| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 80053 |
|
10,862 |
7,084 |
$872K |
| 87497 |
|
828 |
476 |
$681K |
| 85025 |
|
12,338 |
7,575 |
$474K |
| J9144 |
Daratumumab, hyaluronidase |
220 |
166 |
$347K |
| 86900 |
|
2,767 |
1,486 |
$312K |
| 86850 |
|
2,730 |
1,415 |
$253K |
| G0463 |
Hospital outpt clinic visit |
7,323 |
5,384 |
$210K |
| 87799 |
|
679 |
391 |
$190K |
| 83735 |
|
1,818 |
903 |
$177K |
| 82784 |
|
2,340 |
1,462 |
$166K |
| 86901 |
|
2,665 |
1,406 |
$166K |
| 96413 |
|
4,601 |
2,887 |
$145K |
| 87798 |
|
174 |
85 |
$135K |
| 87496 |
|
174 |
87 |
$135K |
| 83615 |
|
1,827 |
1,057 |
$131K |
| 96375 |
|
3,577 |
2,287 |
$76K |
| 96372 |
|
2,000 |
1,513 |
$35K |
| 96401 |
|
544 |
310 |
$35K |
| J0897 |
Denosumab injection |
83 |
76 |
$30K |
| Q3014 |
Telehealth facility fee |
2,177 |
1,778 |
$28K |
| Z7500 |
|
786 |
366 |
$27K |
| 86334 |
|
836 |
765 |
$22K |
| 36430 |
|
265 |
199 |
$20K |
| 77334 |
|
118 |
94 |
$19K |
| C9062 |
Daratumumab hyaluronidase |
20 |
12 |
$19K |
| 84165 |
|
1,092 |
988 |
$18K |
| 0760 |
|
1,701 |
1,051 |
$17K |
| P9040 |
Rbc leukoreduced irradiated |
312 |
254 |
$16K |
| J1642 |
Inj heparin sodium per 10 u |
2,028 |
1,263 |
$15K |
| 77300 |
|
70 |
66 |
$12K |
| 36415 |
|
1,365 |
935 |
$11K |
| 96367 |
|
397 |
267 |
$11K |
| 96415 |
|
698 |
478 |
$10K |
| 96417 |
|
905 |
604 |
$10K |
| 96361 |
|
953 |
626 |
$10K |
| 83883 |
|
1,076 |
647 |
$9K |
| 77336 |
|
330 |
193 |
$9K |
| 96365 |
|
260 |
162 |
$7K |
| 82728 |
|
188 |
177 |
$7K |
| J7030 |
Normal saline solution infus |
444 |
292 |
$6K |
| J1100 |
Dexamethasone sodium phos |
1,558 |
947 |
$5K |
| 96374 |
|
186 |
134 |
$4K |
| 0510 |
|
2,493 |
1,884 |
$3K |
| 83521 |
|
347 |
319 |
$3K |
| 84100 |
|
16 |
12 |
$2K |
| 96360 |
|
112 |
66 |
$2K |
| J3490 |
Drugs unclassified injection |
167 |
114 |
$2K |
| J2506 |
Inj pegfilgrast ex bio 0.5mg |
17 |
13 |
$2K |
| 0272 |
|
363 |
266 |
$1K |
| J1626 |
Granisetron hcl injection |
529 |
332 |
$1K |
| 71260 |
|
40 |
38 |
$942.50 |
| 82378 |
|
356 |
305 |
$884.49 |
| 86300 |
|
190 |
155 |
$869.60 |
| 0761 |
|
13 |
12 |
$256.64 |
| J7040 |
Normal saline solution infus |
54 |
30 |
$256.07 |
| J1453 |
Fosaprepitant injection |
71 |
43 |
$232.42 |
| J1200 |
Diphenhydramine hcl injectio |
173 |
117 |
$195.11 |
| 0949 |
|
24 |
24 |
$175.94 |
| 81001 |
|
20 |
15 |
$154.94 |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
34 |
30 |
$149.81 |
| 84439 |
|
79 |
70 |
$149.09 |
| 86301 |
|
43 |
37 |
$130.42 |
| 83550 |
|
63 |
57 |
$104.26 |
| 83540 |
|
77 |
70 |
$89.08 |
| 85027 |
|
17 |
16 |
$80.05 |
| 99211 |
|
34 |
27 |
$34.20 |
| 84443 |
|
65 |
60 |
$27.42 |
| 86304 |
|
15 |
14 |
$14.80 |
| 84481 |
|
16 |
12 |
$11.98 |
| 85610 |
|
35 |
25 |
$4.32 |