| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 90999 |
|
63,555 |
6,128 |
$5.33M |
| J0887 |
Epoetin beta esrd use |
4,192 |
2,631 |
$1.49M |
| Q4081 |
Epoetin alfa, 100 units esrd |
1,902 |
874 |
$747K |
| J1756 |
Iron sucrose injection |
6,409 |
2,769 |
$359K |
| J1644 |
Inj heparin sodium per 1000u |
29,500 |
2,571 |
$334K |
| Q5105 |
Inj retacrit esrd on dialysi |
7,550 |
959 |
$208K |
| 0064A |
|
21 |
20 |
$166.00 |
| 85025 |
|
3,959 |
3,705 |
$0.00 |
| 86803 |
|
411 |
380 |
$0.00 |
| A4657 |
Syringe w/wo needle |
51,747 |
5,235 |
$0.00 |
| 84132 |
|
2,891 |
1,357 |
$0.00 |
| 85018 |
|
8,493 |
3,735 |
$0.00 |
| 80069 |
|
3,051 |
2,846 |
$0.00 |
| J1270 |
Injection, doxercalciferol |
1,516 |
154 |
$0.00 |
| 82728 |
|
1,937 |
1,804 |
$0.00 |
| 83550 |
|
3,994 |
3,733 |
$0.00 |
| 84075 |
|
595 |
556 |
$0.00 |
| 80051 |
|
353 |
333 |
$0.00 |
| J3490 |
Drugs unclassified injection |
12,468 |
1,958 |
$0.00 |
| 87340 |
|
1,282 |
1,169 |
$0.00 |
| 83036 |
|
785 |
735 |
$0.00 |
| 83735 |
|
1,260 |
1,175 |
$0.00 |
| 86706 |
|
438 |
398 |
$0.00 |
| G0010 |
Admin hepatitis b vaccine |
211 |
192 |
$0.00 |
| 82040 |
|
866 |
765 |
$0.00 |
| G0008 |
Admin influenza virus vac |
484 |
464 |
$0.00 |
| 90739 |
|
67 |
67 |
$0.00 |
| G0009 |
Admin pneumococcal vaccine |
31 |
30 |
$0.00 |
| 0001A |
|
13 |
13 |
$0.00 |
| 90688 |
|
108 |
106 |
$0.00 |
| 90673 |
|
14 |
14 |
$0.00 |
| Q0164 |
Prochlorperazine maleate 5mg |
21 |
12 |
$0.00 |
| 90732 |
|
31 |
30 |
$0.00 |
| 90686 |
|
169 |
158 |
$0.00 |
| 83970 |
|
2,336 |
2,157 |
$0.00 |
| 84520 |
|
5,781 |
3,734 |
$0.00 |
| 84450 |
|
2,305 |
2,170 |
$0.00 |
| 83540 |
|
4,007 |
3,739 |
$0.00 |
| 82565 |
|
443 |
412 |
$0.00 |
| 80061 |
|
110 |
103 |
$0.00 |
| 90740 |
|
145 |
126 |
$0.00 |
| 84100 |
|
845 |
715 |
$0.00 |
| 82310 |
|
806 |
683 |
$0.00 |
| A6216 |
Non-sterile gauze<=16 sq in |
1,200 |
187 |
$0.00 |
| 84155 |
|
1,765 |
1,654 |
$0.00 |
| 84460 |
|
649 |
608 |
$0.00 |
| 90662 |
|
52 |
48 |
$0.00 |
| 90682 |
|
63 |
61 |
$0.00 |
| 85046 |
|
19 |
19 |
$0.00 |
| 0002A |
|
12 |
12 |
$0.00 |
| 90661 |
|
35 |
35 |
$0.00 |