| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 90999 |
|
101,634 |
13,499 |
$19.73M |
| A4657 |
Syringe w/wo needle |
184,829 |
12,096 |
$281K |
| J0606 |
Inj, etelcalcetide, 0.1 mg |
564 |
172 |
$93K |
| 85018 |
|
28,088 |
12,497 |
$27K |
| J0604 |
Cinacalcet, esrd on dialysis |
1,552 |
738 |
$20K |
| 80051 |
|
10,087 |
9,751 |
$13K |
| 0250 |
|
31,189 |
3,240 |
$9K |
| J0887 |
Epoetin beta esrd use |
13,467 |
8,955 |
$8K |
| 82310 |
|
14,281 |
12,513 |
$5K |
| 85027 |
|
1,944 |
1,880 |
$4K |
| 83970 |
|
11,896 |
11,481 |
$4K |
| J1270 |
Injection, doxercalciferol |
49,460 |
7,747 |
$3K |
| J1644 |
Inj heparin sodium per 1000u |
117,696 |
4,746 |
$3K |
| 84100 |
|
15,265 |
12,604 |
$2K |
| 84520 |
|
27,998 |
12,629 |
$2K |
| 82565 |
|
12,595 |
12,077 |
$2K |
| 83540 |
|
12,685 |
12,353 |
$2K |
| 82108 |
|
1,476 |
1,443 |
$1K |
| J1756 |
Iron sucrose injection |
23,839 |
7,498 |
$1K |
| 85025 |
|
10,086 |
9,905 |
$1K |
| 84075 |
|
3,403 |
3,350 |
$899.04 |
| 84132 |
|
10,290 |
5,893 |
$843.83 |
| 82728 |
|
7,961 |
7,741 |
$777.77 |
| 84466 |
|
767 |
749 |
$368.00 |
| 82040 |
|
12,648 |
12,338 |
$201.12 |
| 87340 |
|
5,006 |
4,844 |
$106.90 |
| 83550 |
|
11,844 |
11,543 |
$6.89 |
| 83735 |
|
3,506 |
3,454 |
$6.02 |
| 84155 |
|
12,222 |
11,983 |
$2.96 |
| J3490 |
Drugs unclassified injection |
6,126 |
1,787 |
$2.13 |
| 82374 |
|
2,509 |
2,466 |
$0.00 |
| 84295 |
|
2,505 |
2,453 |
$0.00 |
| J2405 |
Ondansetron hcl injection |
515 |
166 |
$0.00 |
| 84450 |
|
457 |
450 |
$0.00 |
| A6216 |
Non-sterile gauze<=16 sq in |
17,770 |
1,777 |
$0.00 |
| 90740 |
|
88 |
82 |
$0.00 |
| 90662 |
|
108 |
108 |
$0.00 |
| 85046 |
|
26 |
26 |
$0.00 |
| 84460 |
|
480 |
473 |
$0.00 |
| J1200 |
Diphenhydramine hcl injectio |
180 |
37 |
$0.00 |
| 90682 |
|
122 |
121 |
$0.00 |
| 90670 |
|
33 |
33 |
$0.00 |
| 90661 |
|
47 |
47 |
$0.00 |
| 82607 |
|
172 |
165 |
$0.00 |
| 86706 |
|
2,390 |
2,316 |
$0.00 |
| G0010 |
Admin hepatitis b vaccine |
458 |
446 |
$0.00 |
| 90686 |
|
281 |
278 |
$0.00 |
| 83036 |
|
157 |
156 |
$0.00 |
| 90739 |
|
370 |
363 |
$0.00 |
| G0307 |
Cbc without platelet |
51 |
49 |
$0.00 |
| 86704 |
|
247 |
234 |
$0.00 |
| 82746 |
|
630 |
613 |
$0.00 |
| G0009 |
Admin pneumococcal vaccine |
99 |
99 |
$0.00 |
| 86803 |
|
425 |
415 |
$0.00 |
| G0008 |
Admin influenza virus vac |
698 |
694 |
$0.00 |
| 86580 |
|
141 |
134 |
$0.00 |
| 90688 |
|
117 |
116 |
$0.00 |
| Q4081 |
Epoetin alfa, 100 units esrd |
553 |
74 |
$0.00 |
| 90677 |
|
45 |
45 |
$0.00 |
| 82435 |
|
25 |
25 |
$0.00 |
| 0064A |
|
58 |
58 |
$0.00 |
| 90673 |
|
15 |
15 |
$0.00 |