| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| J1726 |
Makena, 10 mg |
11,330 |
2,981 |
$7.85M |
| S9500 |
Hit antibiotic q24h diem |
16,488 |
5,735 |
$5.38M |
| 99601 |
|
54,841 |
20,017 |
$5.31M |
| S9342 |
Hit enteral pump diem |
18,591 |
9,328 |
$4.52M |
| S9379 |
Hit noc per diem |
6,849 |
3,255 |
$3.46M |
| S9366 |
Hit tpn 2 liter diem |
4,078 |
852 |
$2.75M |
| S9502 |
Hit antibiotic q8h diem |
4,746 |
1,831 |
$1.78M |
| B4161 |
Ef ped hydrolyzed/amino acid |
3,126 |
2,355 |
$1.61M |
| J1745 |
Infliximab not biosimil 10mg |
510 |
432 |
$1.54M |
| B4185 |
Pn soln nos 10 grams lipids |
5,503 |
1,447 |
$1.29M |
| S9501 |
Hit antibiotic q12h diem |
3,549 |
1,299 |
$1.20M |
| J1335 |
Ertapenem injection |
2,978 |
1,296 |
$1.14M |
| Q5103 |
Injection, inflectra |
234 |
207 |
$1.09M |
| B4160 |
Ef ped caloric dense>/=0.7kc |
3,162 |
2,328 |
$1.02M |
| S9365 |
Hit tpn 1 liter diem |
1,522 |
228 |
$811K |
| 99602 |
Nursing care in home rn |
5,867 |
3,808 |
$739K |
| J1561 |
Gamunex-c/gammaked |
141 |
49 |
$579K |
| J0878 |
Daptomycin injection |
1,792 |
516 |
$542K |
| S9367 |
Hit tpn 3 liter diem |
1,082 |
140 |
$415K |
| A4223 |
Infusion supplies w/o pump |
4,767 |
1,861 |
$376K |
| B4035 |
Enteral feed supp pump per d |
3,830 |
3,133 |
$364K |
| J3380 |
Inj vedolizumab iv 1 mg |
43 |
39 |
$309K |
| J0696 |
Ceftriaxone sodium injection |
4,301 |
1,683 |
$262K |
| S9343 |
Hit enteral bolus nurs |
2,727 |
980 |
$254K |
| A4222 |
Infusion supplies with pump |
2,236 |
876 |
$220K |
| S9542 |
Ht inj noc per diem |
8,678 |
2,567 |
$219K |
| B4152 |
Ef calorie dense>/=1.5kcal |
2,378 |
1,621 |
$205K |
| B4088 |
Gastro/jejuno tube, low-pro |
1,818 |
1,780 |
$205K |
| S9374 |
Hit hydra 1 liter diem |
1,053 |
299 |
$203K |
| J3370 |
Vancomycin hcl injection |
2,976 |
825 |
$175K |
| S9338 |
Hit immunotherapy diem |
1,901 |
1,160 |
$170K |
| B4150 |
Ef complet w/intact nutrient |
1,852 |
1,280 |
$153K |
| A4221 |
Supp non-insulin inf cath/wk |
5,926 |
3,320 |
$126K |
| B4154 |
Ef spec metabolic noninherit |
362 |
296 |
$57K |
| J0692 |
Cefepime hcl for injection |
448 |
192 |
$53K |
| B4034 |
Enter feed supkit syr by day |
980 |
861 |
$43K |
| J2185 |
Meropenem |
262 |
112 |
$41K |
| B4158 |
Ef ped complete intact nut |
193 |
129 |
$37K |
| J0690 |
Cefazolin sodium injection |
570 |
178 |
$35K |
| B4155 |
Ef incomplete/modular |
541 |
390 |
$28K |
| J0872 |
Daptomycin (xellia) unrefrig |
23 |
12 |
$23K |
| J1580 |
Garamycin gentamicin inj |
2,249 |
1,540 |
$22K |
| B4197 |
Parenteral sol 74-100 gm pro |
32 |
12 |
$22K |
| S9359 |
Hit anti-tnf per diem |
195 |
185 |
$21K |
| B4153 |
Ef hydrolyzed/amino acids |
81 |
54 |
$20K |
| B4224 |
Parenteral administration ki |
606 |
174 |
$19K |
| J0873 |
Inj daptomycin (xellia) |
48 |
16 |
$18K |
| B4180 |
Parenteral sol carb > 50% |
592 |
152 |
$18K |
| B4149 |
Ef blenderized foods |
68 |
40 |
$17K |
| S9503 |
Hit antibiotic q6h diem |
25 |
13 |
$11K |
| J2248 |
Micafungin sodium injection |
31 |
12 |
$10K |
| A4216 |
Sterile water/saline, 10 ml |
500 |
244 |
$9K |
| B4220 |
Parenteral supply kit premix |
239 |
67 |
$7K |
| J2543 |
Piperacillin/tazobactam |
58 |
25 |
$4K |
| J2260 |
Inj milrinone lactate / 5 mg |
42 |
13 |
$3K |
| B9002 |
Enter nutr inf pump any type |
104 |
104 |
$2K |
| J7030 |
Normal saline solution infus |
240 |
142 |
$983.29 |
| E0776 |
Iv pole |
12 |
12 |
$462.31 |
| A4927 |
Non-sterile gloves |
25 |
14 |
$301.15 |
| A4217 |
Sterile water/saline, 500 ml |
44 |
15 |
$163.74 |
| A4245 |
Alcohol wipes per box |
40 |
30 |
$62.55 |
| J1642 |
Inj heparin sodium per 10 u |
41 |
14 |
$29.70 |