| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 90935 |
|
23,572 |
2,140 |
$5.87M |
| Q4081 |
Epoetin alfa, 100 units esrd |
12,976 |
1,639 |
$1.92M |
| 90999 |
|
35,034 |
3,148 |
$1.65M |
| J7030 |
Normal saline solution infus |
12,428 |
1,153 |
$886K |
| J1270 |
Injection, doxercalciferol |
18,488 |
2,158 |
$763K |
| P9047 |
Albumin (human), 25%, 50ml |
3,326 |
832 |
$346K |
| J2916 |
Na ferric gluconate complex |
7,492 |
2,812 |
$342K |
| Q5105 |
Inj retacrit esrd on dialysi |
21,969 |
2,223 |
$325K |
| 85027 |
|
9,437 |
4,896 |
$277K |
| 80053 |
|
5,334 |
4,892 |
$201K |
| 83550 |
|
5,335 |
4,906 |
$183K |
| 84100 |
|
5,732 |
4,918 |
$182K |
| 87340 |
|
4,607 |
4,232 |
$181K |
| 83540 |
|
5,335 |
4,906 |
$175K |
| 83615 |
|
5,233 |
4,864 |
$172K |
| 82465 |
|
5,239 |
4,874 |
$172K |
| J1644 |
Inj heparin sodium per 1000u |
6,642 |
1,148 |
$122K |
| 85018 |
|
3,051 |
1,819 |
$115K |
| 85014 |
|
2,908 |
1,741 |
$114K |
| 83970 |
|
1,823 |
1,697 |
$74K |
| 82728 |
|
1,848 |
1,710 |
$66K |
| 83036 |
|
1,490 |
1,383 |
$51K |
| 86803 |
|
822 |
766 |
$33K |
| 84520 |
|
3,042 |
2,309 |
$21K |
| 86706 |
|
423 |
383 |
$18K |
| 86704 |
|
411 |
382 |
$18K |
| 87081 |
|
399 |
372 |
$17K |
| 86592 |
|
328 |
318 |
$17K |
| 86580 |
|
187 |
177 |
$5K |
| 90685 |
|
51 |
51 |
$5K |
| G0008 |
Admin influenza virus vac |
166 |
158 |
$4K |
| OP251 |
|
1,898 |
1,707 |
$3K |
| 82310 |
|
39 |
38 |
$2K |
| 90686 |
|
78 |
72 |
$1K |
| 87635 |
|
21 |
13 |
$821.63 |
| OP259 |
|
1,345 |
1,199 |
$550.64 |
| 90662 |
|
31 |
28 |
$286.10 |
| 87641 |
|
68 |
64 |
$244.42 |
| 90682 |
|
17 |
16 |
$50.94 |
| G0499 |
Hepb screen high risk indiv |
20 |
17 |
$38.78 |
| 36415 |
|
33 |
17 |
$30.69 |
| 90747 |
|
14 |
12 |
$17.48 |