| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| S9500 |
Hit antibiotic q24h diem |
17,251 |
1,283 |
$1.67M |
| A4223 |
Infusion supplies w/o pump |
27,538 |
3,619 |
$815K |
| S9340 |
Hit enteral per diem |
18,258 |
878 |
$623K |
| B4152 |
Ef calorie dense>/=1.5kcal |
3,555 |
2,280 |
$328K |
| A4222 |
Infusion supplies with pump |
7,031 |
1,361 |
$264K |
| B4035 |
Enteral feed supp pump per d |
4,689 |
1,862 |
$215K |
| S9502 |
Hit antibiotic q8h diem |
1,572 |
112 |
$208K |
| J0878 |
Daptomycin injection |
3,742 |
260 |
$202K |
| J1335 |
Ertapenem injection |
472 |
248 |
$192K |
| B4150 |
Ef complet w/intact nutrient |
1,870 |
1,169 |
$161K |
| A4221 |
Supp non-insulin inf cath/wk |
10,368 |
5,011 |
$147K |
| E0781 |
External ambulatory infus pu |
13,167 |
882 |
$110K |
| B4034 |
Enter feed supkit syr by day |
2,862 |
1,264 |
$84K |
| J3370 |
Vancomycin hcl injection |
969 |
215 |
$56K |
| S9330 |
Hit cont chem diem |
632 |
191 |
$55K |
| B4153 |
Ef hydrolyzed/amino acids |
121 |
73 |
$42K |
| J9190 |
Fluorouracil injection |
2,230 |
1,276 |
$26K |
| S9501 |
Hit antibiotic q12h diem |
188 |
13 |
$24K |
| J0696 |
Ceftriaxone sodium injection |
1,197 |
376 |
$22K |
| 99601 |
|
251 |
88 |
$17K |
| B9002 |
Enter nutr inf pump any type |
332 |
272 |
$14K |
| B4154 |
Ef spec metabolic noninherit |
120 |
75 |
$14K |
| J0690 |
Cefazolin sodium injection |
120 |
24 |
$4K |
| B4224 |
Parenteral administration ki |
55 |
12 |
$2K |
| A4305 |
Drug delivery system >=50 ml |
128 |
12 |
$2K |
| B4220 |
Parenteral supply kit premix |
55 |
12 |
$692.33 |