| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| B4189 |
Parenteral sol amino acid & |
3,069 |
628 |
$1.90M |
| B4224 |
Parenteral administration ki |
3,527 |
611 |
$226K |
| B4220 |
Parenteral supply kit premix |
3,527 |
611 |
$72K |
| E0781 |
External ambulatory infus pu |
883 |
554 |
$59K |
| A4222 |
Infusion supplies with pump |
333 |
143 |
$33K |
| B4185 |
Pn soln nos 10 grams lipids |
451 |
132 |
$28K |
| A4221 |
Supp non-insulin inf cath/wk |
743 |
420 |
$12K |
| A4245 |
Alcohol wipes per box |
392 |
364 |
$7K |
| A4216 |
Sterile water/saline, 10 ml |
94 |
68 |
$1K |
| A6219 |
Gauze <= 16 sq in w/border |
253 |
220 |
$338.08 |
| A9999 |
Dme supply or accessory, nos |
109 |
31 |
$263.90 |
| A4657 |
Syringe w/wo needle |
205 |
141 |
$181.88 |