| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 0821 |
|
101,734 |
8,416 |
$12.44M |
| 90999 |
|
49,000 |
3,967 |
$2.91M |
| 0634 |
|
95,040 |
6,535 |
$1.09M |
| 0636 |
|
89,752 |
8,862 |
$447K |
| J1756 |
Injection, iron sucrose, 1 mg |
6,792 |
1,940 |
$148K |
| J1270 |
Injection, doxercalciferol, 1 mcg |
3,992 |
731 |
$108K |
| Q4081 |
Injection, epoetin alfa, 100 units (for esrd on dialysis) |
9,953 |
1,190 |
$58K |
| 0851 |
|
1,193 |
50 |
$43K |
| 0635 |
|
573 |
116 |
$19K |
| J0887 |
Injection, epoetin beta, 1 microgram, (for esrd on dialysis) |
1,631 |
907 |
$3K |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
23 |
12 |
$3K |
| 83970 |
|
126 |
125 |
$2K |
| 90661 |
|
51 |
51 |
$1K |
| 83540 |
|
113 |
112 |
$466.53 |
| 85041 |
|
182 |
182 |
$446.96 |
| 90662 |
|
20 |
20 |
$439.75 |
| 0301 |
|
19,703 |
6,281 |
$412.82 |
| 85048 |
|
185 |
184 |
$394.07 |
| 82728 |
|
113 |
112 |
$307.20 |
| 0305 |
|
13,116 |
6,161 |
$212.98 |
| 90674 |
|
14 |
14 |
$153.00 |
| 0771 |
|
491 |
469 |
$117.17 |
| G0008 |
Administration of influenza virus vaccine |
46 |
46 |
$45.52 |
| 0270 |
|
6,452 |
5,966 |
$0.00 |
| A4657 |
Syringe, with or without needle, each |
161 |
157 |
$0.00 |
| 0250 |
|
14,707 |
953 |
$0.00 |
| 0306 |
|
26 |
25 |
$0.00 |
| 99213 |
|
696 |
39 |
$0.00 |
| 0302 |
|
252 |
238 |
$0.00 |
| 84466 |
|
102 |
101 |
$0.00 |