| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| J0585 |
Injection,onabotulinumtoxina |
371 |
370 |
$10K |
| J7298 |
Mirena, 52 mg |
584 |
580 |
$5K |
| J7300 |
Intra copp contra (paragard) |
459 |
458 |
$3K |
| J7307 |
Etonogestrel implant system |
113 |
112 |
$2K |
| 90750 |
|
646 |
640 |
$1K |
| 90715 |
|
433 |
432 |
$141.44 |
| J1050 |
Medroxyprogesterone acetate |
189 |
189 |
$42.00 |
| J0717 |
Certolizumab pegol inj 1mg |
66 |
62 |
$0.00 |
| Q5103 |
Injection, inflectra |
102 |
95 |
$0.00 |
| J3490 |
Drugs unclassified injection |
2,362 |
2,192 |
$0.00 |
| J2790 |
Rho d immune globulin inj |
27 |
26 |
$0.00 |
| J3590 |
Unclassified biologics |
108 |
95 |
$0.00 |
| J1100 |
Dexamethasone sodium phos |
49 |
48 |
$0.00 |
| 90732 |
|
142 |
142 |
$0.00 |
| 90686 |
|
41 |
41 |
$0.00 |
| 90651 |
|
38 |
37 |
$0.00 |
| 90670 |
|
61 |
61 |
$0.00 |
| J7318 |
Inj, durolane 1 mg |
14 |
14 |
$0.00 |
| J1200 |
Diphenhydramine hcl injectio |
43 |
41 |
$0.00 |
| J0897 |
Denosumab injection |
12 |
12 |
$0.00 |
| S0028 |
Injection, famotidine, 20 mg |
13 |
13 |
$0.00 |