| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A4223 |
Infusion supplies w/o pump |
2,043 |
757 |
$1.38M |
| B4105 |
Enzyme cartridge enteral nut |
364 |
265 |
$1.36M |
| A4222 |
Infusion supplies with pump |
5,960 |
2,084 |
$569K |
| B4035 |
Enteral feed supp pump per d |
4,355 |
2,331 |
$359K |
| B4185 |
Pn soln nos 10 grams lipids |
2,604 |
556 |
$308K |
| 99601 |
|
2,394 |
1,045 |
$221K |
| J0878 |
Daptomycin injection |
893 |
63 |
$165K |
| B4161 |
Ef ped hydrolyzed/amino acid |
348 |
185 |
$124K |
| B4224 |
Parenteral administration ki |
1,417 |
276 |
$119K |
| B4150 |
Ef complet w/intact nutrient |
2,170 |
1,246 |
$116K |
| B4152 |
Ef calorie dense>/=1.5kcal |
2,464 |
1,355 |
$105K |
| A4305 |
Drug delivery system >=50 ml |
787 |
271 |
$83K |
| A4221 |
Supp non-insulin inf cath/wk |
5,996 |
2,252 |
$79K |
| B4034 |
Enter feed supkit syr by day |
1,936 |
1,213 |
$79K |
| S9500 |
Hit antibiotic q24h diem |
951 |
103 |
$63K |
| B4220 |
Parenteral supply kit premix |
1,000 |
195 |
$37K |
| B4153 |
Ef hydrolyzed/amino acids |
109 |
52 |
$16K |
| B4160 |
Ef ped caloric dense>/=0.7kc |
151 |
75 |
$16K |
| 99602 |
Nursing care in home rn |
165 |
89 |
$13K |
| S9342 |
Hit enteral pump diem |
337 |
49 |
$11K |
| B4154 |
Ef spec metabolic noninherit |
20 |
12 |
$6K |
| A4213 |
20+ cc syringe only |
673 |
249 |
$5K |
| J0696 |
Ceftriaxone sodium injection |
232 |
55 |
$4K |
| B4088 |
Gastro/jejuno tube, low-pro |
16 |
13 |
$283.34 |