| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 90999 |
|
60,682 |
5,249 |
$2.14M |
| J0887 |
Epoetin beta esrd use |
7,933 |
4,086 |
$317K |
| J1756 |
Iron sucrose injection |
11,179 |
3,544 |
$48K |
| J0604 |
Cinacalcet, esrd on dialysis |
2,267 |
214 |
$46K |
| J0882 |
Darbepoetin alfa, esrd use |
47 |
41 |
$6K |
| 90682 |
|
32 |
32 |
$784.14 |
| 90677 |
|
22 |
22 |
$288.66 |
| 90747 |
|
16 |
16 |
$280.85 |
| 90686 |
|
57 |
56 |
$236.41 |
| 91322 |
|
24 |
23 |
$145.92 |
| G0008 |
Admin influenza virus vac |
130 |
127 |
$45.00 |
| 90480 |
|
24 |
23 |
$40.09 |
| G0009 |
Admin pneumococcal vaccine |
20 |
20 |
$28.62 |
| A4657 |
Syringe w/wo needle |
26,069 |
3,800 |
$0.00 |
| J0606 |
Inj, etelcalcetide, 0.1 mg |
8,954 |
718 |
$0.00 |
| G0010 |
Admin hepatitis b vaccine |
16 |
16 |
$0.00 |
| J1644 |
Inj heparin sodium per 1000u |
5,439 |
247 |
$0.00 |