| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| S9342 |
Hit enteral pump diem |
10,153 |
3,436 |
$964K |
| B4152 |
Ef calorie dense>/=1.5kcal |
5,827 |
4,034 |
$786K |
| B4153 |
Ef hydrolyzed/amino acids |
994 |
594 |
$634K |
| B4035 |
Enteral feed supp pump per d |
8,487 |
4,460 |
$552K |
| A4223 |
Infusion supplies w/o pump |
1,638 |
617 |
$516K |
| B4150 |
Ef complet w/intact nutrient |
3,600 |
2,828 |
$375K |
| 99601 |
|
2,399 |
871 |
$331K |
| B4149 |
Ef blenderized foods |
1,364 |
523 |
$226K |
| S9500 |
Hit antibiotic q24h diem |
768 |
160 |
$185K |
| B4185 |
Pn soln nos 10 grams lipids |
559 |
139 |
$165K |
| S9343 |
Hit enteral bolus nurs |
1,424 |
643 |
$129K |
| B4036 |
Enteral feed sup kit grav by |
1,671 |
942 |
$91K |
| B4160 |
Ef ped caloric dense>/=0.7kc |
704 |
391 |
$79K |
| B4088 |
Gastro/jejuno tube, low-pro |
1,388 |
989 |
$77K |
| S9341 |
Hit enteral grav diem |
1,402 |
357 |
$55K |
| B4155 |
Ef incomplete/modular |
1,308 |
855 |
$55K |
| B4034 |
Enter feed supkit syr by day |
1,518 |
835 |
$54K |
| T1999 |
Noc retail items andsupplies |
3,099 |
626 |
$36K |
| S9330 |
Hit cont chem diem |
332 |
140 |
$32K |
| B4161 |
Ef ped hydrolyzed/amino acid |
51 |
36 |
$18K |
| 99602 |
Nursing care in home rn |
144 |
84 |
$18K |
| B4154 |
Ef spec metabolic noninherit |
43 |
25 |
$12K |
| B9998 |
Enteral supp not otherwise c |
167 |
124 |
$7K |
| S9338 |
Hit immunotherapy diem |
31 |
12 |
$3K |
| J9190 |
Fluorouracil injection |
370 |
140 |
$2K |
| A4213 |
20+ cc syringe only |
160 |
104 |
$799.81 |
| J7030 |
Normal saline solution infus |
108 |
52 |
$542.52 |
| A4221 |
Supp non-insulin inf cath/wk |
26 |
12 |
$433.41 |
| B9002 |
Enter nutr inf pump any type |
38 |
37 |
$394.27 |
| A6402 |
Sterile gauze <= 16 sq in |
13 |
12 |
$244.86 |
| S1015 |
Iv tubing extension set |
18 |
12 |
$81.00 |
| A4216 |
Sterile water/saline, 10 ml |
24 |
12 |
$62.70 |
| A4452 |
Waterproof tape |
35 |
27 |
$60.30 |