| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 90999 |
|
76,038 |
6,192 |
$10.69M |
| J0882 |
Darbepoetin alfa, esrd use |
11,714 |
3,005 |
$800K |
| J0606 |
Inj, etelcalcetide, 0.1 mg |
1,849 |
141 |
$204K |
| Q4081 |
Epoetin alfa, 100 units esrd |
6,078 |
620 |
$83K |
| J1756 |
Iron sucrose injection |
4,448 |
2,220 |
$83K |
| A4657 |
Syringe w/wo needle |
5,304 |
942 |
$26K |
| 84520 |
|
4,596 |
2,154 |
$9K |
| 84100 |
|
2,318 |
2,133 |
$6K |
| 82310 |
|
2,295 |
2,103 |
$5K |
| 82040 |
|
2,276 |
2,102 |
$5K |
| 85045 |
|
1,967 |
1,874 |
$5K |
| 84075 |
|
2,172 |
2,133 |
$4K |
| 82565 |
|
2,149 |
2,101 |
$4K |
| 84155 |
|
2,113 |
2,074 |
$4K |
| 83970 |
|
742 |
728 |
$3K |
| 90677 |
|
19 |
19 |
$3K |
| 90688 |
|
145 |
145 |
$3K |
| 84132 |
|
1,472 |
1,137 |
$2K |
| 84466 |
|
868 |
841 |
$2K |
| 82728 |
|
725 |
708 |
$2K |
| 83540 |
|
867 |
840 |
$2K |
| 85025 |
|
1,871 |
1,761 |
$1K |
| 87340 |
|
698 |
668 |
$1K |
| 90747 |
|
12 |
12 |
$951.80 |
| 80051 |
|
710 |
700 |
$912.25 |
| 90694 |
|
79 |
79 |
$855.58 |
| G0008 |
Admin influenza virus vac |
197 |
197 |
$723.38 |
| 90732 |
|
22 |
22 |
$660.92 |
| 90756 |
|
25 |
25 |
$606.65 |
| 90661 |
|
18 |
18 |
$578.50 |
| 84450 |
|
1,725 |
1,699 |
$545.58 |
| 86706 |
|
183 |
176 |
$396.66 |
| 85018 |
|
696 |
407 |
$300.71 |
| 82947 |
|
1,079 |
1,061 |
$268.42 |
| 84443 |
|
133 |
132 |
$218.22 |
| 83036 |
|
218 |
217 |
$156.56 |
| 82435 |
|
1,143 |
1,115 |
$154.67 |
| J8499 |
Oral prescrip drug non chemo |
3,961 |
303 |
$139.00 |
| 84295 |
|
1,135 |
1,107 |
$133.05 |
| 82374 |
|
1,136 |
1,108 |
$130.90 |
| J1644 |
Inj heparin sodium per 1000u |
283 |
24 |
$126.48 |
| 80061 |
|
76 |
75 |
$117.63 |
| 86803 |
|
70 |
54 |
$101.48 |
| 83718 |
|
167 |
166 |
$85.75 |
| 84478 |
|
175 |
174 |
$56.79 |
| 82465 |
|
175 |
174 |
$38.79 |
| G0009 |
Admin pneumococcal vaccine |
17 |
17 |
$28.39 |
| A4913 |
Misc dialysis supplies noc |
4,562 |
1,213 |
$0.00 |
| 82746 |
|
41 |
41 |
$0.00 |
| 83735 |
|
42 |
42 |
$0.00 |
| 82306 |
|
33 |
32 |
$0.00 |
| 82607 |
|
42 |
42 |
$0.00 |
| 0064A |
|
12 |
12 |
$0.00 |
| 90662 |
|
63 |
63 |
$0.00 |