| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| J9271 |
Inj pembrolizumab |
288 |
225 |
$1.65M |
| 99214 |
|
34,263 |
20,074 |
$1.40M |
| 96375 |
|
15,768 |
6,120 |
$888K |
| 96360 |
|
7,634 |
3,593 |
$689K |
| 96365 |
|
9,441 |
3,916 |
$656K |
| P9046 |
Albumin (human), 25%, 20 ml |
2,892 |
1,071 |
$314K |
| 96372 |
|
14,052 |
10,259 |
$286K |
| 99215 |
Prolong outpt/office vis |
4,327 |
3,252 |
$280K |
| 96374 |
|
3,136 |
1,647 |
$194K |
| 85025 |
|
31,318 |
18,549 |
$176K |
| 96413 |
|
5,385 |
3,176 |
$166K |
| 80048 |
|
25,552 |
15,790 |
$154K |
| J7030 |
Normal saline solution infus |
12,340 |
4,620 |
$142K |
| 96367 |
|
3,576 |
1,663 |
$141K |
| Q5106 |
Inj retacrit non-esrd use |
302 |
167 |
$68K |
| J3480 |
Inj potassium chloride |
2,533 |
791 |
$67K |
| 99232 |
|
1,224 |
427 |
$49K |
| J7050 |
Normal saline solution infus |
9,039 |
4,972 |
$49K |
| 96361 |
|
5,036 |
2,606 |
$44K |
| 99213 |
|
1,470 |
1,152 |
$41K |
| 96415 |
|
768 |
422 |
$35K |
| J2780 |
Ranitidine hydrochloride inj |
3,723 |
2,076 |
$34K |
| 96366 |
|
1,366 |
538 |
$32K |
| J0897 |
Denosumab injection |
64 |
62 |
$31K |
| J3420 |
Vitamin b12 injection |
8,941 |
7,450 |
$29K |
| J3475 |
Inj magnesium sulfate |
6,015 |
1,575 |
$28K |
| J0885 |
Epoetin alfa, non-esrd |
95 |
65 |
$28K |
| J1644 |
Inj heparin sodium per 1000u |
4,653 |
1,415 |
$22K |
| 96417 |
|
372 |
243 |
$20K |
| J1453 |
Fosaprepitant injection |
191 |
105 |
$18K |
| J2469 |
Palonosetron hcl |
327 |
193 |
$18K |
| J1626 |
Granisetron hcl injection |
3,843 |
2,098 |
$17K |
| J1200 |
Diphenhydramine hcl injectio |
4,432 |
2,619 |
$14K |
| 99245 |
|
59 |
57 |
$11K |
| 99233 |
Prolong inpt eval add15 m |
209 |
82 |
$10K |
| Q5122 |
Inj, nyvepria |
15 |
13 |
$10K |
| J1100 |
Dexamethasone sodium phos |
1,182 |
675 |
$7K |
| S0028 |
Injection, famotidine, 20 mg |
1,145 |
677 |
$6K |
| 96411 |
|
139 |
73 |
$4K |
| Q0138 |
Ferumoxytol, non-esrd |
33 |
24 |
$3K |
| J7040 |
Normal saline solution infus |
1,532 |
695 |
$3K |
| J0640 |
Leucovorin calcium injection |
26 |
12 |
$993.16 |
| J2765 |
Metoclopramide hcl injection |
423 |
245 |
$975.06 |
| 80076 |
|
6,674 |
5,318 |
$681.11 |
| J3490 |
Drugs unclassified injection |
1,083 |
677 |
$667.18 |
| 82728 |
|
2,925 |
2,783 |
$608.71 |
| 83735 |
|
3,954 |
1,822 |
$484.92 |
| 99212 |
|
19 |
15 |
$477.15 |
| 85610 |
|
170 |
122 |
$361.86 |
| J9190 |
Fluorouracil injection |
27 |
13 |
$357.82 |
| 96523 |
|
17 |
13 |
$336.86 |
| 80053 |
|
685 |
626 |
$276.87 |
| 83615 |
|
2,994 |
2,595 |
$270.19 |
| 82607 |
|
1,054 |
1,036 |
$240.64 |
| 82378 |
|
415 |
364 |
$200.05 |
| 82746 |
|
1,206 |
1,179 |
$199.59 |
| J1170 |
Hydromorphone injection |
27 |
13 |
$136.69 |
| J2060 |
Lorazepam injection |
22 |
12 |
$58.85 |
| 84443 |
|
315 |
301 |
$49.63 |
| J1642 |
Inj heparin sodium per 10 u |
50 |
24 |
$30.27 |
| J2270 |
Morphine sulfate injection |
30 |
12 |
$25.44 |
| 86140 |
|
118 |
114 |
$13.50 |
| 84439 |
|
178 |
168 |
$13.24 |
| 99000 |
|
9,146 |
5,433 |
$0.00 |
| 36415 |
|
2,754 |
1,784 |
$0.00 |