| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 90999 |
|
68,738 |
5,176 |
$3.73M |
| J0887 |
Epoetin beta esrd use |
5,652 |
3,308 |
$543K |
| J1756 |
Iron sucrose injection |
12,872 |
2,954 |
$22K |
| A4657 |
Syringe w/wo needle |
70,908 |
3,969 |
$10K |
| Q4081 |
Epoetin alfa, 100 units esrd |
115 |
12 |
$4K |
| 85018 |
|
12,016 |
3,958 |
$1K |
| 83970 |
|
3,280 |
2,883 |
$1K |
| J0604 |
Cinacalcet, esrd on dialysis |
472 |
91 |
$964.80 |
| J1270 |
Injection, doxercalciferol |
2,216 |
209 |
$652.95 |
| J3490 |
Drugs unclassified injection |
1,891 |
381 |
$547.11 |
| 82728 |
|
2,592 |
2,288 |
$475.80 |
| 83550 |
|
4,788 |
4,185 |
$408.67 |
| 84132 |
|
3,471 |
1,321 |
$400.51 |
| 85025 |
|
4,769 |
4,133 |
$365.08 |
| 84520 |
|
11,054 |
4,205 |
$364.37 |
| 82310 |
|
5,682 |
3,716 |
$350.90 |
| 83540 |
|
4,828 |
4,220 |
$309.95 |
| 82565 |
|
4,207 |
3,561 |
$229.67 |
| 90732 |
|
30 |
24 |
$228.42 |
| 82040 |
|
4,211 |
3,637 |
$226.64 |
| 84100 |
|
5,269 |
3,720 |
$207.74 |
| 82108 |
|
638 |
581 |
$203.86 |
| 90686 |
|
116 |
99 |
$196.45 |
| A4913 |
Misc dialysis supplies noc |
63 |
27 |
$147.54 |
| 84155 |
|
3,882 |
3,425 |
$141.27 |
| 83735 |
|
2,005 |
1,780 |
$118.89 |
| J2405 |
Ondansetron hcl injection |
1,190 |
195 |
$117.40 |
| 84075 |
|
1,986 |
1,748 |
$91.85 |
| 0064A |
|
17 |
17 |
$40.00 |
| 82947 |
|
1,263 |
1,094 |
$36.52 |
| 82746 |
|
344 |
312 |
$33.20 |
| 83036 |
|
88 |
67 |
$27.11 |
| J1644 |
Inj heparin sodium per 1000u |
34,916 |
1,323 |
$9.84 |
| 80069 |
|
350 |
290 |
$9.09 |
| A6216 |
Non-sterile gauze<=16 sq in |
5,989 |
655 |
$0.90 |
| 80051 |
|
4,102 |
3,544 |
$0.06 |
| 82607 |
|
566 |
486 |
$0.00 |
| G0008 |
Admin influenza virus vac |
280 |
257 |
$0.00 |
| 86706 |
|
458 |
404 |
$0.00 |
| 87340 |
|
1,962 |
1,711 |
$0.00 |
| 0012A |
|
20 |
20 |
$0.00 |
| G0010 |
Admin hepatitis b vaccine |
29 |
25 |
$0.00 |
| G0009 |
Admin pneumococcal vaccine |
30 |
24 |
$0.00 |
| 90688 |
|
89 |
86 |
$0.00 |
| 86803 |
|
147 |
126 |
$0.00 |
| 86704 |
|
84 |
76 |
$0.00 |
| 90739 |
|
16 |
12 |
$0.00 |
| 0011A |
|
19 |
19 |
$0.00 |
| 85046 |
|
125 |
111 |
$0.00 |
| 90682 |
|
32 |
28 |
$0.00 |