| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| J0585 |
Injection, onabotulinumtoxina, 1 unit |
371 |
370 |
$10K |
| J7298 |
Levonorgestrel-releasing intrauterine contraceptive system (mirena), 52 mg |
584 |
580 |
$5K |
| J7300 |
Intrauterine copper contraceptive (paragard) |
459 |
458 |
$3K |
| J7307 |
Etonogestrel (contraceptive) implant system, including implant and supplies |
113 |
112 |
$2K |
| 90750 |
|
646 |
640 |
$1K |
| 90715 |
|
433 |
432 |
$141.44 |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
189 |
189 |
$42.00 |
| 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) |
66 |
62 |
$0.00 |
| Q5103 |
Injection, infliximab-dyyb, biosimilar, (inflectra), 10 mg |
102 |
95 |
$0.00 |
| J3490 |
Unclassified drugs |
2,362 |
2,192 |
$0.00 |
| J2790 |
Injection, rho d immune globulin, human, full dose, 300 micrograms (1500 i.u.) |
27 |
26 |
$0.00 |
| J3590 |
Unclassified biologics |
108 |
95 |
$0.00 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
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 |
Hyaluronan or derivative, durolane, for intra-articular injection, 1 mg |
14 |
14 |
$0.00 |
| J1200 |
Injection, diphenhydramine hcl, up to 50 mg |
43 |
41 |
$0.00 |
| J0897 |
Injection, denosumab, 1 mg |
12 |
12 |
$0.00 |
| S0028 |
Injection, famotidine, 20 mg |
13 |
13 |
$0.00 |