| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 90999 |
Unlisted dialysis procedure, inpatient or outpatient |
1,183 |
193 |
$621K |
| A4657 |
Syringe, with or without needle, each |
46 |
42 |
$21K |
| J1756 |
Injection, iron sucrose, 1 mg |
124 |
25 |
$17K |
| G0306 |
Complete cbc, automated (hgb, hct, rbc, wbc, without platelet count) and automated wbc differential count |
26 |
26 |
$8K |
| 87340 |
|
26 |
26 |
$8K |
| 82728 |
|
26 |
26 |
$8K |
| 86706 |
|
26 |
26 |
$8K |
| 83550 |
|
26 |
26 |
$8K |
| 83970 |
|
26 |
26 |
$8K |
| 83540 |
|
26 |
26 |
$8K |
| J1644 |
Injection, heparin sodium, per 1000 units |
15 |
13 |
$6K |
| J0887 |
Injection, epoetin beta, 1 microgram, (for esrd on dialysis) |
15 |
12 |
$0.00 |