| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 90999 |
Unlisted dialysis procedure, inpatient or outpatient |
31,266 |
3,021 |
$3.74M |
| Z6004 |
|
1,420 |
1,420 |
$2.24M |
| Q4081 |
Injection, epoetin alfa, 100 units (for esrd on dialysis) |
16,373 |
1,266 |
$571K |
| J2501 |
Injection, paricalcitol, 1 mcg |
30,125 |
3,036 |
$236K |
| Q5105 |
Injection, epoetin alfa-epbx, biosimilar, (retacrit) (for esrd on dialysis), 100 units |
6,234 |
856 |
$188K |
| J1756 |
Injection, iron sucrose, 1 mg |
1,496 |
272 |
$45K |
| J0882 |
Injection, darbepoetin alfa, 1 microgram (for esrd on dialysis) |
937 |
292 |
$24K |
| J0606 |
Injection, etelcalcetide, 0.1 mg |
12 |
12 |
$7K |
| 83540 |
|
395 |
372 |
$7K |
| 82310 |
|
208 |
195 |
$5K |
| 82040 |
|
79 |
75 |
$4K |
| 82728 |
|
103 |
100 |
$4K |
| 85018 |
|
452 |
427 |
$3K |
| 84520 |
|
328 |
312 |
$2K |
| 83735 |
|
275 |
269 |
$1K |
| 83550 |
|
215 |
200 |
$1K |
| 90658 |
|
49 |
49 |
$1K |
| 90756 |
|
75 |
75 |
$911.91 |
| 84100 |
|
117 |
115 |
$620.75 |
| 90686 |
|
21 |
21 |
$474.81 |
| 82565 |
|
51 |
51 |
$338.47 |
| 83970 |
|
44 |
42 |
$121.33 |
| Q2038 |
Influenza virus vaccine, split virus, when administered to individuals 3 years of age and older, for intramuscular use (fluzone) |
27 |
27 |
$112.35 |
| Q2037 |
Influenza virus vaccine, split virus, when administered to individuals 3 years of age and older, for intramuscular use (fluvirin) |
35 |
35 |
$75.00 |
| G0008 |
Administration of influenza virus vaccine |
22 |
22 |
$30.00 |