| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| S9342 |
Hit enteral pump diem |
6,560 |
6,281 |
$2.90M |
| B9998 |
Enteral supp not otherwise c |
41,769 |
36,331 |
$2.20M |
| B4035 |
Enteral feed supp pump per d |
18,237 |
18,032 |
$2.04M |
| S9343 |
Hit enteral bolus nurs |
4,082 |
3,918 |
$1.81M |
| B4088 |
Gastro/jejuno tube, low-pro |
11,557 |
11,445 |
$1.36M |
| A4223 |
Infusion supplies w/o pump |
34,911 |
3,730 |
$931K |
| B9999 |
Parenteral supp not othrws c |
25,201 |
3,470 |
$824K |
| A4322 |
Irrigation syringe |
27,628 |
25,531 |
$399K |
| A4305 |
Drug delivery system >=50 ml |
2,060 |
897 |
$274K |
| B9002 |
Enter nutr inf pump any type |
1,136 |
1,124 |
$268K |
| A6402 |
Sterile gauze <= 16 sq in |
14,876 |
14,059 |
$167K |
| S1015 |
Iv tubing extension set |
8,897 |
2,207 |
$143K |
| T5999 |
Supply, nos |
21,937 |
3,533 |
$136K |
| A4248 |
Chlorhexidine antisept |
13,273 |
2,855 |
$86K |
| E0781 |
External ambulatory infus pu |
406 |
391 |
$70K |
| A6209 |
Foam drsg <=16 sq in w/o bdr |
4,229 |
1,425 |
$62K |
| A4657 |
Syringe w/wo needle |
21,863 |
15,503 |
$51K |
| S9500 |
Hit antibiotic q24h diem |
95 |
37 |
$38K |
| S9330 |
Hit cont chem diem |
256 |
154 |
$29K |
| E0776 |
Iv pole |
925 |
908 |
$28K |
| A4930 |
Sterile, gloves per pair |
9,087 |
3,113 |
$24K |
| A6258 |
Transparent film >16<=48 in |
1,986 |
873 |
$18K |
| A6257 |
Transparent film <= 16 sq in |
5,509 |
1,673 |
$17K |
| S9502 |
Hit antibiotic q8h diem |
30 |
12 |
$12K |
| A4209 |
5+ cc sterile syringe&needle |
10,197 |
2,795 |
$11K |
| A4245 |
Alcohol wipes per box |
10,873 |
3,580 |
$8K |
| A6234 |
Hydrocolld drg <=16 w/o bdr |
152 |
148 |
$6K |
| A4456 |
Adhesive remover, wipes |
8,644 |
2,838 |
$5K |
| A5120 |
Skin barrier, wipe or swab |
7,905 |
2,604 |
$4K |
| B4081 |
Enteral ng tubing w/ stylet |
160 |
154 |
$4K |
| A4208 |
3 cc sterile syringe&needle |
2,540 |
760 |
$3K |
| 99601 |
|
32 |
24 |
$3K |
| A6457 |
Tubular dressing |
1,100 |
546 |
$3K |
| B4034 |
Enter feed supkit syr by day |
82 |
77 |
$2K |
| A4215 |
Sterile needle |
2,470 |
881 |
$2K |
| A4247 |
Betadine/iodine swabs/wipes |
327 |
101 |
$206.86 |
| A4332 |
Lube sterile packet |
3,847 |
3,832 |
$158.33 |