| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 90999 |
|
53,006 |
6,122 |
$6.51M |
| Q4081 |
Epoetin alfa, 100 units esrd |
24,577 |
3,756 |
$125K |
| J0882 |
Darbepoetin alfa, esrd use |
3,857 |
1,608 |
$49K |
| J0604 |
Cinacalcet, esrd on dialysis |
12 |
12 |
$8K |
| 82040 |
|
2,001 |
1,553 |
$0.00 |
| 80069 |
|
2,989 |
2,975 |
$0.00 |
| 82728 |
|
4,379 |
4,327 |
$0.00 |
| 84075 |
|
4,370 |
4,331 |
$0.00 |
| 85018 |
|
11,724 |
4,376 |
$0.00 |
| A4657 |
Syringe w/wo needle |
9,502 |
6,032 |
$0.00 |
| 83550 |
|
4,407 |
4,299 |
$0.00 |
| 87340 |
|
960 |
947 |
$0.00 |
| 90686 |
|
146 |
146 |
$0.00 |
| 82306 |
|
1,540 |
1,528 |
$0.00 |
| J2501 |
Paricalcitol |
33,100 |
3,879 |
$0.00 |
| 84132 |
|
1,483 |
1,292 |
$0.00 |
| Q2035 |
Afluria vacc, 3 yrs & >, im |
39 |
39 |
$0.00 |
| G0008 |
Admin influenza virus vac |
307 |
307 |
$0.00 |
| 86706 |
|
361 |
355 |
$0.00 |
| 90480 |
|
40 |
40 |
$0.00 |
| 90694 |
|
28 |
28 |
$0.00 |
| 82435 |
|
1,248 |
1,236 |
$0.00 |
| G0009 |
Admin pneumococcal vaccine |
51 |
51 |
$0.00 |
| 91301 |
|
118 |
117 |
$0.00 |
| 83735 |
|
376 |
363 |
$0.00 |
| 0134A |
|
25 |
25 |
$0.00 |
| 0012A |
|
35 |
35 |
$0.00 |
| 90747 |
|
12 |
12 |
$0.00 |
| 80048 |
|
35 |
26 |
$0.00 |
| 0011A |
|
37 |
36 |
$0.00 |
| G0010 |
Admin hepatitis b vaccine |
12 |
12 |
$0.00 |
| 85045 |
|
4,426 |
4,329 |
$0.00 |
| 85048 |
|
4,468 |
4,333 |
$0.00 |
| 85041 |
|
4,430 |
4,333 |
$0.00 |
| J1756 |
Iron sucrose injection |
7,796 |
3,869 |
$0.00 |
| 85014 |
|
11,553 |
4,373 |
$0.00 |
| 82310 |
|
1,826 |
1,386 |
$0.00 |
| 84466 |
|
4,365 |
4,330 |
$0.00 |
| 84155 |
|
4,362 |
4,332 |
$0.00 |
| 83970 |
|
2,229 |
1,959 |
$0.00 |
| 82247 |
|
4,365 |
4,328 |
$0.00 |
| 82465 |
|
1,490 |
1,469 |
$0.00 |
| 83540 |
|
4,439 |
4,333 |
$0.00 |
| 84520 |
|
6,763 |
4,305 |
$0.00 |
| 82374 |
|
1,450 |
1,246 |
$0.00 |
| 82108 |
|
369 |
362 |
$0.00 |
| 82947 |
|
1,250 |
1,237 |
$0.00 |
| 82565 |
|
1,249 |
1,237 |
$0.00 |
| 85046 |
|
4,354 |
4,296 |
$0.00 |
| 84100 |
|
3,146 |
1,684 |
$0.00 |
| 90756 |
|
32 |
32 |
$0.00 |
| J2916 |
Na ferric gluconate complex |
400 |
177 |
$0.00 |
| 84295 |
|
1,250 |
1,235 |
$0.00 |
| 91313 |
|
25 |
25 |
$0.00 |
| 90670 |
|
15 |
15 |
$0.00 |
| 0013A |
|
39 |
39 |
$0.00 |
| 91322 |
|
38 |
38 |
$0.00 |
| 90653 |
|
14 |
14 |
$0.00 |