| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 90999 |
Unlisted dialysis procedure, inpatient or outpatient |
6,614 |
486 |
$148K |
| J1756 |
Injection, iron sucrose, 1 mg |
1,517 |
282 |
$83K |
| Q5105 |
Injection, epoetin alfa-epbx, biosimilar, (retacrit) (for esrd on dialysis), 100 units |
3,674 |
305 |
$78K |
| Q4081 |
Injection, epoetin alfa, 100 units (for esrd on dialysis) |
2,779 |
309 |
$29K |
| 83970 |
|
767 |
735 |
$7K |
| 82728 |
|
771 |
737 |
$2K |
| 87340 |
|
810 |
740 |
$2K |
| 83550 |
|
773 |
736 |
$1K |
| 84132 |
|
1,287 |
762 |
$910.74 |
| 86704 |
|
94 |
91 |
$248.07 |
| 86706 |
|
83 |
79 |
$208.87 |
| 90686 |
|
12 |
12 |
$110.78 |
| 84520 |
|
1,722 |
738 |
$91.24 |
| 90674 |
|
18 |
18 |
$81.44 |
| 86708 |
|
12 |
12 |
$22.60 |
| 84100 |
|
776 |
734 |
$9.19 |
| 82310 |
|
769 |
733 |
$4.71 |
| 82040 |
|
768 |
733 |
$0.00 |
| 82435 |
|
762 |
733 |
$0.00 |
| G0008 |
Administration of influenza virus vaccine |
14 |
14 |
$0.00 |
| 84075 |
|
762 |
733 |
$0.00 |
| J1270 |
Injection, doxercalciferol, 1 mcg |
1,126 |
113 |
$0.00 |
| 84460 |
|
762 |
733 |
$0.00 |
| 82565 |
|
771 |
733 |
$0.00 |
| 84295 |
|
762 |
733 |
$0.00 |
| 84155 |
|
762 |
733 |
$0.00 |
| 82247 |
|
763 |
733 |
$0.00 |
| 84450 |
|
762 |
733 |
$0.00 |
| 82947 |
|
771 |
733 |
$0.00 |
| J1644 |
Injection, heparin sodium, per 1000 units |
2,308 |
228 |
$0.00 |