| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| J9271 |
Inj pembrolizumab |
1,211 |
959 |
$2.12M |
| 96413 |
|
2,413 |
1,586 |
$308K |
| Q5107 |
Inj mvasi 10 mg |
290 |
135 |
$263K |
| J9305 |
Inj. pemetrexed nos 10mg |
176 |
79 |
$257K |
| 99214 |
|
2,692 |
2,524 |
$174K |
| 99215 |
Prolong outpt/office vis |
1,547 |
1,337 |
$120K |
| Q5108 |
Injection, fulphila |
98 |
68 |
$93K |
| J9202 |
Goserelin acetate implant |
216 |
201 |
$73K |
| 96367 |
|
1,666 |
1,103 |
$52K |
| 99205 |
Prolong outpt/office vis |
459 |
433 |
$51K |
| 96417 |
|
697 |
521 |
$47K |
| 99213 |
|
1,057 |
989 |
$43K |
| Q5111 |
Injection, udenyca 0.5 mg |
18 |
12 |
$43K |
| 96416 |
|
282 |
173 |
$42K |
| 99204 |
|
344 |
339 |
$35K |
| 96415 |
|
727 |
499 |
$29K |
| 96411 |
|
354 |
246 |
$25K |
| J2469 |
Palonosetron hcl |
3,403 |
2,193 |
$24K |
| J1439 |
Inj ferric carboxymaltos 1mg |
34 |
25 |
$21K |
| 80053 |
|
2,318 |
1,540 |
$19K |
| 36591 |
|
976 |
635 |
$16K |
| 96375 |
|
793 |
598 |
$15K |
| 31575 |
|
42 |
40 |
$14K |
| J0640 |
Leucovorin calcium injection |
1,387 |
836 |
$14K |
| 85025 |
|
2,562 |
1,667 |
$12K |
| 96372 |
|
704 |
470 |
$12K |
| 96365 |
|
161 |
96 |
$9K |
| U0003 |
Cov-19 amp prb hgh thruput |
112 |
110 |
$9K |
| 80050 |
|
106 |
96 |
$8K |
| 96402 |
|
200 |
186 |
$6K |
| J9190 |
Fluorouracil injection |
1,499 |
867 |
$6K |
| 99407 |
|
222 |
211 |
$5K |
| 83735 |
|
744 |
526 |
$5K |
| J9267 |
Paclitaxel injection |
328 |
152 |
$5K |
| J0185 |
Inj., aprepitant, 1 mg |
552 |
377 |
$4K |
| G0463 |
Hospital outpt clinic visit |
2,044 |
1,665 |
$4K |
| 96368 |
|
373 |
244 |
$3K |
| J9263 |
Oxaliplatin |
404 |
179 |
$3K |
| J9045 |
Carboplatin injection |
408 |
303 |
$3K |
| J1100 |
Dexamethasone sodium phos |
5,079 |
2,955 |
$2K |
| 99024 |
|
172 |
134 |
$2K |
| J9206 |
Irinotecan injection |
225 |
142 |
$2K |
| Q3014 |
Telehealth facility fee |
276 |
251 |
$2K |
| U0001 |
2019-ncov diagnostic p |
52 |
47 |
$2K |
| 82378 |
|
97 |
71 |
$1K |
| 86304 |
|
28 |
25 |
$689.66 |
| 84443 |
|
169 |
138 |
$655.50 |
| 91200 |
|
14 |
14 |
$602.80 |
| 96361 |
|
38 |
30 |
$540.07 |
| J2405 |
Ondansetron hcl injection |
576 |
317 |
$526.03 |
| J1200 |
Diphenhydramine hcl injectio |
2,148 |
1,192 |
$484.72 |
| J7030 |
Normal saline solution infus |
209 |
110 |
$470.89 |
| J0461 |
Atropine sulfate injection |
134 |
90 |
$242.00 |
| 90686 |
|
14 |
14 |
$234.36 |
| 86850 |
|
27 |
24 |
$165.88 |
| 86901 |
|
27 |
24 |
$113.68 |
| 86900 |
|
27 |
24 |
$112.34 |
| 83615 |
|
16 |
12 |
$55.75 |
| J3420 |
Vitamin b12 injection |
27 |
26 |
$9.70 |
| A9270 |
Non-covered item or service |
20 |
14 |
$4.16 |
| S0028 |
Injection, famotidine, 20 mg |
537 |
255 |
$0.00 |
| J1756 |
Iron sucrose injection |
297 |
149 |
$0.00 |
| J1453 |
Fosaprepitant injection |
453 |
284 |
$0.00 |
| J3475 |
Inj magnesium sulfate |
49 |
29 |
$0.00 |
| J3480 |
Inj potassium chloride |
17 |
12 |
$0.00 |
| 0001A |
|
13 |
13 |
$0.00 |
| J1950 |
Leuprolide acetate /3.75 mg |
12 |
12 |
$0.00 |
| J3490 |
Drugs unclassified injection |
13 |
12 |
$0.00 |