| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 90999 |
|
56,949 |
4,752 |
$6.95M |
| J0882 |
Darbepoetin alfa, esrd use |
9,593 |
2,405 |
$793K |
| J0606 |
Inj, etelcalcetide, 0.1 mg |
2,678 |
192 |
$202K |
| Q4081 |
Epoetin alfa, 100 units esrd |
4,792 |
498 |
$91K |
| J1756 |
Iron sucrose injection |
3,497 |
1,791 |
$76K |
| 90677 |
|
39 |
39 |
$5K |
| J1644 |
Inj heparin sodium per 1000u |
713 |
73 |
$2K |
| 90688 |
|
131 |
131 |
$2K |
| 83970 |
|
494 |
482 |
$1K |
| 90732 |
|
14 |
13 |
$759.36 |
| J8499 |
Oral prescrip drug non chemo |
553 |
36 |
$692.20 |
| 90694 |
|
29 |
29 |
$669.96 |
| 90756 |
|
26 |
26 |
$584.35 |
| A4657 |
Syringe w/wo needle |
5,753 |
705 |
$380.07 |
| 84443 |
|
124 |
123 |
$378.58 |
| 86803 |
|
119 |
107 |
$321.54 |
| 84520 |
|
2,971 |
1,344 |
$304.13 |
| 85025 |
|
1,175 |
1,108 |
$292.53 |
| 82947 |
|
629 |
602 |
$246.17 |
| 84100 |
|
1,332 |
1,298 |
$229.83 |
| 82040 |
|
1,371 |
1,247 |
$210.81 |
| 80051 |
|
306 |
304 |
$190.43 |
| 83718 |
|
134 |
134 |
$183.41 |
| 85045 |
|
1,360 |
1,305 |
$179.72 |
| 83036 |
|
128 |
128 |
$172.55 |
| 84478 |
|
134 |
134 |
$128.88 |
| 82728 |
|
469 |
451 |
$103.27 |
| 85018 |
|
184 |
87 |
$99.62 |
| 82465 |
|
134 |
134 |
$97.61 |
| 87340 |
|
83 |
82 |
$97.04 |
| 84466 |
|
498 |
478 |
$96.46 |
| 85014 |
|
48 |
18 |
$72.32 |
| 82310 |
|
1,432 |
1,257 |
$62.99 |
| G0008 |
Admin influenza virus vac |
131 |
131 |
$61.80 |
| 84075 |
|
1,295 |
1,271 |
$45.40 |
| 82565 |
|
1,284 |
1,231 |
$44.81 |
| 83540 |
|
498 |
478 |
$44.56 |
| 84155 |
|
1,259 |
1,239 |
$32.31 |
| 84132 |
|
1,272 |
792 |
$27.52 |
| 84450 |
|
878 |
861 |
$27.08 |
| 82435 |
|
807 |
757 |
$24.53 |
| 84295 |
|
805 |
755 |
$21.06 |
| 82746 |
|
14 |
14 |
$14.22 |
| 86706 |
|
109 |
105 |
$13.54 |
| 82374 |
|
804 |
754 |
$6.80 |
| 83735 |
|
14 |
14 |
$6.49 |
| 90662 |
|
41 |
41 |
$6.06 |
| 82607 |
|
13 |
13 |
$1.17 |
| 80061 |
|
38 |
38 |
$0.00 |
| A4913 |
Misc dialysis supplies noc |
2,681 |
703 |
$0.00 |
| G0009 |
Admin pneumococcal vaccine |
25 |
25 |
$0.00 |