| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A4223 |
Infusion supplies not used with external infusion pump, per cassette or bag (list drugs separately) |
2,655 |
704 |
$189K |
| A4222 |
Infusion supplies for external drug infusion pump, per cassette or bag (list drugs separately) |
302 |
109 |
$77K |
| A4221 |
Supplies for maintenance of non-insulin drug infusion catheter, per week (list drugs separately) |
3,599 |
1,416 |
$64K |
| B4185 |
Parenteral nutrition solution, not otherwise specified, 10 grams lipids |
99 |
24 |
$15K |
| J1642 |
Injection, heparin sodium, (heparin lock flush), per 10 units |
960 |
462 |
$14K |
| A4216 |
Sterile water, saline and/or dextrose, diluent/flush, 10 ml |
1,592 |
723 |
$10K |
| B4224 |
Parenteral nutrition administration kit, per day |
103 |
24 |
$7K |
| B4220 |
Parenteral nutrition supply kit; premix, per day |
103 |
24 |
$2K |
| E0781 |
Ambulatory infusion pump, single or multiple channels, electric or battery operated, with administrative equipment, worn by patient |
39 |
13 |
$1K |
| J7030 |
Infusion, normal saline solution , 1000 cc |
47 |
24 |
$671.58 |