| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A4223 |
Infusion supplies w/o pump |
8,002 |
2,655 |
$600K |
| A4216 |
Sterile water/saline, 10 ml |
3,285 |
1,685 |
$139K |
| B4152 |
Ef calorie dense>/=1.5kcal |
1,558 |
651 |
$130K |
| B4160 |
Ef ped caloric dense>/=0.7kc |
511 |
231 |
$66K |
| A4222 |
Infusion supplies with pump |
2,055 |
506 |
$43K |
| J3370 |
Vancomycin hcl injection |
105 |
26 |
$13K |
| A4221 |
Supp non-insulin inf cath/wk |
2,336 |
1,040 |
$12K |
| 99601 |
|
971 |
389 |
$6K |
| B4034 |
Enter feed supkit syr by day |
45 |
36 |
$4K |
| B4150 |
Ef complet w/intact nutrient |
22 |
13 |
$3K |
| 99602 |
Nursing care in home rn |
287 |
184 |
$408.86 |
| J0696 |
Ceftriaxone sodium injection |
51 |
12 |
$169.92 |