| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 90999 |
Unlisted dialysis procedure, inpatient or outpatient |
15,714 |
1,389 |
$1.57M |
| 0821 |
|
9,926 |
894 |
$1.35M |
| J0887 |
Injection, epoetin beta, 1 microgram, (for esrd on dialysis) |
1,699 |
1,253 |
$257K |
| J1756 |
Injection, iron sucrose, 1 mg |
1,839 |
824 |
$221K |
| Q5105 |
Injection, epoetin alfa-epbx, biosimilar, (retacrit) (for esrd on dialysis), 100 units |
1,201 |
410 |
$138K |
| J0882 |
Injection, darbepoetin alfa, 1 microgram (for esrd on dialysis) |
29 |
28 |
$22K |
| 83970 |
|
305 |
262 |
$1K |
| 90747 |
|
13 |
13 |
$1K |
| A4657 |
Syringe, with or without needle, each |
2,579 |
1,657 |
$801.06 |
| G0008 |
Administration of influenza virus vaccine |
40 |
40 |
$490.96 |
| 90653 |
|
13 |
13 |
$443.45 |
| 90656 |
|
29 |
29 |
$409.03 |
| 90662 |
|
15 |
15 |
$386.96 |
| 90686 |
|
23 |
23 |
$362.50 |
| 84100 |
|
397 |
262 |
$231.57 |
| 84520 |
|
423 |
260 |
$175.46 |
| 83735 |
|
478 |
262 |
$165.20 |
| 84466 |
|
254 |
240 |
$165.08 |
| 82728 |
|
82 |
82 |
$126.72 |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
62 |
49 |
$110.62 |
| 83540 |
|
257 |
241 |
$108.37 |
| 80051 |
|
231 |
230 |
$67.87 |
| 82565 |
|
264 |
262 |
$51.24 |
| 86706 |
|
28 |
27 |
$49.33 |
| 82310 |
|
296 |
262 |
$48.72 |
| 82040 |
|
374 |
262 |
$47.76 |
| 87340 |
|
29 |
29 |
$47.34 |
| 84155 |
|
262 |
262 |
$35.16 |
| 0250 |
|
2,298 |
378 |
$31.17 |
| 84075 |
|
241 |
241 |
$24.54 |
| 82108 |
|
21 |
21 |
$19.52 |
| A4913 |
Miscellaneous dialysis supplies, not otherwise specified |
1,128 |
522 |
$0.00 |
| 82374 |
|
16 |
14 |
$0.00 |
| 84295 |
|
13 |
12 |
$0.00 |