| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 90999 |
|
67,822 |
5,761 |
$2.97M |
| A4657 |
Syringe, with or without needle, each |
12,570 |
1,757 |
$19K |
| 0250 |
|
4,804 |
483 |
$14K |
| J1756 |
Injection, iron sucrose, 1 mg |
8,519 |
2,776 |
$14K |
| J0887 |
Injection, epoetin beta, 1 microgram, (for esrd on dialysis) |
4,349 |
2,879 |
$11K |
| J1644 |
Injection, heparin sodium, per 1000 units |
2,929 |
244 |
$9K |
| 83970 |
|
1,026 |
988 |
$5K |
| 83540 |
|
2,390 |
2,328 |
$4K |
| 85018 |
|
10,838 |
3,735 |
$2K |
| 83550 |
|
2,402 |
2,340 |
$2K |
| 84520 |
|
6,386 |
2,910 |
$2K |
| 84132 |
|
3,878 |
1,852 |
$1K |
| 80051 |
|
1,818 |
1,766 |
$1K |
| 82040 |
|
2,961 |
2,294 |
$1K |
| 84100 |
|
3,311 |
2,330 |
$948.12 |
| 82310 |
|
2,759 |
2,288 |
$925.83 |
| 82565 |
|
2,344 |
2,269 |
$867.14 |
| 82728 |
|
1,043 |
1,018 |
$781.11 |
| 85027 |
|
2,194 |
2,175 |
$525.98 |
| 85025 |
|
1,099 |
1,089 |
$466.89 |
| J3490 |
Unclassified drugs |
4,130 |
328 |
$445.07 |
| 90739 |
|
13 |
13 |
$232.51 |
| 87340 |
|
514 |
508 |
$161.69 |
| 84075 |
|
686 |
673 |
$133.95 |
| 0012A |
|
22 |
22 |
$80.00 |
| 90682 |
|
62 |
62 |
$77.08 |
| 90686 |
|
73 |
71 |
$70.86 |
| J1200 |
Injection, diphenhydramine hcl, up to 50 mg |
73 |
12 |
$60.17 |
| 83735 |
|
213 |
207 |
$52.69 |
| 86706 |
|
246 |
241 |
$47.05 |
| 90688 |
|
43 |
43 |
$17.48 |
| G0010 |
Administration of hepatitis b vaccine |
13 |
13 |
$8.90 |
| 84295 |
|
337 |
328 |
$0.00 |
| 82947 |
|
65 |
63 |
$0.00 |
| 90662 |
|
85 |
85 |
$0.00 |
| 82374 |
|
290 |
277 |
$0.00 |
| 82108 |
|
94 |
94 |
$0.00 |
| G0008 |
Administration of influenza virus vaccine |
264 |
263 |
$0.00 |
| 82607 |
|
14 |
13 |
$0.00 |
| 86803 |
|
31 |
31 |
$0.00 |