| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 90999 |
|
182,502 |
12,811 |
$22.14M |
| A4657 |
Syringe w/wo needle |
144,493 |
7,662 |
$699K |
| 0250 |
|
27,349 |
2,989 |
$315K |
| 80069 |
|
5,369 |
5,175 |
$305K |
| A0429 |
Bls-emergency |
9,371 |
709 |
$228K |
| J0887 |
Epoetin beta esrd use |
12,358 |
7,432 |
$203K |
| J1756 |
Iron sucrose injection |
28,072 |
6,556 |
$180K |
| 85018 |
|
27,364 |
9,047 |
$136K |
| 80051 |
|
3,798 |
3,557 |
$79K |
| 85025 |
|
9,379 |
9,016 |
$58K |
| 84520 |
|
16,202 |
8,415 |
$54K |
| 90945 |
|
327 |
12 |
$39K |
| 83550 |
|
9,012 |
8,662 |
$36K |
| J1644 |
Inj heparin sodium per 1000u |
107,684 |
4,369 |
$24K |
| 83540 |
|
9,330 |
8,976 |
$20K |
| 87340 |
|
3,244 |
3,116 |
$19K |
| 84155 |
|
9,161 |
8,800 |
$18K |
| J0604 |
Cinacalcet, esrd on dialysis |
986 |
380 |
$16K |
| 84100 |
|
6,640 |
5,024 |
$16K |
| J3490 |
Drugs unclassified injection |
32,431 |
3,234 |
$14K |
| 82040 |
|
4,081 |
3,710 |
$10K |
| 83970 |
|
7,369 |
6,917 |
$9K |
| A4913 |
Misc dialysis supplies noc |
184 |
60 |
$7K |
| G0010 |
Admin hepatitis b vaccine |
548 |
539 |
$5K |
| 86706 |
|
1,381 |
1,344 |
$5K |
| 82565 |
|
4,112 |
3,736 |
$5K |
| 90740 |
|
257 |
249 |
$5K |
| A6216 |
Non-sterile gauze<=16 sq in |
12,548 |
1,385 |
$5K |
| 84132 |
|
3,025 |
1,372 |
$4K |
| 80053 |
|
18 |
18 |
$4K |
| G0008 |
Admin influenza virus vac |
700 |
687 |
$4K |
| 90688 |
|
186 |
184 |
$4K |
| 82728 |
|
4,049 |
3,926 |
$3K |
| 82310 |
|
5,218 |
4,047 |
$3K |
| 84075 |
|
2,780 |
2,724 |
$2K |
| 84466 |
|
149 |
144 |
$1K |
| 83735 |
|
2,861 |
2,817 |
$1K |
| 86803 |
|
299 |
298 |
$796.43 |
| 90739 |
|
282 |
281 |
$739.03 |
| 90682 |
|
50 |
50 |
$671.29 |
| 82108 |
|
1,004 |
984 |
$319.97 |
| Q5105 |
Inj retacrit esrd on dialysi |
117 |
12 |
$167.49 |
| 90686 |
|
337 |
334 |
$152.80 |
| 82746 |
|
771 |
755 |
$125.00 |
| G0009 |
Admin pneumococcal vaccine |
62 |
62 |
$122.21 |
| 90662 |
|
150 |
144 |
$59.12 |
| 82570 |
|
270 |
141 |
$57.28 |
| 84443 |
|
1,026 |
1,012 |
$32.18 |
| 85046 |
|
521 |
507 |
$17.15 |
| 83036 |
|
954 |
946 |
$16.99 |
| 82607 |
|
172 |
162 |
$16.74 |
| 80061 |
|
377 |
373 |
$11.54 |
| 82962 |
|
45 |
13 |
$7.86 |
| 82945 |
|
36 |
27 |
$6.97 |
| 84540 |
|
13 |
12 |
$6.62 |
| J1200 |
Diphenhydramine hcl injectio |
68 |
12 |
$4.48 |
| 82575 |
|
146 |
134 |
$3.84 |
| 90732 |
|
12 |
12 |
$2.26 |
| 85027 |
|
21 |
20 |
$1.78 |
| 85045 |
|
34 |
33 |
$0.12 |
| 0270 |
|
2,036 |
111 |
$0.00 |
| 0771 |
|
13 |
12 |
$0.00 |
| 86580 |
|
15 |
14 |
$0.00 |
| 0304 |
|
1,483 |
140 |
$0.00 |
| 0064A |
|
20 |
20 |
$0.00 |
| 0012A |
|
17 |
17 |
$0.00 |
| 0636 |
|
325 |
115 |
$0.00 |
| 0011A |
|
18 |
17 |
$0.00 |
| 90670 |
|
15 |
15 |
$0.00 |