| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 90999 |
Unlisted dialysis procedure, inpatient or outpatient |
29,302 |
2,387 |
$3.13M |
| 0821 |
|
5,285 |
402 |
$735K |
| Q4081 |
Injection, epoetin alfa, 100 units (for esrd on dialysis) |
7,822 |
1,000 |
$711K |
| J2916 |
Injection, sodium ferric gluconate complex in sucrose injection, 12.5 mg |
4,317 |
1,538 |
$132K |
| Q5105 |
Injection, epoetin alfa-epbx, biosimilar, (retacrit) (for esrd on dialysis), 100 units |
874 |
91 |
$24K |
| J0882 |
Injection, darbepoetin alfa, 1 microgram (for esrd on dialysis) |
65 |
26 |
$20K |
| 82040 |
|
250 |
250 |
$9K |
| J1270 |
Injection, doxercalciferol, 1 mcg |
1,106 |
98 |
$8K |
| 90630 |
|
12 |
12 |
$292.37 |
| 84520 |
|
498 |
250 |
$279.48 |
| 82565 |
|
250 |
250 |
$168.05 |
| 84100 |
|
238 |
238 |
$165.45 |
| 84075 |
|
250 |
250 |
$163.07 |
| 82310 |
|
251 |
250 |
$162.14 |
| 84295 |
|
250 |
250 |
$145.65 |
| 84132 |
|
250 |
250 |
$143.78 |
| 82435 |
|
250 |
250 |
$135.51 |
| 84155 |
|
250 |
250 |
$130.10 |
| 90756 |
|
19 |
19 |
$110.49 |
| 82374 |
|
250 |
250 |
$85.30 |