| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| Q5127 |
Inj, stimufend, 0.5 mg |
177 |
142 |
$581K |
| 99214 |
|
17,972 |
16,245 |
$428K |
| J1439 |
Inj ferric carboxymaltos 1mg |
603 |
480 |
$413K |
| Q5122 |
Inj, nyvepria |
95 |
80 |
$247K |
| J1449 |
Inj eflapegrastim-xnst 0.1mg |
66 |
55 |
$236K |
| Q5106 |
Inj retacrit non-esrd use |
1,483 |
903 |
$200K |
| 96375 |
|
7,485 |
5,440 |
$194K |
| 96413 |
|
8,800 |
6,536 |
$174K |
| 96372 |
|
14,174 |
8,721 |
$159K |
| 96365 |
|
3,396 |
2,813 |
$152K |
| J2469 |
Palonosetron hcl |
2,802 |
2,014 |
$135K |
| Q0138 |
Ferumoxytol, non-esrd |
408 |
320 |
$126K |
| 99205 |
Prolong outpt/office vis |
1,420 |
1,414 |
$95K |
| J3590 |
Unclassified biologics |
17 |
12 |
$59K |
| Q5108 |
Injection, fulphila |
21 |
16 |
$50K |
| 96417 |
|
1,598 |
1,224 |
$42K |
| J0885 |
Epoetin alfa, non-esrd |
338 |
199 |
$41K |
| J1100 |
Dexamethasone sodium phos |
5,091 |
3,587 |
$35K |
| J1627 |
Inj, granisetron, xr, 0.1 mg |
57 |
37 |
$29K |
| 96367 |
|
853 |
656 |
$26K |
| 99215 |
Prolong outpt/office vis |
422 |
397 |
$17K |
| 99232 |
|
591 |
299 |
$16K |
| J0185 |
Inj., aprepitant, 1 mg |
76 |
60 |
$14K |
| J1200 |
Diphenhydramine hcl injectio |
2,066 |
1,574 |
$11K |
| J2820 |
Sargramostim injection |
29 |
12 |
$8K |
| J3420 |
Vitamin b12 injection |
2,536 |
1,948 |
$3K |
| 96415 |
|
111 |
88 |
$2K |
| 99222 |
|
36 |
36 |
$2K |
| 99204 |
|
25 |
25 |
$1K |
| J1720 |
Hydrocortisone sodium succ i |
87 |
62 |
$1K |
| J3489 |
Zoledronic acid 1mg |
40 |
37 |
$882.89 |
| 99213 |
|
35 |
34 |
$449.49 |
| 85025 |
|
74 |
56 |
$240.48 |
| J1642 |
Inj heparin sodium per 10 u |
221 |
200 |
$239.28 |
| 96411 |
|
14 |
12 |
$213.36 |
| J2920 |
Methylprednisolone injection |
31 |
25 |
$166.24 |
| 36415 |
|
232 |
198 |
$0.00 |
| 99497 |
|
15 |
15 |
$0.00 |