| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| Q5103 |
Injection, inflectra |
1,131 |
1,079 |
$1.68M |
| J3380 |
Inj vedolizumab iv 1 mg |
189 |
179 |
$848K |
| J1745 |
Infliximab not biosimil 10mg |
406 |
341 |
$798K |
| Q5104 |
Injection, renflexis |
529 |
497 |
$749K |
| J2357 |
Omalizumab injection |
447 |
391 |
$608K |
| J1439 |
Inj ferric carboxymaltos 1mg |
792 |
515 |
$483K |
| 96365 |
|
14,587 |
6,238 |
$431K |
| 96413 |
|
4,434 |
4,125 |
$209K |
| J1756 |
Iron sucrose injection |
2,137 |
822 |
$78K |
| J2356 |
Inj tezepelumab-ekko, 1mg |
36 |
36 |
$66K |
| 96415 |
|
3,657 |
3,420 |
$47K |
| 96366 |
|
2,720 |
956 |
$41K |
| 96360 |
|
2,226 |
737 |
$31K |
| 96375 |
|
2,093 |
1,397 |
$17K |
| 96372 |
|
2,864 |
2,330 |
$12K |
| 96361 |
|
1,131 |
407 |
$11K |
| J2930 |
Methylprednisolone injection |
717 |
500 |
$10K |
| 36415 |
|
4,343 |
3,238 |
$10K |
| 96367 |
|
561 |
301 |
$8K |
| J7030 |
Normal saline solution infus |
1,194 |
414 |
$3K |
| J2916 |
Na ferric gluconate complex |
108 |
36 |
$2K |
| J0885 |
Epoetin alfa, non-esrd |
18 |
13 |
$1K |
| J3411 |
Thiamine hcl 100 mg |
545 |
264 |
$1K |
| J2405 |
Ondansetron hcl injection |
2,944 |
739 |
$1K |
| J3489 |
Zoledronic acid 1mg |
39 |
38 |
$889.79 |
| J3480 |
Inj potassium chloride |
356 |
143 |
$382.08 |
| J2919 |
Inj, methylpred sod succ 5mg |
174 |
127 |
$338.57 |
| J3490 |
Drugs unclassified injection |
202 |
112 |
$318.77 |
| J7120 |
Ringers lactate infusion |
86 |
29 |
$226.92 |
| J3475 |
Inj magnesium sulfate |
50 |
12 |
$189.51 |
| J1100 |
Dexamethasone sodium phos |
89 |
62 |
$83.12 |
| J2920 |
Methylprednisolone injection |
12 |
12 |
$45.82 |