| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 90999 |
Unlisted dialysis procedure, inpatient or outpatient |
23,071 |
2,030 |
$1.96M |
| Q4081 |
Injection, epoetin alfa, 100 units (for esrd on dialysis) |
6,261 |
1,027 |
$188K |
| 0821 |
|
588 |
48 |
$78K |
| J1756 |
Injection, iron sucrose, 1 mg |
996 |
245 |
$72K |
| J1270 |
Injection, doxercalciferol, 1 mcg |
3,840 |
619 |
$38K |
| 90677 |
|
14 |
14 |
$2K |
| J8499 |
Prescription drug, oral, non chemotherapeutic, nos |
80 |
12 |
$311.60 |
| 84100 |
|
559 |
310 |
$156.99 |
| 83970 |
|
110 |
110 |
$150.21 |
| 82728 |
|
316 |
310 |
$145.54 |
| 84466 |
|
317 |
310 |
$141.34 |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
110 |
110 |
$119.37 |
| 83735 |
|
332 |
310 |
$105.42 |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
303 |
297 |
$102.65 |
| 83540 |
|
304 |
298 |
$97.55 |
| 86580 |
|
57 |
55 |
$81.29 |
| 84520 |
|
408 |
278 |
$64.93 |
| 82108 |
|
45 |
45 |
$31.67 |
| 87340 |
|
58 |
58 |
$24.38 |
| 86706 |
|
45 |
45 |
$21.07 |
| Q2038 |
Influenza virus vaccine, split virus, when administered to individuals 3 years of age and older, for intramuscular use (fluzone) |
19 |
19 |
$10.65 |
| 82310 |
|
29 |
12 |
$8.95 |
| 82040 |
|
32 |
13 |
$8.92 |
| G0008 |
Administration of influenza virus vaccine |
20 |
19 |
$7.50 |