| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 90999 |
|
11,748 |
1,121 |
$3.01M |
| J0887 |
Injection, epoetin beta, 1 microgram, (for esrd on dialysis) |
368 |
237 |
$8K |
| A4657 |
Syringe, with or without needle, each |
4,688 |
313 |
$583.04 |
| 83970 |
|
142 |
141 |
$479.95 |
| J1270 |
Injection, doxercalciferol, 1 mcg |
614 |
67 |
$466.25 |
| J1756 |
Injection, iron sucrose, 1 mg |
117 |
42 |
$378.66 |
| 83550 |
|
422 |
420 |
$243.25 |
| 84520 |
|
662 |
425 |
$207.99 |
| 80069 |
|
99 |
99 |
$201.43 |
| 85018 |
|
1,255 |
452 |
$196.89 |
| 83540 |
|
423 |
422 |
$180.22 |
| 84100 |
|
357 |
231 |
$129.83 |
| 85025 |
|
225 |
224 |
$125.99 |
| 82728 |
|
114 |
113 |
$125.25 |
| 82310 |
|
276 |
175 |
$123.54 |
| 83735 |
|
96 |
96 |
$55.70 |
| 84075 |
|
95 |
95 |
$43.00 |
| 82108 |
|
37 |
37 |
$39.05 |
| 85045 |
|
125 |
124 |
$37.04 |
| 84450 |
|
77 |
77 |
$35.34 |
| 82040 |
|
45 |
42 |
$21.53 |
| 86706 |
|
38 |
37 |
$16.48 |
| 87340 |
|
36 |
36 |
$15.82 |
| J1644 |
Injection, heparin sodium, per 1000 units |
1,044 |
64 |
$6.48 |
| 80061 |
|
33 |
33 |
$0.00 |
| 86803 |
|
16 |
16 |
$0.00 |
| 83036 |
|
16 |
16 |
$0.00 |