| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 90999 |
|
32,229 |
2,896 |
$2.89M |
| J0887 |
Injection, epoetin beta, 1 microgram, (for esrd on dialysis) |
1,748 |
1,078 |
$163K |
| J1756 |
Injection, iron sucrose, 1 mg |
5,428 |
1,331 |
$65K |
| A4657 |
Syringe, with or without needle, each |
34,816 |
2,065 |
$17K |
| J1270 |
Injection, doxercalciferol, 1 mcg |
7,387 |
703 |
$15K |
| J1644 |
Injection, heparin sodium, per 1000 units |
6,756 |
255 |
$14K |
| 80069 |
|
1,499 |
1,452 |
$11K |
| 83970 |
|
989 |
932 |
$5K |
| 85018 |
|
6,777 |
2,287 |
$4K |
| 84520 |
|
4,012 |
2,306 |
$2K |
| 83540 |
|
2,383 |
2,295 |
$2K |
| 82108 |
|
659 |
637 |
$2K |
| 85025 |
|
950 |
881 |
$2K |
| 83550 |
|
1,294 |
1,241 |
$2K |
| 84466 |
|
709 |
678 |
$2K |
| 82728 |
|
757 |
733 |
$1K |
| 84100 |
|
1,371 |
1,081 |
$1K |
| 84155 |
|
2,347 |
2,250 |
$1K |
| 85027 |
|
837 |
802 |
$1K |
| 87340 |
|
484 |
455 |
$821.99 |
| A6216 |
Gauze, non-impregnated, non-sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
586 |
96 |
$705.50 |
| 84075 |
|
758 |
714 |
$508.64 |
| 82040 |
|
472 |
377 |
$373.58 |
| 84460 |
|
553 |
516 |
$353.96 |
| 82746 |
|
160 |
152 |
$264.73 |
| 86706 |
|
144 |
135 |
$218.73 |
| 83735 |
|
227 |
216 |
$187.96 |
| 90739 |
|
24 |
24 |
$173.09 |
| 82607 |
|
95 |
89 |
$166.20 |
| 82310 |
|
141 |
103 |
$110.48 |
| 80051 |
|
69 |
62 |
$76.20 |
| 83036 |
|
38 |
38 |
$60.43 |
| 82565 |
|
76 |
66 |
$52.02 |
| G0008 |
Administration of influenza virus vaccine |
80 |
78 |
$48.39 |
| 90682 |
|
20 |
20 |
$26.31 |
| G0010 |
Administration of hepatitis b vaccine |
24 |
24 |
$25.04 |
| 86803 |
|
18 |
18 |
$22.23 |
| 90686 |
|
27 |
26 |
$6.40 |
| J3490 |
Unclassified drugs |
225 |
48 |
$4.27 |
| 82947 |
|
14 |
12 |
$0.00 |
| G0009 |
Administration of pneumococcal vaccine |
12 |
12 |
$0.00 |