| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| J0135 |
Adalimumab injection |
1,696 |
1,377 |
$851K |
| J1438 |
Etanercept injection |
793 |
645 |
$482K |
| J2357 |
Omalizumab injection |
835 |
637 |
$444K |
| J3490 |
Drugs unclassified injection |
1,736 |
1,536 |
$388K |
| J1726 |
Makena, 10 mg |
456 |
338 |
$92K |
| J2182 |
Injection, mepolizumab, 1mg |
25 |
24 |
$18K |
| J2941 |
Somatropin injection |
36 |
24 |
$15K |
| J3590 |
Unclassified biologics |
710 |
533 |
$8K |
| J1650 |
Inj enoxaparin sodium |
54 |
51 |
$5K |
| S5000 |
Prescription drug, generic |
51 |
39 |
$3K |
| J8521 |
Capecitabine, oral, 500 mg |
23 |
15 |
$1K |
| Q0511 |
Sup fee antiem,antica,immuno |
296 |
265 |
$234.69 |
| Q0512 |
Px sup fee anti-can sub pres |
34 |
28 |
$16.20 |