559 |
Hizentra injection |
390 |
226 |
$959K |
| J1950 |
Leuprolide acetate /3.75 mg |
197 |
178 |
$504K |
| J0517 |
Inj., benralizumab, 1 mg |
103 |
100 |
$458K |
| A4222 |
Infusion supplies with pump |
1,580 |
1,007 |
$400K |
| 99601 |
|
755 |
453 |
$155K |
| J3590 |
Unclassified biologics |
30 |
24 |
$70K |
| J7321 |
Hyalgan supartz visco-3 dose |
153 |
84 |
$56K |
| J7296 |
Kyleena, 19.5 mg |
59 |
56 |
$51K |
| J7318 |
Inj, durolane 1 mg |
37 |
27 |
$36K |
| J7326 |
Gel-one |
35 |
28 |
$31K |
| 99602 |
Nursing care in home rn |
117 |
66 |
$26K |
| J3490 |
Drugs unclassified injection |
82 |
67 |
$25K |
| A4221 |
Supp non-insulin inf cath/wk |
1,244 |
784 |
$19K |
| K0455 |
Pump uninterrupted infusion |
529 |
414 |
$14K |
| S9379 |
Hit noc per diem |
77 |
70 |
$3K |
| J7507 |
Tacrolimus imme rel oral 1mg |
620 |
429 |
$3K |
| J7518 |
Mycophenolic acid |
56 |
40 |
$2K |
| E0781 |
External ambulatory infus pu |
108 |
61 |
$2K |
| Q0512 |
Px sup fee anti-can sub pres |
769 |
360 |
$878.72 |
| Q0511 |
Sup fee antiem,antica,immuno |
45 |
38 |
$145.13 |
| J0171 |
Adrenalin epinephrine inject |
16 |
16 |
$10.08 |