| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| J1439 |
Inj ferric carboxymaltos 1mg |
2,989 |
1,949 |
$2.45M |
| J0881 |
Darbepoetin alfa, non-esrd |
2,143 |
1,698 |
$1.42M |
| J0897 |
Denosumab injection |
802 |
775 |
$1.33M |
| 99214 |
|
23,933 |
22,149 |
$1.03M |
| J2505 |
Injection, pegfilgrastim 6mg |
186 |
135 |
$788K |
| 96413 |
|
7,639 |
4,886 |
$502K |
| J9355 |
Inj trastuzumab excl biosimi |
115 |
71 |
$458K |
| Q5108 |
Injection, fulphila |
82 |
59 |
$265K |
| Q5118 |
Inj., zirabev, 10 mg |
178 |
81 |
$245K |
| J1453 |
Fosaprepitant injection |
1,357 |
959 |
$237K |
| 85025 |
|
39,178 |
31,149 |
$185K |
| 96372 |
|
9,402 |
7,594 |
$168K |
| 99233 |
Prolong inpt eval add15 m |
4,613 |
1,190 |
$156K |
| 99205 |
Prolong outpt/office vis |
1,876 |
1,869 |
$155K |
| J9271 |
Inj pembrolizumab |
14 |
13 |
$135K |
| 96374 |
|
2,875 |
1,904 |
$133K |
| 96375 |
|
3,393 |
2,177 |
$125K |
| 99213 |
|
3,108 |
3,033 |
$100K |
| 96417 |
|
2,026 |
1,380 |
$84K |
| 96367 |
|
1,835 |
1,321 |
$64K |
| 96415 |
|
1,778 |
1,225 |
$59K |
| J1626 |
Granisetron hcl injection |
3,295 |
1,993 |
$48K |
| 99245 |
|
326 |
326 |
$33K |
| 96365 |
|
364 |
197 |
$23K |
| 99203 |
|
404 |
404 |
$22K |
| J9171 |
Docetaxel injection |
17 |
12 |
$18K |
| 99204 |
|
217 |
217 |
$14K |
| 96402 |
|
1,067 |
1,009 |
$12K |
| 36415 |
|
8,992 |
7,684 |
$10K |
| J3420 |
Vitamin b12 injection |
3,145 |
2,755 |
$10K |
| J2469 |
Palonosetron hcl |
33 |
25 |
$6K |
| 96411 |
|
395 |
277 |
$6K |
| J2916 |
Na ferric gluconate complex |
250 |
107 |
$5K |
| 99223 |
Prolong inpt eval add15 m |
25 |
25 |
$2K |
| 99212 |
|
19 |
19 |
$465.51 |
| 99211 |
|
32 |
32 |
$458.33 |
| J1100 |
Dexamethasone sodium phos |
84 |
66 |
$316.84 |