| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| J0585 |
Injection,onabotulinumtoxina |
2,838 |
2,273 |
$2.72M |
| S9500 |
Hit antibiotic q24h diem |
8,618 |
1,498 |
$1.23M |
| J1726 |
Makena, 10 mg |
1,431 |
454 |
$1.15M |
| 99601 |
|
8,252 |
2,907 |
$784K |
| S9502 |
Hit antibiotic q8h diem |
4,058 |
545 |
$581K |
| J1335 |
Ertapenem injection |
928 |
348 |
$281K |
| A4554 |
Disposable underpads |
2,223 |
2,136 |
$184K |
| S9501 |
Hit antibiotic q12h diem |
1,335 |
182 |
$165K |
| A4305 |
Drug delivery system >=50 ml |
1,020 |
453 |
$139K |
| T4523 |
Adult size brief/diaper lg |
1,015 |
983 |
$137K |
| T4522 |
Adult size brief/diaper med |
963 |
936 |
$96K |
| T4537 |
Reusable underpad bed size |
1,419 |
1,367 |
$55K |
| T4535 |
Disposable liner/shield/pad |
1,448 |
1,386 |
$44K |
| T4524 |
Adult size brief/diaper xl |
218 |
206 |
$26K |
| T4540 |
Reusable underpad chair size |
1,055 |
1,024 |
$22K |
| E0570 |
Nebulizer with compression |
223 |
221 |
$21K |
| J0696 |
Ceftriaxone sodium injection |
258 |
71 |
$16K |
| A4927 |
Non-sterile gloves |
2,383 |
2,283 |
$10K |
| J3370 |
Vancomycin hcl injection |
84 |
26 |
$8K |
| A7005 |
Nondisposable nebulizer set |
221 |
220 |
$3K |
| 0012A |
|
60 |
60 |
$1K |
| 0011A |
|
63 |
63 |
$1K |
| A7015 |
Aerosol mask used w nebulize |
117 |
116 |
$112.80 |