| Code | Description | Claims | Beneficiaries | Total Paid |
| 90999 |
|
5,097 |
342 |
$231K |
| Q4081 |
Injection, epoetin alfa, 100 units (for esrd on dialysis) |
3,134 |
159 |
$41K |
| J1756 |
Injection, iron sucrose, 1 mg |
481 |
104 |
$2K |
| 83970 |
|
135 |
124 |
$2K |
| A4657 |
Syringe, with or without needle, each |
146 |
133 |
$230.50 |
| 83550 |
|
33 |
24 |
$105.93 |
| 85041 |
|
96 |
89 |
$88.66 |
| 85048 |
|
96 |
89 |
$82.50 |
| 82728 |
|
25 |
24 |
$78.47 |
| 83540 |
|
33 |
24 |
$69.57 |
| G0499 |
Hepatitis b screening in non-pregnant, high risk individual includes hepatitis b surface antigen (hbsag), antibodies to hbsag (anti-hbs) and antibodies to hepatitis b core antigen (anti-hbc), and is followed by a neutralizing confirmatory test, when performed, only for an initially reactive hbsag result |
23 |
12 |
$0.00 |