| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A4222 |
Infusion supplies with pump |
3,455 |
1,376 |
$999K |
| A4223 |
Infusion supplies w/o pump |
1,700 |
910 |
$571K |
| A4221 |
Supp non-insulin inf cath/wk |
4,405 |
2,724 |
$135K |
| E2402 |
Neg press wound therapy pump |
289 |
179 |
$100K |
| A6550 |
Neg pres wound ther drsg set |
632 |
237 |
$32K |
| A4305 |
Drug delivery system >=50 ml |
50 |
40 |
$6K |
| A4216 |
Sterile water/saline, 10 ml |
649 |
343 |
$5K |
| J1642 |
Inj heparin sodium per 10 u |
577 |
302 |
$5K |
| B4152 |
Ef calorie dense>/=1.5kcal |
113 |
63 |
$4K |
| A7000 |
Disposable canister for pump |
642 |
243 |
$3K |
| 99601 |
|
61 |
24 |
$2K |
| A6216 |
Non-sterile gauze<=16 sq in |
157 |
102 |
$374.62 |
| S9810 |
Ht pharm per hour |
33 |
13 |
$354.70 |
| A6260 |
Wound cleanser any type/size |
12 |
12 |
$165.60 |
| J7030 |
Normal saline solution infus |
14 |
12 |
$2.49 |