| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99601 |
|
40,120 |
13,319 |
$4.76M |
| S9342 |
Hit enteral pump diem |
20,194 |
7,182 |
$2.45M |
| 90378 |
|
756 |
603 |
$1.47M |
| S9494 |
Hit antibiotic total diem |
5,327 |
1,502 |
$1.28M |
| S9379 |
Hit noc per diem |
9,911 |
1,874 |
$1.04M |
| A4223 |
Infusion supplies w/o pump |
4,981 |
1,323 |
$1.01M |
| S9374 |
Hit hydra 1 liter diem |
4,649 |
982 |
$969K |
| S9500 |
Hit antibiotic q24h diem |
3,012 |
656 |
$740K |
| B4157 |
Ef special metabolic inherit |
1,320 |
951 |
$591K |
| 99602 |
Nursing care in home rn |
4,190 |
2,259 |
$496K |
| S9338 |
Hit immunotherapy diem |
6,337 |
2,615 |
$457K |
| S9373 |
Hit hydra total diem |
2,159 |
706 |
$399K |
| J1559 |
Hizentra injection |
227 |
75 |
$332K |
| B4153 |
Ef hydrolyzed/amino acids |
646 |
526 |
$280K |
| S9502 |
Hit antibiotic q8h diem |
1,130 |
212 |
$278K |
| S9351 |
Hit cont antiemetic diem |
1,216 |
334 |
$277K |
| S9375 |
Hit hydra 2 liter diem |
1,410 |
254 |
$250K |
| B4152 |
Ef calorie dense>/=1.5kcal |
1,749 |
1,436 |
$233K |
| B4160 |
Ef ped caloric dense>/=0.7kc |
1,480 |
1,013 |
$216K |
| J1745 |
Infliximab not biosimil 10mg |
58 |
50 |
$206K |
| B4035 |
Enteral feed supp pump per d |
4,656 |
1,360 |
$194K |
| B4161 |
Ef ped hydrolyzed/amino acid |
384 |
268 |
$176K |
| S9330 |
Hit cont chem diem |
1,439 |
573 |
$172K |
| S9376 |
Hit hydra 3 liter diem |
909 |
264 |
$160K |
| A4305 |
Drug delivery system >=50 ml |
989 |
245 |
$148K |
| B4185 |
Pn soln nos 10 grams lipids |
2,366 |
383 |
$145K |
| S9501 |
Hit antibiotic q12h diem |
492 |
104 |
$132K |
| B4155 |
Ef incomplete/modular |
1,248 |
844 |
$103K |
| Q5103 |
Injection, inflectra |
107 |
97 |
$96K |
| A4222 |
Infusion supplies with pump |
1,459 |
395 |
$95K |
| S9329 |
Hit chemo per diem |
874 |
377 |
$94K |
| B4162 |
Ef ped specmetabolic inherit |
208 |
165 |
$76K |
| S9359 |
Hit anti-tnf per diem |
795 |
719 |
$61K |
| S9435 |
Medical foods for inborn err |
260 |
226 |
$60K |
| S9343 |
Hit enteral bolus nurs |
895 |
233 |
$59K |
| J3490 |
Drugs unclassified injection |
152 |
94 |
$40K |
| S9341 |
Hit enteral grav diem |
922 |
251 |
$39K |
| S9562 |
Ht inj palivizumab/ab diem |
748 |
606 |
$37K |
| J7030 |
Normal saline solution infus |
10,314 |
3,995 |
$35K |
| B4149 |
Ef blenderized foods |
106 |
76 |
$34K |
| B4150 |
Ef complet w/intact nutrient |
357 |
231 |
$33K |
| B4154 |
Ef spec metabolic noninherit |
196 |
134 |
$32K |
| A4221 |
Supp non-insulin inf cath/wk |
1,859 |
811 |
$31K |
| S9366 |
Hit tpn 2 liter diem |
73 |
12 |
$28K |
| S9370 |
Ht inj antiemetic diem |
192 |
29 |
$20K |
| J9190 |
Fluorouracil injection |
1,116 |
614 |
$19K |
| M0243 |
Casirivi and imdevi inj |
44 |
41 |
$13K |
| S9357 |
Hit enzyme replace diem |
166 |
49 |
$12K |
| B9002 |
Enter nutr inf pump any type |
425 |
404 |
$9K |
| S5498 |
Hit simple cath care |
462 |
273 |
$8K |
| J7120 |
Ringers lactate infusion |
554 |
194 |
$8K |
| S5501 |
Hit complex cath care |
296 |
59 |
$7K |
| M0222 |
Bebtelovimab injection |
24 |
24 |
$7K |
| M0247 |
Sotrovimab infusion |
19 |
14 |
$6K |
| A4216 |
Sterile water/saline, 10 ml |
1,055 |
420 |
$4K |
| S5502 |
Hit interim cath care |
124 |
119 |
$4K |
| J2997 |
Alteplase recombinant |
18 |
12 |
$4K |
| J3370 |
Vancomycin hcl injection |
44 |
13 |
$3K |
| 96372 |
|
282 |
214 |
$2K |
| J0696 |
Ceftriaxone sodium injection |
106 |
26 |
$1K |
| E0781 |
External ambulatory infus pu |
37 |
36 |
$955.73 |
| J1642 |
Inj heparin sodium per 10 u |
289 |
130 |
$714.97 |
| J2405 |
Ondansetron hcl injection |
117 |
53 |
$598.62 |
| J0171 |
Adrenalin epinephrine inject |
34 |
31 |
$252.05 |
| J2919 |
Inj, methylpred sod succ 5mg |
53 |
43 |
$212.68 |
| J2930 |
Methylprednisolone injection |
15 |
13 |
$74.37 |