| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 90999 |
Unlisted dialysis procedure, inpatient or outpatient |
22,887 |
1,431 |
$660K |
| Q5105 |
Injection, epoetin alfa-epbx, biosimilar, (retacrit) (for esrd on dialysis), 100 units |
1,089 |
177 |
$26K |
| J1644 |
Injection, heparin sodium, per 1000 units |
22,408 |
1,128 |
$21K |
| 36592 |
|
667 |
395 |
$9K |
| J0882 |
Injection, darbepoetin alfa, 1 microgram (for esrd on dialysis) |
294 |
64 |
$7K |
| 83970 |
|
694 |
495 |
$6K |
| 80053 |
Comprehensive metabolic panel |
2,080 |
1,434 |
$4K |
| 83550 |
|
2,039 |
1,431 |
$3K |
| 85027 |
|
2,037 |
1,433 |
$3K |
| 83540 |
|
2,042 |
1,434 |
$3K |
| 84100 |
|
2,042 |
1,434 |
$2K |
| 82728 |
|
693 |
492 |
$2K |
| 84520 |
|
2,214 |
1,431 |
$2K |
| 86803 |
|
167 |
118 |
$533.66 |
| 90686 |
|
38 |
31 |
$361.63 |
| 87340 |
|
174 |
106 |
$336.26 |
| 80061 |
Lipid panel |
83 |
54 |
$234.74 |
| J2916 |
Injection, sodium ferric gluconate complex in sucrose injection, 12.5 mg |
53 |
12 |
$172.80 |
| 87641 |
|
20 |
13 |
$108.78 |
| 0001A |
|
19 |
13 |
$81.00 |
| 0002A |
|
19 |
13 |
$81.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
15 |
13 |
$79.00 |
| 86580 |
|
73 |
50 |
$42.25 |
| A4657 |
Syringe, with or without needle, each |
2,546 |
234 |
$28.00 |
| 91300 |
|
19 |
13 |
$0.00 |