| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 90999 |
Unlisted dialysis procedure, inpatient or outpatient |
39 |
12 |
$1K |
| Q4081 |
Injection, epoetin alfa, 100 units (for esrd on dialysis) |
1,935 |
149 |
$367.74 |
| A4657 |
Syringe, with or without needle, each |
343 |
338 |
$0.00 |
| 83550 |
|
103 |
100 |
$0.00 |
| 82728 |
|
147 |
144 |
$0.00 |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
58 |
57 |
$0.00 |
| J1270 |
Injection, doxercalciferol, 1 mcg |
132 |
28 |
$0.00 |
| G0499 |
Hepatitis b screening in non-pregnant, high risk individual includes hepatitis b surface antigen (hbsag), antibodies to hbsag (anti-hbs) and antibodies to hepatitis b core antigen (anti-hbc), and is followed by a neutralizing confirmatory test, when performed, only for an initially reactive hbsag result |
105 |
68 |
$0.00 |
| 83540 |
|
144 |
141 |
$0.00 |
| 85041 |
|
253 |
233 |
$0.00 |
| 85048 |
|
241 |
221 |
$0.00 |
| 85045 |
|
141 |
134 |
$0.00 |
| 82108 |
|
27 |
27 |
$0.00 |
| 83970 |
|
254 |
198 |
$0.00 |