| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| J0135 |
Injection, adalimumab, 20 mg |
547 |
511 |
$1.12M |
| J7324 |
Hyaluronan or derivative, orthovisc, for intra-articular injection, per dose |
894 |
891 |
$968K |
| J3490 |
Unclassified drugs |
1,843 |
1,647 |
$650K |
| J0897 |
Injection, denosumab, 1 mg |
457 |
440 |
$642K |
| J7325 |
Hyaluronan or derivative, synvisc or synvisc-one, for intra-articular injection, 1 mg |
591 |
584 |
$603K |
| J3590 |
Unclassified biologics |
666 |
636 |
$577K |
| J9355 |
Injection, trastuzumab, excludes biosimilar, 10 mg |
182 |
134 |
$515K |
| J9271 |
Injection, pembrolizumab, 1 mg |
66 |
54 |
$496K |
| J9217 |
Leuprolide acetate (for depot suspension), 7.5 mg |
252 |
246 |
$324K |
| 99601 |
|
3,832 |
940 |
$315K |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
1,173 |
976 |
$275K |
| J0585 |
Injection, onabotulinumtoxina, 1 unit |
397 |
395 |
$251K |
| J9035 |
Injection, bevacizumab, 10 mg |
61 |
49 |
$222K |
| J1200 |
Injection, diphenhydramine hcl, up to 50 mg |
810 |
686 |
$183K |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
769 |
646 |
$150K |
| J1726 |
Injection, hydroxyprogesterone caproate, (makena), 10 mg |
77 |
73 |
$138K |
| J9306 |
Injection, pertuzumab, 1 mg |
36 |
25 |
$126K |
| B4160 |
Enteral formula, for pediatrics, nutritionally complete calorically dense (equal to or greater than 0.7 kcal/ml) with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit |
595 |
502 |
$86K |
| J1438 |
Injection, etanercept, 25 mg (code may be used for medicare when drug administered under the direct supervision of a physician, not for use when drug is self administered) |
63 |
62 |
$70K |
| S9500 |
Home infusion therapy, antibiotic, antiviral, or antifungal therapy; once every 24 hours; administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem |
77 |
36 |
$53K |
| 90750 |
|
478 |
477 |
$51K |
| J1453 |
Injection, fosaprepitant, 1 mg |
178 |
155 |
$50K |
| J1626 |
Injection, granisetron hydrochloride, 100 mcg |
40 |
36 |
$32K |
| S9542 |
Home injectable therapy, not otherwise classified, including administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem |
783 |
740 |
$28K |
| S0028 |
Injection, famotidine, 20 mg |
290 |
242 |
$28K |
| J3489 |
Injection, zoledronic acid, 1 mg |
162 |
153 |
$26K |
| A4223 |
Infusion supplies not used with external infusion pump, per cassette or bag (list drugs separately) |
1,073 |
299 |
$26K |
| J7321 |
Hyaluronan or derivative, hyalgan, supartz or visco-3, for intra-articular injection, per dose |
38 |
38 |
$20K |
| 90715 |
|
351 |
351 |
$16K |
| S9374 |
Home infusion therapy, hydration therapy; one liter per day, administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem |
65 |
26 |
$9K |
| J1950 |
Injection, leuprolide acetate (for depot suspension), per 3.75 mg |
13 |
13 |
$6K |
| J2790 |
Injection, rho d immune globulin, human, full dose, 300 micrograms (1500 i.u.) |
37 |
37 |
$3K |
| A4230 |
Infusion set for external insulin pump, non needle cannula type |
327 |
65 |
$3K |
| A4927 |
Gloves, non-sterile, per 100 |
1,329 |
1,214 |
$2K |
| J1642 |
Injection, heparin sodium, (heparin lock flush), per 10 units |
132 |
96 |
$2K |
| J9190 |
Injection, fluorouracil, 500 mg |
28 |
25 |
$2K |
| 99602 |
Nursing care in home rn |
15 |
12 |
$2K |
| J2505 |
Injection, pegfilgrastim, 6 mg |
22 |
17 |
$1K |
| J9045 |
Injection, carboplatin, 50 mg |
16 |
13 |
$1K |
| A6209 |
Foam dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
90 |
72 |
$995.42 |
| A4212 |
Non-coring needle or stylet with or without catheter |
89 |
57 |
$986.60 |
| J2469 |
Injection, palonosetron hcl, 25 mcg |
37 |
28 |
$828.69 |
| E0776 |
Iv pole |
12 |
12 |
$821.81 |
| A4245 |
Alcohol wipes, per box |
1,174 |
1,117 |
$764.57 |
| J9263 |
Injection, oxaliplatin, 0.5 mg |
17 |
15 |
$559.68 |
| J1040 |
Injection, methylprednisolone acetate, 80 mg |
37 |
37 |
$505.27 |
| A4231 |
Infusion set for external insulin pump, needle type |
69 |
12 |
$339.11 |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
25 |
25 |
$311.90 |
| J9070 |
Cyclophosphamide, 100 mg |
22 |
16 |
$207.66 |
| A4216 |
Sterile water, saline and/or dextrose, diluent/flush, 10 ml |
66 |
54 |
$191.30 |
| A6210 |
Foam dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing |
418 |
407 |
$45.58 |
| J9000 |
Injection, doxorubicin hydrochloride, 10 mg |
18 |
13 |
$0.00 |