| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 90378 |
|
1,218 |
792 |
$2.51M |
| S9500 |
Hit antibiotic q24h diem |
3,483 |
564 |
$576K |
| A4223 |
Infusion supplies w/o pump |
8,798 |
1,574 |
$268K |
| L4360 |
Pneumat walking boot pre cst |
1,486 |
1,289 |
$190K |
| A4221 |
Supp non-insulin inf cath/wk |
9,707 |
3,976 |
$145K |
| L4361 |
Pneuma/vac walk boot pre ots |
473 |
428 |
$58K |
| A4222 |
Infusion supplies with pump |
824 |
160 |
$55K |
| J3490 |
Drugs unclassified injection |
182 |
92 |
$51K |
| L1832 |
Ko adj jnt pos r sup pre cst |
129 |
108 |
$39K |
| L3908 |
Who cock-up nonmolde pre ots |
931 |
775 |
$31K |
| J7030 |
Normal saline solution infus |
1,959 |
633 |
$28K |
| J7517 |
Mycophenolate mofetil oral |
922 |
788 |
$24K |
| J7507 |
Tacrolimus imme rel oral 1mg |
1,280 |
759 |
$23K |
| L1810 |
Ko elastic with joints |
323 |
284 |
$17K |
| L3809 |
Whfo w/o joints pre ots |
137 |
112 |
$16K |
| J7050 |
Normal saline solution infus |
3,689 |
1,358 |
$15K |
| S9562 |
Ht inj palivizumab/ab diem |
921 |
883 |
$14K |
| L3670 |
So acro/clav can web pre ots |
191 |
171 |
$9K |
| Q0512 |
Px sup fee anti-can sub pres |
2,563 |
1,206 |
$9K |
| Q0511 |
Sup fee antiem,antica,immuno |
1,264 |
1,106 |
$7K |
| S9542 |
Ht inj noc per diem |
66 |
26 |
$7K |
| L1812 |
Ko elastic w/joints pre ots |
114 |
107 |
$6K |
| L1833 |
Ko adj jnt pos r sup pre ots |
28 |
25 |
$4K |
| E0114 |
Crutch underarm pair no wood |
168 |
157 |
$3K |
| J0696 |
Ceftriaxone sodium injection |
83 |
28 |
$1K |
| A4217 |
Sterile water/saline, 500 ml |
228 |
96 |
$1K |
| J0171 |
Adrenalin epinephrine inject |
126 |
116 |
$832.10 |
| L1902 |
Afo ankle gauntlet pre ots |
12 |
12 |
$482.14 |
| J7512 |
Prednisone ir or dr oral 1mg |
554 |
479 |
$441.03 |
| A4212 |
Non coring needle or stylet |
18 |
14 |
$254.88 |