| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| J2350 |
Injection, ocrelizumab, 1 mg |
1,760 |
1,552 |
$24.46M |
| J2357 |
Omalizumab injection |
12,353 |
6,604 |
$12.09M |
| J1745 |
Infliximab not biosimil 10mg |
8,320 |
5,712 |
$10.85M |
| J3380 |
Inj vedolizumab iv 1 mg |
1,904 |
1,795 |
$8.82M |
| J2323 |
Natalizumab injection |
2,687 |
2,453 |
$7.53M |
| J1561 |
Gamunex-c/gammaked |
4,018 |
1,687 |
$6.50M |
| J0490 |
Belimumab injection |
3,482 |
1,822 |
$4.37M |
| J9312 |
Inj., rituximab, 10 mg |
586 |
420 |
$2.74M |
| Q5121 |
Inj. avsola, 10 mg |
2,060 |
1,091 |
$2.40M |
| J1568 |
Octagam injection |
1,446 |
403 |
$2.36M |
| J0517 |
Inj., benralizumab, 1 mg |
963 |
916 |
$2.16M |
| J1569 |
Gammagard liquid injection |
1,161 |
548 |
$2.12M |
| Q5103 |
Injection, inflectra |
2,889 |
1,798 |
$1.96M |
| 96413 |
|
14,377 |
12,351 |
$1.19M |
| J2182 |
Injection, mepolizumab, 1mg |
648 |
577 |
$1.03M |
| J0129 |
Abatacept injection |
444 |
379 |
$645K |
| 96365 |
|
8,081 |
4,837 |
$399K |
| S9500 |
Hit antibiotic q24h diem |
6,486 |
529 |
$263K |
| 96401 |
|
5,111 |
3,817 |
$239K |
| 96366 |
|
5,352 |
3,152 |
$224K |
| 96415 |
|
8,374 |
7,228 |
$215K |
| J9310 |
Rituximab injection |
41 |
28 |
$179K |
| J2356 |
Inj tezepelumab-ekko, 1mg |
98 |
92 |
$178K |
| Q5104 |
Injection, renflexis |
102 |
50 |
$139K |
| J3032 |
Inj. eptinezumab-jjmr 1 mg |
68 |
67 |
$129K |
| J0897 |
Denosumab injection |
419 |
391 |
$123K |
| 96375 |
|
4,541 |
3,513 |
$83K |
| J1439 |
Inj ferric carboxymaltos 1mg |
124 |
67 |
$55K |
| J2930 |
Methylprednisolone injection |
2,427 |
1,676 |
$33K |
| J0491 |
Inj anifrolumab-fnia 1mg |
12 |
12 |
$28K |
| S9501 |
Hit antibiotic q12h diem |
577 |
72 |
$27K |
| J3262 |
Tocilizumab injection |
35 |
24 |
$23K |
| S9502 |
Hit antibiotic q8h diem |
509 |
38 |
$17K |
| J7050 |
Normal saline solution infus |
9,065 |
7,404 |
$7K |
| J2920 |
Methylprednisolone injection |
807 |
693 |
$3K |
| J7040 |
Normal saline solution infus |
1,689 |
1,254 |
$3K |
| 96372 |
|
660 |
574 |
$3K |
| J1200 |
Diphenhydramine hcl injectio |
2,357 |
1,915 |
$3K |
| J1750 |
Inj iron dextran |
14 |
12 |
$3K |
| 96361 |
|
56 |
26 |
$557.96 |
| 99211 |
|
12 |
12 |
$238.18 |
| J2919 |
Inj, methylpred sod succ 5mg |
313 |
260 |
$162.15 |