| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 90935 |
|
3,616 |
1,791 |
$187K |
| J3490 |
Unclassified drugs |
1,370 |
461 |
$99K |
| J0887 |
Injection, epoetin beta, 1 microgram, (for esrd on dialysis) |
742 |
577 |
$18K |
| J1756 |
Injection, iron sucrose, 1 mg |
409 |
183 |
$2K |
| A4657 |
Syringe, with or without needle, each |
1,289 |
869 |
$964.81 |
| J2916 |
Injection, sodium ferric gluconate complex in sucrose injection, 12.5 mg |
27 |
25 |
$454.85 |
| J1644 |
Injection, heparin sodium, per 1000 units |
550 |
429 |
$447.80 |
| 83970 |
|
544 |
485 |
$170.80 |
| 85018 |
|
553 |
416 |
$67.96 |
| 82728 |
|
338 |
320 |
$56.37 |
| 82108 |
|
77 |
75 |
$44.55 |
| 84520 |
|
672 |
443 |
$44.23 |
| 83550 |
|
606 |
530 |
$39.62 |
| 83540 |
|
607 |
531 |
$32.06 |
| 85025 |
|
443 |
396 |
$27.51 |
| 80069 |
|
150 |
140 |
$23.91 |
| 84155 |
|
310 |
291 |
$23.17 |
| 83735 |
|
150 |
145 |
$14.96 |
| 87340 |
|
169 |
127 |
$13.92 |
| 84075 |
|
145 |
140 |
$12.29 |
| 82746 |
|
12 |
12 |
$5.36 |
| 86704 |
|
61 |
60 |
$4.93 |
| 86706 |
|
49 |
48 |
$4.76 |
| 80051 |
|
27 |
12 |
$0.00 |
| 82040 |
|
23 |
12 |
$0.00 |
| 82310 |
|
107 |
75 |
$0.00 |
| 84100 |
|
125 |
89 |
$0.00 |
| 82565 |
|
28 |
13 |
$0.00 |