| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A4223 |
Infusion supplies w/o pump |
41,135 |
8,220 |
$265K |
| J3490 |
Drugs unclassified injection |
9,423 |
788 |
$206K |
| E0791 |
Parenteral infusion pump sta |
2,455 |
2,385 |
$185K |
| G0299 |
Hhs/hospice of rn ea 15 min |
1,130 |
621 |
$184K |
| A4222 |
Infusion supplies with pump |
5,899 |
2,265 |
$172K |
| J1642 |
Inj heparin sodium per 10 u |
10,249 |
2,081 |
$130K |
| B4150 |
Ef complet w/intact nutrient |
1,353 |
1,146 |
$68K |
| B4185 |
Pn soln nos 10 grams lipids |
485 |
169 |
$67K |
| G0162 |
Hhc rn e&m plan svs, 15 min |
426 |
424 |
$64K |
| B4035 |
Enteral feed supp pump per d |
1,988 |
1,606 |
$63K |
| B4154 |
Ef spec metabolic noninherit |
633 |
532 |
$58K |
| S9500 |
Hit antibiotic q24h diem |
143 |
74 |
$54K |
| A6457 |
Tubular dressing |
5,785 |
3,702 |
$46K |
| B4152 |
Ef calorie dense>/=1.5kcal |
1,207 |
746 |
$46K |
| A4216 |
Sterile water/saline, 10 ml |
4,718 |
2,114 |
$45K |
| B4034 |
Enter feed supkit syr by day |
2,239 |
1,240 |
$44K |
| 99601 |
|
423 |
217 |
$41K |
| S9374 |
Hit hydra 1 liter diem |
173 |
106 |
$37K |
| B9999 |
Parenteral supp not othrws c |
4,156 |
2,249 |
$31K |
| B9002 |
Enter nutr inf pump any type |
1,602 |
1,548 |
$29K |
| E0776 |
Iv pole |
4,548 |
4,247 |
$26K |
| A4322 |
Irrigation syringe |
1,694 |
1,601 |
$24K |
| T5999 |
Supply, nos |
1,571 |
518 |
$18K |
| A4217 |
Sterile water/saline, 500 ml |
4,323 |
1,185 |
$17K |
| A6209 |
Foam drsg <=16 sq in w/o bdr |
2,317 |
1,293 |
$13K |
| S1015 |
Iv tubing extension set |
7,421 |
4,130 |
$13K |
| A6402 |
Sterile gauze <= 16 sq in |
3,074 |
2,772 |
$12K |
| A4657 |
Syringe w/wo needle |
9,725 |
4,669 |
$8K |
| A4245 |
Alcohol wipes per box |
6,533 |
3,646 |
$7K |
| 96365 |
|
84 |
58 |
$5K |
| J3370 |
Vancomycin hcl injection |
297 |
85 |
$5K |
| B9998 |
Enteral supp not otherwise c |
254 |
245 |
$4K |
| A4221 |
Supp non-insulin inf cath/wk |
228 |
123 |
$2K |
| J7040 |
Normal saline solution infus |
729 |
268 |
$2K |
| S9338 |
Hit immunotherapy diem |
16 |
12 |
$1K |
| A4209 |
5+ cc sterile syringe&needle |
2,071 |
791 |
$872.89 |
| A4212 |
Non coring needle or stylet |
144 |
93 |
$808.84 |
| A4927 |
Non-sterile gloves |
499 |
320 |
$791.48 |
| A4649 |
Surgical supplies |
803 |
642 |
$531.62 |
| A4215 |
Sterile needle |
2,038 |
701 |
$249.24 |
| A6403 |
Sterile gauze>16 <= 48 sq in |
26 |
26 |
$241.39 |
| J3475 |
Inj magnesium sulfate |
233 |
67 |
$177.83 |
| A4450 |
Non-waterproof tape |
618 |
533 |
$165.49 |
| A4213 |
20+ cc syringe only |
440 |
128 |
$158.25 |
| A4208 |
3 cc sterile syringe&needle |
145 |
136 |
$101.83 |
| K0603 |
Repl batt alkaline 1.5 v |
151 |
69 |
$40.17 |
| J7799 |
Non-inhalation drug for dme |
44 |
12 |
$0.00 |
| J0610 |
Calcium glucon (fresenius) |
42 |
12 |
$0.00 |