| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| S9342 |
Hit enteral pump diem |
44,077 |
36,249 |
$16.64M |
| B4161 |
Ef ped hydrolyzed/amino acid |
17,781 |
15,939 |
$8.78M |
| B4149 |
Ef blenderized foods |
11,612 |
10,169 |
$3.98M |
| B4160 |
Ef ped caloric dense>/=0.7kc |
19,730 |
17,962 |
$2.96M |
| J1559 |
Hizentra injection |
3,219 |
1,523 |
$2.40M |
| S9343 |
Hit enteral bolus nurs |
8,371 |
7,505 |
$2.27M |
| B4153 |
Ef hydrolyzed/amino acids |
5,079 |
4,496 |
$2.15M |
| B4152 |
Ef calorie dense>/=1.5kcal |
16,615 |
14,748 |
$1.96M |
| B4150 |
Ef complet w/intact nutrient |
15,839 |
14,140 |
$1.70M |
| S9500 |
Hit antibiotic q24h diem |
8,509 |
2,357 |
$1.70M |
| B4185 |
Pn soln nos 10 grams lipids |
7,987 |
2,155 |
$1.51M |
| J1745 |
Infliximab not biosimil 10mg |
223 |
212 |
$1.50M |
| S9366 |
Hit tpn 2 liter diem |
5,960 |
1,070 |
$1.33M |
| B4088 |
Gastro/jejuno tube, low-pro |
11,140 |
10,436 |
$873K |
| 99601 |
|
9,892 |
4,553 |
$867K |
| B4162 |
Ef ped specmetabolic inherit |
1,182 |
1,069 |
$844K |
| S9502 |
Hit antibiotic q8h diem |
3,418 |
970 |
$823K |
| B4154 |
Ef spec metabolic noninherit |
3,799 |
3,354 |
$732K |
| S9338 |
Hit immunotherapy diem |
6,904 |
4,174 |
$665K |
| B4155 |
Ef incomplete/modular |
6,833 |
6,164 |
$621K |
| B4157 |
Ef special metabolic inherit |
676 |
617 |
$603K |
| B4197 |
Parenteral sol 74-100 gm pro |
542 |
122 |
$540K |
| B4158 |
Ef ped complete intact nut |
2,265 |
2,022 |
$509K |
| S9501 |
Hit antibiotic q12h diem |
2,631 |
628 |
$502K |
| S9373 |
Hit hydra total diem |
4,445 |
1,022 |
$463K |
| 99602 |
Nursing care in home rn |
4,496 |
2,611 |
$459K |
| B4035 |
Enteral feed supp pump per d |
9,974 |
8,558 |
$402K |
| S9374 |
Hit hydra 1 liter diem |
2,387 |
738 |
$383K |
| S9341 |
Hit enteral grav diem |
947 |
877 |
$367K |
| J1569 |
Gammagard liquid injection |
67 |
37 |
$338K |
| B4103 |
Ef ped fluid and electrolyte |
1,510 |
1,352 |
$163K |
| Q5103 |
Injection, inflectra |
63 |
58 |
$160K |
| S9379 |
Hit noc per diem |
356 |
238 |
$137K |
| B4034 |
Enter feed supkit syr by day |
4,021 |
3,614 |
$96K |
| B4189 |
Parenteral sol amino acid & |
128 |
37 |
$95K |
| B4100 |
Food thickener oral |
1,008 |
939 |
$93K |
| S9367 |
Hit tpn 3 liter diem |
432 |
87 |
$92K |
| S9359 |
Hit anti-tnf per diem |
819 |
792 |
$66K |
| J3490 |
Drugs unclassified injection |
200 |
62 |
$65K |
| B9002 |
Enter nutr inf pump any type |
2,916 |
2,765 |
$60K |
| B4193 |
Parenteral sol 52-73 gm prot |
58 |
12 |
$43K |
| S5502 |
Hit interim cath care |
1,253 |
823 |
$40K |
| S9365 |
Hit tpn 1 liter diem |
80 |
24 |
$32K |
| S5501 |
Hit complex cath care |
251 |
52 |
$16K |
| B4036 |
Enteral feed sup kit grav by |
458 |
412 |
$16K |
| A4221 |
Supp non-insulin inf cath/wk |
2,187 |
1,382 |
$13K |
| J1955 |
Inj levocarnitine per 1 gm |
121 |
38 |
$10K |
| B4224 |
Parenteral administration ki |
441 |
123 |
$9K |
| A4222 |
Infusion supplies with pump |
65 |
34 |
$8K |
| B4087 |
Gastro/jejuno tube, std |
549 |
536 |
$8K |
| B4104 |
Additive for enteral formula |
58 |
54 |
$5K |
| J0696 |
Ceftriaxone sodium injection |
92 |
24 |
$3K |
| B4220 |
Parenteral supply kit premix |
367 |
104 |
$3K |
| B4102 |
Ef adult fluids and electro |
13 |
12 |
$2K |
| J1200 |
Diphenhydramine hcl injectio |
82 |
49 |
$1K |
| K0552 |
Sup/ext non-ins inf pump syr |
1,214 |
971 |
$1K |
| S0028 |
Injection, famotidine, 20 mg |
41 |
12 |
$361.52 |
| A4223 |
Infusion supplies w/o pump |
39 |
25 |
$0.00 |