| Code | Description | Claims | Beneficiaries | Total Paid |
| 90999 |
|
78,484 |
6,851 |
$5.40M |
| J0606 |
Inj, etelcalcetide, 0.1 mg |
10,560 |
735 |
$539K |
| J0882 |
Darbepoetin alfa, esrd use |
15,907 |
4,186 |
$403K |
| Q4081 |
Epoetin alfa, 100 units esrd |
14,816 |
1,520 |
$310K |
| J1756 |
Iron sucrose injection |
8,949 |
3,924 |
$223K |
| 0250 |
|
29,401 |
1,792 |
$92K |
| A4657 |
Syringe w/wo needle |
39,625 |
3,973 |
$84K |
| J8499 |
Oral prescrip drug non chemo |
8,692 |
552 |
$23K |
| 83970 |
|
2,283 |
2,187 |
$8K |
| J1644 |
Inj heparin sodium per 1000u |
3,254 |
304 |
$5K |
| 90677 |
|
49 |
49 |
$3K |
| 84466 |
|
1,999 |
1,966 |
$3K |
| 84520 |
|
8,067 |
3,555 |
$2K |
| 80051 |
|
3,247 |
3,152 |
$2K |
| 85018 |
|
417 |
379 |
$2K |
| 82728 |
|
1,540 |
1,521 |
$2K |
| 82310 |
|
4,350 |
3,363 |
$1K |
| 82040 |
|
4,209 |
3,484 |
$1K |
| 85025 |
|
750 |
732 |
$1K |
| 83540 |
|
2,003 |
1,969 |
$1K |
| 84100 |
|
3,946 |
3,383 |
$1K |
| 84075 |
|
3,591 |
3,510 |
$1K |
| 82565 |
|
3,644 |
3,495 |
$1K |
| 85045 |
|
3,994 |
3,859 |
$1K |
| 84155 |
|
3,548 |
3,470 |
$946.22 |
| 90694 |
|
78 |
78 |
$922.22 |
| 84450 |
|
404 |
391 |
$881.08 |
| 90688 |
|
97 |
97 |
$776.48 |
| 87340 |
|
1,071 |
1,041 |
$677.25 |
| G0008 |
Admin influenza virus vac |
136 |
136 |
$507.97 |
| 84132 |
|
1,371 |
700 |
$404.71 |
| 90662 |
|
32 |
32 |
$353.46 |
| 86706 |
|
341 |
330 |
$327.81 |
| 90732 |
|
16 |
15 |
$292.69 |
| 90756 |
|
24 |
24 |
$246.58 |
| 90653 |
|
24 |
24 |
$230.97 |
| 82746 |
|
60 |
59 |
$149.33 |
| 84443 |
|
20 |
19 |
$119.29 |
| 86803 |
|
23 |
21 |
$115.19 |
| G0009 |
Admin pneumococcal vaccine |
20 |
20 |
$114.26 |
| 80061 |
|
21 |
20 |
$93.27 |
| 83735 |
|
60 |
59 |
$68.06 |
| 82435 |
|
213 |
209 |
$54.22 |
| 84295 |
|
199 |
194 |
$53.22 |
| 80069 |
|
14 |
14 |
$45.60 |
| 83036 |
|
16 |
15 |
$43.40 |
| 82607 |
|
54 |
53 |
$32.33 |
| 84540 |
|
128 |
117 |
$27.70 |
| 80048 |
|
71 |
66 |
$26.52 |
| 82947 |
|
29 |
28 |
$23.42 |
| 82374 |
|
197 |
193 |
$20.40 |
| A4913 |
Misc dialysis supplies noc |
50 |
12 |
$0.00 |
| 90661 |
|
12 |
12 |
$0.00 |