| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| J3380 |
Inj vedolizumab iv 1 mg |
2,137 |
2,034 |
$10.25M |
| J2350 |
Injection, ocrelizumab, 1 mg |
365 |
336 |
$8.65M |
| Q5103 |
Injection, inflectra |
4,484 |
2,608 |
$4.92M |
| 99233 |
Prolong inpt eval add15 m |
90,873 |
31,204 |
$4.56M |
| J1745 |
Infliximab not biosimil 10mg |
3,174 |
1,742 |
$3.93M |
| J2323 |
Natalizumab injection |
564 |
530 |
$2.74M |
| J2357 |
Omalizumab injection |
1,534 |
1,110 |
$2.34M |
| J2182 |
Injection, mepolizumab, 1mg |
641 |
597 |
$1.41M |
| 99232 |
|
33,420 |
14,748 |
$1.21M |
| 99223 |
Prolong inpt eval add15 m |
8,929 |
8,568 |
$847K |
| Q5104 |
Injection, renflexis |
726 |
425 |
$728K |
| 96413 |
|
8,871 |
7,967 |
$553K |
| 99255 |
|
4,930 |
4,561 |
$532K |
| 96365 |
|
18,698 |
5,788 |
$482K |
| J1569 |
Gammagard liquid injection |
135 |
76 |
$425K |
| 99222 |
|
2,485 |
2,437 |
$175K |
| 99214 |
|
2,312 |
2,111 |
$141K |
| 96415 |
|
6,557 |
5,939 |
$105K |
| 99254 |
|
1,183 |
1,149 |
$100K |
| 99213 |
|
1,067 |
909 |
$43K |
| J1335 |
Ertapenem injection |
1,370 |
138 |
$41K |
| 99215 |
Prolong outpt/office vis |
372 |
323 |
$32K |
| 96372 |
|
2,832 |
2,399 |
$30K |
| 96366 |
|
1,353 |
893 |
$30K |
| J2930 |
Methylprednisolone injection |
1,411 |
916 |
$21K |
| 96375 |
|
2,395 |
2,004 |
$18K |
| 96401 |
|
704 |
634 |
$18K |
| J0878 |
Daptomycin injection |
278 |
26 |
$14K |
| 36415 |
|
2,308 |
1,779 |
$6K |
| 99204 |
|
70 |
69 |
$6K |
| 99231 |
|
172 |
112 |
$4K |
| J1720 |
Hydrocortisone sodium succ i |
67 |
51 |
$817.03 |
| J1200 |
Diphenhydramine hcl injectio |
1,236 |
1,064 |
$716.21 |
| J2920 |
Methylprednisolone injection |
149 |
136 |
$586.96 |
| J2919 |
Inj, methylpred sod succ 5mg |
93 |
84 |
$538.47 |