| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| J9299 |
Injection, nivolumab |
1,214 |
513 |
$3.39M |
| J9271 |
Inj pembrolizumab |
422 |
270 |
$2.47M |
| J0897 |
Denosumab injection |
883 |
767 |
$1.28M |
| 80053 |
|
17,126 |
11,404 |
$819K |
| J2505 |
Injection, pegfilgrastim 6mg |
85 |
67 |
$595K |
| 96413 |
|
5,901 |
3,550 |
$487K |
| 96375 |
|
4,307 |
2,315 |
$487K |
| 74177 |
|
743 |
701 |
$408K |
| 71260 |
|
1,519 |
1,435 |
$368K |
| 74178 |
|
606 |
576 |
$341K |
| J0881 |
Darbepoetin alfa, non-esrd |
309 |
220 |
$314K |
| G0463 |
Hospital outpt clinic visit |
14,257 |
11,604 |
$312K |
| 85025 |
|
16,025 |
10,457 |
$281K |
| J9217 |
Leuprolide acetate suspnsion |
214 |
210 |
$278K |
| J9035 |
Bevacizumab injection |
206 |
79 |
$231K |
| J1626 |
Granisetron hcl injection |
2,763 |
1,505 |
$207K |
| J7050 |
Normal saline solution infus |
5,272 |
3,261 |
$160K |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
2,331 |
1,628 |
$150K |
| 0510 |
|
3,523 |
3,059 |
$137K |
| 96372 |
|
3,387 |
2,184 |
$125K |
| 36415 |
|
9,743 |
7,566 |
$117K |
| 83735 |
|
6,539 |
3,681 |
$117K |
| 0272 |
|
532 |
380 |
$115K |
| 96365 |
|
1,108 |
584 |
$108K |
| J1453 |
Fosaprepitant injection |
153 |
74 |
$106K |
| J0885 |
Epoetin alfa, non-esrd |
352 |
168 |
$102K |
| Z7500 |
|
2,965 |
1,747 |
$101K |
| J1100 |
Dexamethasone sodium phos |
2,384 |
1,549 |
$86K |
| 96417 |
|
1,407 |
952 |
$86K |
| J0640 |
Leucovorin calcium injection |
96 |
53 |
$85K |
| J1200 |
Diphenhydramine hcl injectio |
1,420 |
869 |
$75K |
| 96415 |
|
1,506 |
963 |
$72K |
| 77336 |
|
703 |
321 |
$69K |
| 0250 |
|
3,423 |
2,145 |
$69K |
| 0761 |
|
975 |
850 |
$66K |
| 99221 |
|
2,771 |
2,468 |
$59K |
| 77386 |
|
118 |
13 |
$54K |
| 77334 |
|
116 |
91 |
$53K |
| 96361 |
|
687 |
456 |
$52K |
| 80197 |
|
2,113 |
1,079 |
$47K |
| 96367 |
|
1,041 |
716 |
$46K |
| 84100 |
|
4,602 |
2,359 |
$43K |
| J7060 |
5% dextrose/water |
2,125 |
1,195 |
$42K |
| 87497 |
|
868 |
472 |
$42K |
| 83615 |
|
6,161 |
3,689 |
$41K |
| 85027 |
|
2,481 |
1,612 |
$33K |
| 99199 |
|
53 |
47 |
$31K |
| 96411 |
|
385 |
258 |
$27K |
| 84443 |
|
1,425 |
1,227 |
$27K |
| 82378 |
|
1,630 |
1,375 |
$27K |
| 86850 |
|
1,855 |
1,009 |
$26K |
| J3490 |
Drugs unclassified injection |
690 |
363 |
$22K |
| 77300 |
|
106 |
94 |
$22K |
| 82728 |
|
1,462 |
997 |
$21K |
| J9201 |
In gemcitabine hcl nos 200mg |
44 |
25 |
$21K |
| J9312 |
Inj., rituximab, 10 mg |
19 |
12 |
$20K |
| Q3014 |
Telehealth facility fee |
1,670 |
1,567 |
$19K |
| 85610 |
|
1,345 |
1,112 |
$19K |
| A0429 |
Bls-emergency |
141 |
80 |
$17K |
| A9270 |
Non-covered item or service |
1,599 |
953 |
$16K |
| J1642 |
Inj heparin sodium per 10 u |
3,452 |
1,589 |
$16K |
| 96416 |
|
127 |
77 |
$15K |
| 86901 |
|
1,990 |
1,194 |
$15K |
| 86900 |
|
1,955 |
1,124 |
$14K |
| 99212 |
|
687 |
644 |
$14K |
| J7030 |
Normal saline solution infus |
629 |
407 |
$14K |
| 88321 |
|
302 |
293 |
$14K |
| 80048 |
|
541 |
484 |
$13K |
| 77301 |
|
12 |
12 |
$12K |
| J9190 |
Fluorouracil injection |
99 |
55 |
$12K |
| 81001 |
|
1,308 |
1,163 |
$12K |
| P9040 |
Rbc leukoreduced irradiated |
82 |
58 |
$12K |
| 82105 |
|
541 |
457 |
$11K |
| 88305 |
|
109 |
104 |
$10K |
| 85730 |
|
830 |
728 |
$10K |
| 87086 |
|
420 |
404 |
$10K |
| J9310 |
Rituximab injection |
20 |
12 |
$9K |
| 84153 |
|
840 |
801 |
$9K |
| 71250 |
|
68 |
64 |
$9K |
| 87635 |
|
261 |
241 |
$9K |
| 86301 |
|
549 |
470 |
$9K |
| 36592 |
|
213 |
134 |
$8K |
| 96402 |
|
267 |
259 |
$8K |
| 86141 |
|
756 |
376 |
$7K |
| J7040 |
Normal saline solution infus |
373 |
258 |
$6K |
| 0710 |
|
26 |
24 |
$6K |
| 83520 |
|
284 |
214 |
$5K |
| U0003 |
Cov-19 amp prb hgh thruput |
63 |
58 |
$5K |
| 77338 |
|
13 |
12 |
$5K |
| 36430 |
|
78 |
43 |
$4K |
| 84439 |
|
243 |
222 |
$4K |
| 86920 |
|
82 |
56 |
$4K |
| 76642 |
|
13 |
12 |
$3K |
| 96374 |
|
79 |
63 |
$3K |
| 82306 |
|
190 |
187 |
$3K |
| 84550 |
|
133 |
100 |
$3K |
| 82784 |
|
222 |
139 |
$3K |
| 77066 |
Tomosynthesis, mammo |
66 |
63 |
$3K |
| 83036 |
|
333 |
315 |
$2K |
| 84165 |
|
324 |
245 |
$2K |
| 0760 |
|
134 |
114 |
$2K |
| 82565 |
|
214 |
201 |
$2K |
| J3010 |
Fentanyl citrate injection |
283 |
266 |
$2K |
| A4649 |
Surgical supplies |
215 |
147 |
$2K |
| 83540 |
|
352 |
332 |
$2K |
| 86300 |
|
158 |
149 |
$2K |
| 0270 |
|
162 |
118 |
$2K |
| 88108 |
|
29 |
27 |
$2K |
| 0637 |
|
175 |
109 |
$2K |
| 85651 |
|
320 |
174 |
$2K |
| 83550 |
|
346 |
326 |
$1K |
| 80061 |
|
214 |
211 |
$1K |
| 52000 |
|
20 |
17 |
$1K |
| 96409 |
|
43 |
30 |
$1K |
| 96401 |
|
68 |
25 |
$1K |
| 87077 |
|
131 |
128 |
$1K |
| G0378 |
Hospital observation per hr |
51 |
44 |
$1K |
| 93005 |
|
28 |
26 |
$1K |
| G0279 |
Tomosynthesis, mammo |
73 |
67 |
$1K |
| 85045 |
|
192 |
164 |
$1K |
| Z7610 |
|
83 |
13 |
$1K |
| 76641 |
|
12 |
12 |
$849.36 |
| 87799 |
|
15 |
12 |
$728.10 |
| 51798 |
|
38 |
36 |
$649.84 |
| J2704 |
Inj, propofol, 10 mg |
68 |
53 |
$629.97 |
| 84403 |
|
90 |
85 |
$578.88 |
| 87186 |
|
41 |
41 |
$491.85 |
| J2405 |
Ondansetron hcl injection |
86 |
67 |
$461.85 |
| 90713 |
|
12 |
12 |
$406.00 |
| 84152 |
|
33 |
30 |
$387.98 |
| 99213 |
|
16 |
12 |
$385.65 |
| 90715 |
|
12 |
12 |
$385.20 |
| 82607 |
|
50 |
45 |
$380.48 |
| 82746 |
|
26 |
22 |
$272.69 |
| 86140 |
|
142 |
119 |
$271.72 |
| 77067 |
|
15 |
15 |
$244.83 |
| 90648 |
|
12 |
12 |
$208.40 |
| J1170 |
Hydromorphone injection |
16 |
12 |
$200.80 |
| J2250 |
Inj midazolam hydrochloride |
27 |
25 |
$108.12 |
| 82668 |
|
13 |
13 |
$104.32 |
| 86803 |
|
13 |
12 |
$80.09 |
| 99211 |
|
14 |
12 |
$60.26 |
| 82570 |
|
46 |
43 |
$38.67 |
| 84156 |
|
14 |
13 |
$2.58 |
| 0300 |
|
66 |
15 |
$0.00 |
| 0636 |
|
36 |
12 |
$0.00 |