| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
|
31,996 |
27,145 |
$707K |
| J9271 |
Inj pembrolizumab |
208 |
169 |
$608K |
| 85025 |
|
42,387 |
26,761 |
$426K |
| 96413 |
|
24,060 |
12,155 |
$221K |
| 99211 |
|
23,416 |
13,250 |
$214K |
| 99213 |
|
23,070 |
22,149 |
$152K |
| 96367 |
|
17,224 |
8,244 |
$150K |
| J2405 |
Ondansetron hcl injection |
16,333 |
7,705 |
$146K |
| 96372 |
|
7,975 |
4,433 |
$131K |
| 99000 |
|
25,333 |
17,501 |
$89K |
| 36415 |
|
8,594 |
6,050 |
$77K |
| J1100 |
Dexamethasone sodium phos |
15,184 |
7,393 |
$73K |
| 96375 |
|
11,098 |
5,498 |
$71K |
| J1642 |
Inj heparin sodium per 10 u |
10,220 |
5,395 |
$59K |
| 96365 |
|
5,935 |
3,557 |
$38K |
| 96361 |
|
4,420 |
2,709 |
$31K |
| 99204 |
|
2,702 |
2,686 |
$29K |
| 96415 |
|
3,518 |
2,216 |
$28K |
| 96368 |
|
9,074 |
4,907 |
$23K |
| 96417 |
|
3,948 |
2,398 |
$22K |
| Q0138 |
Ferumoxytol, non-esrd |
701 |
486 |
$21K |
| 1126F |
|
5,262 |
4,976 |
$15K |
| 80053 |
|
2,061 |
1,566 |
$11K |
| J0885 |
Epoetin alfa, non-esrd |
341 |
240 |
$11K |
| J1453 |
Fosaprepitant injection |
782 |
515 |
$7K |
| 99203 |
|
899 |
899 |
$6K |
| 99232 |
|
486 |
227 |
$4K |
| J7050 |
Normal saline solution infus |
2,888 |
1,814 |
$4K |
| 99215 |
Prolong outpt/office vis |
379 |
345 |
$4K |
| 99205 |
Prolong outpt/office vis |
77 |
74 |
$3K |
| J1439 |
Inj ferric carboxymaltos 1mg |
20 |
13 |
$3K |
| J1200 |
Diphenhydramine hcl injectio |
2,133 |
1,066 |
$2K |
| J1626 |
Granisetron hcl injection |
79 |
42 |
$2K |
| 3074F |
|
1,746 |
1,671 |
$2K |
| 99231 |
|
364 |
134 |
$2K |
| 36591 |
|
2,048 |
1,042 |
$1K |
| 3080F |
|
1,947 |
1,851 |
$1K |
| 96416 |
|
339 |
199 |
$1K |
| 96411 |
|
773 |
454 |
$805.75 |
| 3078F |
|
1,595 |
1,528 |
$726.01 |
| 3077F |
|
2,252 |
2,122 |
$687.37 |
| 96402 |
|
282 |
259 |
$641.16 |
| J9267 |
Paclitaxel injection |
153 |
63 |
$531.79 |
| 3079F |
|
743 |
719 |
$431.08 |
| J0461 |
Atropine sulfate injection |
172 |
108 |
$375.26 |
| 96523 |
|
93 |
74 |
$373.97 |
| 96366 |
|
130 |
79 |
$354.68 |
| 99233 |
Prolong inpt eval add15 m |
80 |
42 |
$310.52 |
| 1159F |
|
439 |
383 |
$305.08 |
| 1125F |
|
172 |
162 |
$285.67 |
| Q5106 |
Inj retacrit non-esrd use |
243 |
157 |
$253.83 |
| S0028 |
Injection, famotidine, 20 mg |
551 |
279 |
$208.36 |
| J3489 |
Zoledronic acid 1mg |
44 |
37 |
$164.09 |
| 3075F |
|
280 |
270 |
$147.01 |
| J9045 |
Carboplatin injection |
71 |
54 |
$133.75 |
| J0640 |
Leucovorin calcium injection |
376 |
224 |
$102.00 |
| 99195 |
|
29 |
24 |
$31.61 |
| J9190 |
Fluorouracil injection |
405 |
218 |
$24.70 |
| J3420 |
Vitamin b12 injection |
106 |
92 |
$23.15 |
| J7030 |
Normal saline solution infus |
21 |
12 |
$2.73 |
| J3490 |
Drugs unclassified injection |
24 |
17 |
$1.75 |
| J7040 |
Normal saline solution infus |
82 |
45 |
$0.00 |
| J9206 |
Irinotecan injection |
41 |
25 |
$0.00 |
| 2010F |
|
97 |
96 |
$0.00 |
| Q5117 |
Inj., kanjinti, 10 mg |
19 |
12 |
$0.00 |