| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| J2350 |
Injection, ocrelizumab, 1 mg |
1,467 |
1,322 |
$39.25M |
| J9271 |
Inj pembrolizumab |
2,331 |
1,827 |
$21.49M |
| J2323 |
Natalizumab injection |
1,224 |
1,174 |
$7.14M |
| 96413 |
|
20,568 |
13,657 |
$3.35M |
| J1561 |
Gamunex-c/gammaked |
713 |
447 |
$2.74M |
| G0463 |
Hospital outpt clinic visit |
16,945 |
14,182 |
$2.56M |
| J9312 |
Inj., rituximab, 10 mg |
430 |
306 |
$2.51M |
| J1745 |
Infliximab not biosimil 10mg |
1,662 |
976 |
$2.36M |
| 96365 |
|
26,764 |
10,470 |
$2.15M |
| J9144 |
Daratumumab, hyaluronidase |
302 |
200 |
$2.10M |
| 96415 |
|
6,663 |
5,186 |
$1.69M |
| 77386 |
|
4,977 |
694 |
$1.68M |
| J0897 |
Denosumab injection |
966 |
883 |
$1.62M |
| 78815 |
|
1,582 |
1,389 |
$1.58M |
| 77412 |
|
4,111 |
674 |
$1.44M |
| J2505 |
Injection, pegfilgrastim 6mg |
495 |
328 |
$1.32M |
| J2506 |
Inj pegfilgrast ex bio 0.5mg |
722 |
567 |
$1.17M |
| 77336 |
|
3,678 |
1,880 |
$1.13M |
| J0485 |
Belatacept injection |
1,450 |
730 |
$1.02M |
| J1439 |
Inj ferric carboxymaltos 1mg |
1,369 |
859 |
$909K |
| J9355 |
Inj trastuzumab excl biosimi |
355 |
125 |
$855K |
| P9016 |
Rbc leukocytes reduced |
1,979 |
1,401 |
$784K |
| 80053 |
|
56,713 |
36,611 |
$777K |
| J9299 |
Injection, nivolumab |
177 |
102 |
$773K |
| 77067 |
|
7,042 |
6,085 |
$595K |
| 96375 |
|
20,882 |
10,204 |
$579K |
| 78452 |
|
2,847 |
1,708 |
$567K |
| 96361 |
|
4,421 |
2,577 |
$538K |
| J0185 |
Inj., aprepitant, 1 mg |
3,014 |
2,061 |
$535K |
| 96372 |
|
28,549 |
7,813 |
$480K |
| 76641 |
|
6,477 |
4,227 |
$456K |
| Q5107 |
Inj mvasi 10 mg |
450 |
171 |
$452K |
| J1756 |
Iron sucrose injection |
9,405 |
4,545 |
$442K |
| J1950 |
Leuprolide acetate /3.75 mg |
292 |
280 |
$440K |
| J3380 |
Inj vedolizumab iv 1 mg |
90 |
72 |
$419K |
| J9035 |
Bevacizumab injection |
114 |
74 |
$414K |
| Q5111 |
Injection, udenyca 0.5 mg |
217 |
152 |
$400K |
| A9552 |
F18 fdg |
1,582 |
1,458 |
$380K |
| 96416 |
|
1,703 |
1,032 |
$363K |
| 36430 |
|
2,388 |
1,531 |
$336K |
| 31575 |
|
864 |
832 |
$335K |
| 77300 |
|
1,187 |
1,007 |
$307K |
| 36415 |
|
51,616 |
25,379 |
$289K |
| 96417 |
|
4,570 |
2,989 |
$281K |
| 96366 |
|
2,561 |
1,804 |
$277K |
| 77334 |
|
1,196 |
946 |
$260K |
| J9070 |
Cyclophosphamide 100 mg inj |
600 |
426 |
$236K |
| 85025 |
|
59,459 |
39,120 |
$230K |
| 77066 |
Tomosynthesis, mammo |
2,338 |
1,979 |
$228K |
| J2469 |
Palonosetron hcl |
6,365 |
3,848 |
$221K |
| 99213 |
|
2,850 |
2,321 |
$205K |
| 96409 |
|
1,949 |
1,273 |
$192K |
| 10005 |
|
487 |
476 |
$190K |
| 83615 |
|
15,224 |
9,152 |
$170K |
| 77063 |
|
7,011 |
6,040 |
$160K |
| 77301 |
|
237 |
229 |
$156K |
| 77065 |
Tomosynthesis, mammo |
2,018 |
1,723 |
$156K |
| 88185 |
|
707 |
655 |
$153K |
| 96367 |
|
2,904 |
2,499 |
$144K |
| 96411 |
|
2,225 |
1,538 |
$140K |
| 96401 |
|
1,715 |
1,101 |
$137K |
| 99211 |
|
13,630 |
12,323 |
$129K |
| 96374 |
|
3,791 |
2,083 |
$122K |
| 99212 |
|
2,749 |
2,450 |
$114K |
| 76642 |
|
2,192 |
1,742 |
$114K |
| 86850 |
|
5,074 |
3,020 |
$110K |
| A9502 |
Tc99m tetrofosmin |
1,106 |
1,094 |
$106K |
| 77290 |
|
272 |
247 |
$106K |
| 93017 |
|
1,807 |
1,781 |
$105K |
| 96402 |
|
2,175 |
2,029 |
$99K |
| J7030 |
Normal saline solution infus |
47,657 |
20,316 |
$80K |
| J9217 |
Leuprolide acetate suspnsion |
197 |
195 |
$71K |
| J9264 |
Paclitaxel protein bound |
40 |
12 |
$71K |
| J0640 |
Leucovorin calcium injection |
1,320 |
786 |
$71K |
| 36591 |
|
1,783 |
1,489 |
$67K |
| 77062 |
|
2,127 |
1,831 |
$65K |
| 77338 |
|
322 |
289 |
$64K |
| 99202 |
|
944 |
937 |
$63K |
| 86901 |
|
5,089 |
3,026 |
$58K |
| J9267 |
Paclitaxel injection |
2,098 |
1,053 |
$56K |
| 77280 |
|
162 |
152 |
$54K |
| 82728 |
|
5,301 |
4,699 |
$52K |
| 96360 |
|
729 |
511 |
$48K |
| 86945 |
|
1,818 |
1,110 |
$44K |
| 86900 |
|
5,093 |
3,027 |
$43K |
| 96523 |
|
1,007 |
881 |
$42K |
| 86480 |
|
783 |
764 |
$41K |
| 77061 |
|
1,271 |
1,112 |
$40K |
| 82378 |
|
3,072 |
2,556 |
$39K |
| J9045 |
Carboplatin injection |
1,749 |
1,121 |
$39K |
| 70551 |
|
281 |
248 |
$37K |
| 77080 |
|
1,271 |
1,095 |
$36K |
| J3490 |
Drugs unclassified injection |
2,486 |
1,576 |
$35K |
| 87497 |
|
1,339 |
905 |
$35K |
| J9202 |
Goserelin acetate implant |
59 |
49 |
$34K |
| 84703 |
|
8,451 |
6,988 |
$32K |
| 77332 |
|
194 |
181 |
$32K |
| 82784 |
|
2,016 |
1,736 |
$31K |
| A9585 |
Gadobutrol injection |
1,933 |
1,181 |
$31K |
| 83883 |
|
1,748 |
1,398 |
$27K |
| J7050 |
Normal saline solution infus |
14,156 |
8,525 |
$26K |
| U0003 |
Cov-19 amp prb hgh thruput |
413 |
365 |
$26K |
| 86923 |
|
1,390 |
1,003 |
$26K |
| 71250 |
|
1,906 |
1,884 |
$24K |
| 84443 |
|
3,405 |
2,946 |
$24K |
| 83735 |
|
5,651 |
3,487 |
$23K |
| 87799 |
|
426 |
229 |
$22K |
| J2930 |
Methylprednisolone injection |
2,103 |
1,824 |
$21K |
| J9190 |
Fluorouracil injection |
1,739 |
1,048 |
$21K |
| 97110 |
|
162 |
111 |
$21K |
| C8908 |
Mri w/o fol w/cont, breast, |
66 |
56 |
$19K |
| 77049 |
|
63 |
55 |
$19K |
| J9263 |
Oxaliplatin |
608 |
387 |
$18K |
| 80048 |
|
1,753 |
1,435 |
$17K |
| 88305 |
|
659 |
608 |
$17K |
| J1642 |
Inj heparin sodium per 10 u |
9,640 |
5,614 |
$17K |
| 88184 |
|
450 |
422 |
$17K |
| 82607 |
|
1,608 |
1,547 |
$16K |
| 84439 |
|
2,188 |
1,844 |
$16K |
| 74177 |
|
79 |
70 |
$15K |
| 86334 |
|
1,147 |
978 |
$15K |
| 96377 |
|
633 |
510 |
$15K |
| J1100 |
Dexamethasone sodium phos |
9,514 |
5,200 |
$15K |
| 82306 |
|
774 |
744 |
$14K |
| 86304 |
|
995 |
817 |
$14K |
| 99195 |
|
140 |
117 |
$14K |
| 88172 |
|
360 |
351 |
$14K |
| 82746 |
|
1,566 |
1,509 |
$14K |
| J9370 |
Vincristine sulfate 1 mg inj |
1,373 |
954 |
$13K |
| 96368 |
|
860 |
544 |
$13K |
| 84100 |
|
3,794 |
2,645 |
$12K |
| 86300 |
|
819 |
748 |
$12K |
| 85730 |
|
2,364 |
2,055 |
$11K |
| J9206 |
Irinotecan injection |
326 |
209 |
$11K |
| 97530 |
|
115 |
93 |
$11K |
| 86301 |
|
767 |
613 |
$10K |
| 83540 |
|
2,563 |
2,341 |
$10K |
| 85045 |
|
3,940 |
3,343 |
$10K |
| 88173 |
|
374 |
363 |
$10K |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
1,259 |
1,150 |
$10K |
| 85610 |
|
2,602 |
2,262 |
$10K |
| J7060 |
5% dextrose/water |
5,835 |
2,472 |
$9K |
| 83550 |
|
2,359 |
2,150 |
$9K |
| 84165 |
|
1,453 |
1,249 |
$8K |
| S0028 |
Injection, famotidine, 20 mg |
5,217 |
3,288 |
$8K |
| 81003 |
|
4,368 |
3,436 |
$8K |
| 86769 |
|
327 |
291 |
$8K |
| 80061 |
|
610 |
569 |
$8K |
| 86140 |
|
2,279 |
2,086 |
$8K |
| 84153 |
|
667 |
605 |
$7K |
| 86803 |
|
869 |
842 |
$7K |
| 86706 |
|
919 |
882 |
$7K |
| J9000 |
Doxorubicin hcl injection |
444 |
241 |
$7K |
| 77295 |
|
36 |
12 |
$7K |
| 86704 |
|
833 |
800 |
$6K |
| 85652 |
|
3,304 |
2,972 |
$6K |
| 80076 |
|
600 |
508 |
$6K |
| 90686 |
|
433 |
423 |
$6K |
| J2919 |
Inj, methylpred sod succ 5mg |
367 |
297 |
$5K |
| 82948 |
|
1,633 |
1,337 |
$5K |
| J2785 |
Regadenoson injection |
155 |
154 |
$5K |
| U0005 |
Infec agen detec ampli probe |
274 |
247 |
$5K |
| 86790 |
|
281 |
275 |
$5K |
| J1200 |
Diphenhydramine hcl injectio |
6,857 |
4,843 |
$5K |
| J9201 |
In gemcitabine hcl nos 200mg |
144 |
79 |
$4K |
| 87340 |
|
752 |
723 |
$4K |
| J1626 |
Granisetron hcl injection |
1,819 |
852 |
$4K |
| 90471 |
|
241 |
235 |
$4K |
| 93005 |
|
317 |
239 |
$3K |
| G0008 |
Admin influenza virus vac |
230 |
226 |
$3K |
| 83021 |
|
200 |
196 |
$3K |
| J0881 |
Darbepoetin alfa, non-esrd |
47 |
35 |
$3K |
| 87633 |
|
25 |
25 |
$3K |
| J9060 |
Cisplatin 10 mg injection |
158 |
84 |
$3K |
| 99201 |
|
70 |
70 |
$3K |
| J7040 |
Normal saline solution infus |
838 |
541 |
$3K |
| J2916 |
Na ferric gluconate complex |
122 |
50 |
$3K |
| C1889 |
Implant/insert device, noc |
86 |
79 |
$2K |
| 85670 |
|
550 |
527 |
$2K |
| Q0163 |
Diphenhydramine hcl 50mg |
3,325 |
2,199 |
$2K |
| J1720 |
Hydrocortisone sodium succ i |
246 |
184 |
$2K |
| 82550 |
|
437 |
380 |
$2K |
| 36416 |
|
121 |
116 |
$2K |
| 85379 |
|
281 |
254 |
$2K |
| 83036 |
|
413 |
405 |
$2K |
| 85240 |
|
121 |
113 |
$2K |
| 71260 |
|
12 |
12 |
$2K |
| 80050 |
|
89 |
69 |
$1K |
| 83010 |
|
135 |
130 |
$1K |
| A4648 |
Implantable tissue marker |
92 |
89 |
$1K |
| 90460 |
|
79 |
73 |
$1K |
| 86160 |
|
83 |
72 |
$1K |
| 84702 |
|
91 |
82 |
$1K |
| 84156 |
|
384 |
319 |
$1K |
| J2405 |
Ondansetron hcl injection |
2,081 |
1,174 |
$1K |
| 84481 |
|
110 |
93 |
$975.02 |
| 84550 |
|
295 |
198 |
$963.19 |
| 85246 |
|
35 |
33 |
$929.57 |
| 82105 |
|
122 |
102 |
$886.22 |
| 80197 |
|
147 |
90 |
$874.38 |
| 82248 |
|
239 |
170 |
$811.98 |
| 88342 |
|
14 |
14 |
$781.74 |
| 90656 |
|
44 |
44 |
$721.21 |
| 71046 |
|
28 |
27 |
$690.19 |
| C8937 |
Cad breast mri |
31 |
27 |
$650.88 |
| 84480 |
|
51 |
41 |
$434.16 |
| 85384 |
|
64 |
49 |
$346.54 |
| 90662 |
|
15 |
15 |
$337.16 |
| 84466 |
|
30 |
28 |
$315.07 |
| J8540 |
Oral dexamethasone |
55 |
25 |
$309.12 |
| 84403 |
|
13 |
13 |
$296.82 |
| 87086 |
|
59 |
56 |
$278.87 |
| J3420 |
Vitamin b12 injection |
226 |
193 |
$213.39 |
| J0461 |
Atropine sulfate injection |
105 |
62 |
$210.08 |
| 85613 |
|
26 |
24 |
$193.10 |
| 85732 |
|
38 |
36 |
$161.52 |
| 85027 |
|
62 |
48 |
$156.28 |
| 81001 |
|
79 |
70 |
$147.29 |
| J2920 |
Methylprednisolone injection |
40 |
25 |
$143.28 |
| 83690 |
|
33 |
26 |
$141.55 |
| 85303 |
|
12 |
12 |
$107.75 |
| J7042 |
5% dextrose/normal saline |
26 |
12 |
$91.90 |
| 85300 |
|
12 |
12 |
$77.78 |
| J3480 |
Inj potassium chloride |
80 |
37 |
$67.90 |
| J3475 |
Inj magnesium sulfate |
26 |
12 |
$65.36 |
| 82150 |
|
16 |
12 |
$63.61 |
| A4216 |
Sterile water/saline, 10 ml |
139 |
100 |
$50.62 |
| 77417 |
|
22 |
12 |
$0.00 |