| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| J3285 |
Treprostinil injection |
12,885 |
7,388 |
$55.30M |
| J7686 |
Treprostinil, non-comp unit |
3,664 |
2,682 |
$12.48M |
| J1559 |
Hizentra injection |
9,258 |
4,885 |
$12.37M |
| J7170 |
Inj., emicizumab-kxwh 0.5 mg |
824 |
495 |
$10.65M |
| J1569 |
Gammagard liquid injection |
5,807 |
2,837 |
$9.62M |
| J1325 |
Epoprostenol injection |
6,735 |
3,346 |
$4.93M |
| J1561 |
Gamunex-c/gammaked |
2,902 |
1,260 |
$4.90M |
| J1555 |
Inj cuvitru, 100 mg |
2,666 |
1,451 |
$4.18M |
| S9347 |
Hit longterm infusion diem |
14,617 |
3,862 |
$4.10M |
| J7192 |
Factor viii recombinant nos |
1,123 |
252 |
$3.01M |
| J1575 |
Hyqvia 100mg immuneglobulin |
1,889 |
901 |
$2.98M |
| J7340 |
Carbidopa levodopa ent 100ml |
1,596 |
1,131 |
$1.81M |
| A4222 |
Infusion supplies with pump |
14,396 |
7,492 |
$953K |
| A4221 |
Supp non-insulin inf cath/wk |
30,168 |
14,994 |
$668K |
| S9338 |
Hit immunotherapy diem |
6,718 |
3,541 |
$586K |
| S9379 |
Hit noc per diem |
5,821 |
787 |
$467K |
| 99601 |
|
4,186 |
1,801 |
$464K |
| Q9992 |
Buprenorphine xr over 100 mg |
210 |
170 |
$359K |
| 99602 |
Nursing care in home rn |
1,874 |
939 |
$306K |
| K0455 |
Pump uninterrupted infusion |
7,062 |
5,833 |
$249K |
| Q2052 |
Home ivig, services/supplies |
1,810 |
1,032 |
$119K |
| Q0513 |
Disp fee inhal drugs/30 days |
2,183 |
1,716 |
$108K |
| E0781 |
External ambulatory infus pu |
1,919 |
1,461 |
$99K |
| K0552 |
Sup/ext non-ins inf pump syr |
7,729 |
5,767 |
$87K |
| J0585 |
Injection,onabotulinumtoxina |
39 |
39 |
$39K |
| S9999 |
Sales tax |
403 |
299 |
$39K |
| J1459 |
Inj ivig privigen 500 mg |
22 |
12 |
$17K |
| S9346 |
Hit alpha-1-proteinas diem |
259 |
77 |
$12K |
| S0155 |
Epoprostenol dilutant |
35 |
24 |
$10K |
| E0779 |
Amb infusion pump mechanical |
1,341 |
1,105 |
$6K |
| E0574 |
Ultrasonic generator w svneb |
595 |
476 |
$3K |
| S9357 |
Hit enzyme replace diem |
17 |
13 |
$1K |
| A7016 |
Nebulizer dome & mouthpiece |
56 |
45 |
$45.71 |