| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| Q5121 |
Inj. avsola, 10 mg |
593 |
569 |
$1.37M |
| J1745 |
Infliximab not biosimil 10mg |
414 |
394 |
$1.35M |
| B4035 |
Enteral feed supp pump per d |
5,759 |
3,886 |
$945K |
| 99601 |
|
9,348 |
4,735 |
$886K |
| B4161 |
Ef ped hydrolyzed/amino acid |
1,741 |
1,397 |
$852K |
| S9500 |
Hit antibiotic q24h diem |
2,804 |
967 |
$825K |
| S9342 |
Hit enteral pump diem |
2,946 |
2,278 |
$786K |
| B4160 |
Ef ped caloric dense>/=0.7kc |
1,585 |
1,187 |
$266K |
| B4105 |
Enzyme cartridge enteral nut |
62 |
50 |
$229K |
| 99602 |
Nursing care in home rn |
2,584 |
1,914 |
$227K |
| S9502 |
Hit antibiotic q8h diem |
568 |
194 |
$180K |
| B4152 |
Ef calorie dense>/=1.5kcal |
2,760 |
1,607 |
$151K |
| B4220 |
Parenteral supply kit premix |
1,411 |
189 |
$140K |
| A4223 |
Infusion supplies w/o pump |
6,312 |
1,603 |
$137K |
| A4221 |
Supp non-insulin inf cath/wk |
6,671 |
2,272 |
$134K |
| S9379 |
Hit noc per diem |
1,602 |
926 |
$133K |
| B4185 |
Pn soln nos 10 grams lipids |
907 |
228 |
$133K |
| A4305 |
Drug delivery system >=50 ml |
1,165 |
362 |
$120K |
| S9494 |
Hit antibiotic total diem |
324 |
98 |
$102K |
| S9359 |
Hit anti-tnf per diem |
1,409 |
1,314 |
$90K |
| B4150 |
Ef complet w/intact nutrient |
2,008 |
1,166 |
$84K |
| B4224 |
Parenteral administration ki |
1,732 |
229 |
$70K |
| B4034 |
Enter feed supkit syr by day |
1,188 |
871 |
$60K |
| J0696 |
Ceftriaxone sodium injection |
727 |
184 |
$56K |
| S9338 |
Hit immunotherapy diem |
469 |
241 |
$42K |
| S9366 |
Hit tpn 2 liter diem |
42 |
13 |
$40K |
| B4088 |
Gastro/jejuno tube, low-pro |
229 |
214 |
$23K |
| S9501 |
Hit antibiotic q12h diem |
65 |
24 |
$22K |
| A4222 |
Infusion supplies with pump |
343 |
77 |
$20K |
| S9343 |
Hit enteral bolus nurs |
87 |
66 |
$18K |
| J3370 |
Vancomycin hcl injection |
172 |
45 |
$14K |
| B4149 |
Ef blenderized foods |
34 |
24 |
$10K |
| B4155 |
Ef incomplete/modular |
212 |
166 |
$6K |