| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| S9342 |
Hit enteral pump diem |
43,886 |
3,468 |
$2.78M |
| S9500 |
Hit antibiotic q24h diem |
13,993 |
1,606 |
$1.82M |
| B4152 |
Ef calorie dense>/=1.5kcal |
22,972 |
8,054 |
$1.28M |
| A4223 |
Infusion supplies w/o pump |
34,269 |
7,016 |
$1.26M |
| B4161 |
Ef ped hydrolyzed/amino acid |
4,344 |
1,714 |
$1.19M |
| B4035 |
Enteral feed supp pump per d |
27,690 |
6,075 |
$1.17M |
| B4153 |
Ef hydrolyzed/amino acids |
5,488 |
1,446 |
$1.13M |
| B4185 |
Pn soln nos 10 grams lipids |
4,895 |
1,179 |
$797K |
| J1745 |
Infliximab not biosimil 10mg |
189 |
149 |
$750K |
| S9343 |
Hit enteral bolus nurs |
9,766 |
900 |
$719K |
| B4160 |
Ef ped caloric dense>/=0.7kc |
8,240 |
2,945 |
$656K |
| S9502 |
Hit antibiotic q8h diem |
4,000 |
427 |
$569K |
| 99601 |
|
5,056 |
2,234 |
$527K |
| S9501 |
Hit antibiotic q12h diem |
3,022 |
381 |
$464K |
| B4150 |
Ef complet w/intact nutrient |
9,126 |
3,009 |
$427K |
| Q5103 |
Injection, inflectra |
161 |
147 |
$357K |
| B4154 |
Ef spec metabolic noninherit |
4,098 |
1,654 |
$353K |
| S9379 |
Hit noc per diem |
2,344 |
321 |
$339K |
| A4222 |
Infusion supplies with pump |
4,879 |
1,384 |
$296K |
| B4149 |
Ef blenderized foods |
2,302 |
597 |
$296K |
| J0878 |
Daptomycin injection |
400 |
133 |
$267K |
| G0299 |
Hhs/hospice of rn ea 15 min |
3,811 |
1,617 |
$262K |
| B4034 |
Enter feed supkit syr by day |
12,530 |
3,521 |
$228K |
| S9366 |
Hit tpn 2 liter diem |
1,020 |
56 |
$195K |
| B4088 |
Gastro/jejuno tube, low-pro |
1,122 |
949 |
$147K |
| B4224 |
Parenteral administration ki |
8,126 |
636 |
$129K |
| S9341 |
Hit enteral grav diem |
3,898 |
174 |
$115K |
| J3370 |
Vancomycin hcl injection |
1,202 |
292 |
$107K |
| A4221 |
Supp non-insulin inf cath/wk |
6,246 |
2,958 |
$103K |
| S9374 |
Hit hydra 1 liter diem |
1,097 |
172 |
$98K |
| B4155 |
Ef incomplete/modular |
4,110 |
1,257 |
$88K |
| B4036 |
Enteral feed sup kit grav by |
2,422 |
656 |
$75K |
| B4220 |
Parenteral supply kit premix |
4,834 |
598 |
$41K |
| S9359 |
Hit anti-tnf per diem |
551 |
478 |
$39K |
| A4305 |
Drug delivery system >=50 ml |
2,796 |
200 |
$36K |
| J0696 |
Ceftriaxone sodium injection |
488 |
175 |
$21K |
| S9340 |
Hit enteral per diem |
187 |
140 |
$20K |
| J1335 |
Ertapenem injection |
30 |
12 |
$19K |
| 99602 |
Nursing care in home rn |
171 |
130 |
$13K |
| J3490 |
Drugs unclassified injection |
112 |
13 |
$11K |
| A4216 |
Sterile water/saline, 10 ml |
593 |
251 |
$11K |
| S5501 |
Hit complex cath care |
240 |
38 |
$10K |
| E0776 |
Iv pole |
153 |
144 |
$8K |
| B9998 |
Enteral supp not otherwise c |
76 |
62 |
$7K |
| J2997 |
Alteplase recombinant |
18 |
16 |
$3K |
| J0690 |
Cefazolin sodium injection |
47 |
12 |
$3K |
| B4102 |
Ef adult fluids and electro |
71 |
43 |
$2K |
| B9002 |
Enter nutr inf pump any type |
59 |
52 |
$2K |
| A4306 |
Drug delivery system <=50 ml |
83 |
12 |
$1K |
| A6209 |
Foam drsg <=16 sq in w/o bdr |
139 |
51 |
$956.35 |
| S5517 |
Hit declotting kit |
16 |
14 |
$555.00 |
| A6257 |
Transparent film <= 16 sq in |
236 |
108 |
$393.80 |
| A4452 |
Waterproof tape |
52 |
44 |
$283.84 |
| Y9167 |
|
30 |
27 |
$108.00 |