| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A4222 |
Infusion supplies for external drug infusion pump, per cassette or bag (list drugs separately) |
3,455 |
1,376 |
$999K |
| A4223 |
Infusion supplies not used with external infusion pump, per cassette or bag (list drugs separately) |
1,700 |
910 |
$571K |
| A4221 |
Supplies for maintenance of non-insulin drug infusion catheter, per week (list drugs separately) |
4,405 |
2,724 |
$135K |
| E2402 |
Negative pressure wound therapy electrical pump, stationary or portable |
289 |
179 |
$100K |
| A6550 |
Wound care set, for negative pressure wound therapy electrical pump, includes all supplies and accessories |
632 |
237 |
$32K |
| A4305 |
Disposable drug delivery system, flow rate of 50 ml or greater per hour |
50 |
40 |
$6K |
| A4216 |
Sterile water, saline and/or dextrose, diluent/flush, 10 ml |
649 |
343 |
$5K |
| J1642 |
Injection, heparin sodium, (heparin lock flush), per 10 units |
577 |
302 |
$5K |
| B4152 |
Enteral formula, nutritionally complete, calorically dense (equal to or greater than 1.5 kcal/ml) with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit |
113 |
63 |
$4K |
| A7000 |
Canister, disposable, used with suction pump, each |
642 |
243 |
$3K |
| 99601 |
|
61 |
24 |
$2K |
| A6216 |
Gauze, non-impregnated, non-sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
157 |
102 |
$374.62 |
| S9810 |
Home therapy; professional pharmacy services for provision of infusion, specialty drug administration, and/or disease state management, not otherwise classified, per hour (do not use this code with any per diem code) |
33 |
13 |
$354.70 |
| A6260 |
Wound cleansers, any type, any size |
12 |
12 |
$165.60 |
| J7030 |
Infusion, normal saline solution , 1000 cc |
14 |
12 |
$2.49 |