| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| J0129 |
Injection, abatacept, 10 mg (code may be used for medicare when drug administered under the direct supervision of a physician, not for use when drug is self administered) |
752 |
658 |
$1.82M |
| Q5104 |
Injection, infliximab-abda, biosimilar, (renflexis), 10 mg |
1,146 |
597 |
$931K |
| J0717 |
Injection, certolizumab pegol, 1 mg (code may be used for medicare when drug administered under the direct supervision of a physician, not for use when drug is self administered) |
443 |
340 |
$765K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
8,448 |
7,870 |
$348K |
| 96413 |
Chemotherapy administration, intravenous infusion; up to 1 hour, single or initial substance |
4,057 |
3,584 |
$281K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
3,242 |
3,027 |
$252K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
1,958 |
1,823 |
$207K |
| J1745 |
Injection, infliximab, excludes biosimilar, 10 mg |
244 |
153 |
$197K |
| A4221 |
Supplies for maintenance of non-insulin drug infusion catheter, per week (list drugs separately) |
3,245 |
2,798 |
$36K |
| 96401 |
|
401 |
341 |
$33K |
| 96415 |
|
1,693 |
1,478 |
$29K |
| 20610 |
|
515 |
334 |
$14K |
| J1030 |
Injection, methylprednisolone acetate, 40 mg |
997 |
907 |
$10K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
447 |
203 |
$5K |
| G2211 |
Visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and/or with medical care services that are part of ongoing care related to a patient's single, serious condition or a complex condition. (add-on code, list separately in addition to office/outpatient evaluation and management visit, new or established) |
302 |
287 |
$3K |
| J7050 |
Infusion, normal saline solution, 250 cc |
2,862 |
2,541 |
$3K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
171 |
151 |
$991.01 |
| 99442 |
|
15 |
12 |
$611.62 |
| J3301 |
Injection, triamcinolone acetonide, not otherwise specified, 10 mg |
104 |
94 |
$565.87 |
| 99070 |
|
227 |
199 |
$29.97 |
| M1003 |
Tb screening performed and results interpreted within twelve months prior to initiation of first-time biologic and/or immune response modifier therapy |
48 |
46 |
$0.00 |
| 1170F |
|
31 |
30 |
$0.00 |
| 0540F |
|
61 |
59 |
$0.00 |
| M1007 |
>=50% of total number of a patient's outpatient ra encounters assessed |
30 |
29 |
$0.00 |
| G2112 |
Patient receiving <=5 mg daily prednisone (or equivalent), or ra activity is worsening, or glucocorticoid use is for less than 6 months |
14 |
14 |
$0.00 |