| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| B4105 |
Enzyme cartridge enteral nut |
375 |
364 |
$2.46M |
| S9366 |
Hit tpn 2 liter diem |
2,769 |
450 |
$1.37M |
| 99601 |
|
16,237 |
6,811 |
$1.07M |
| S9342 |
Hit enteral pump diem |
11,214 |
2,582 |
$989K |
| S9338 |
Hit immunotherapy diem |
6,052 |
2,550 |
$752K |
| S9500 |
Hit antibiotic q24h diem |
3,400 |
1,182 |
$718K |
| S9374 |
Hit hydra 1 liter diem |
2,075 |
612 |
$422K |
| S9502 |
Hit antibiotic q8h diem |
2,264 |
562 |
$405K |
| B4035 |
Enteral feed supp pump per d |
5,699 |
2,393 |
$364K |
| S9379 |
Hit noc per diem |
2,322 |
1,175 |
$334K |
| S9348 |
Hit sympathomim diem |
1,477 |
159 |
$209K |
| 99602 |
Nursing care in home rn |
3,272 |
1,919 |
$197K |
| A4222 |
Infusion supplies with pump |
2,592 |
621 |
$131K |
| B4153 |
Ef hydrolyzed/amino acids |
322 |
264 |
$122K |
| B4185 |
Pn soln nos 10 grams lipids |
1,327 |
368 |
$98K |
| B4161 |
Ef ped hydrolyzed/amino acid |
201 |
166 |
$71K |
| B4152 |
Ef calorie dense>/=1.5kcal |
1,215 |
850 |
$67K |
| A4221 |
Supp non-insulin inf cath/wk |
3,836 |
1,684 |
$41K |
| B4220 |
Parenteral supply kit premix |
1,766 |
422 |
$39K |
| B4150 |
Ef complet w/intact nutrient |
517 |
448 |
$39K |
| B4034 |
Enter feed supkit syr by day |
1,301 |
615 |
$38K |
| S9501 |
Hit antibiotic q12h diem |
161 |
48 |
$29K |
| B4160 |
Ef ped caloric dense>/=0.7kc |
150 |
125 |
$20K |
| S9343 |
Hit enteral bolus nurs |
226 |
81 |
$19K |
| S9359 |
Hit anti-tnf per diem |
289 |
269 |
$16K |
| B4224 |
Parenteral administration ki |
295 |
67 |
$16K |
| A4223 |
Infusion supplies w/o pump |
152 |
24 |
$14K |
| B4149 |
Ef blenderized foods |
60 |
52 |
$12K |
| B4088 |
Gastro/jejuno tube, low-pro |
164 |
159 |
$10K |
| B4154 |
Ef spec metabolic noninherit |
19 |
12 |
$6K |
| B4155 |
Ef incomplete/modular |
66 |
63 |
$2K |
| E0776 |
Iv pole |
13 |
12 |
$86.39 |