| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| B4154 |
Ef spec metabolic noninherit |
7,371 |
7,196 |
$1.37M |
| E0791 |
Parenteral infusion pump sta |
2,675 |
2,590 |
$444K |
| B9999 |
Parenteral supp not othrws c |
23,597 |
6,276 |
$430K |
| A4223 |
Infusion supplies w/o pump |
34,297 |
8,084 |
$240K |
| B4224 |
Parenteral administration ki |
3,622 |
951 |
$182K |
| B4193 |
Parenteral sol 52-73 gm prot |
769 |
257 |
$94K |
| B4189 |
Parenteral sol amino acid & |
1,770 |
498 |
$92K |
| B4220 |
Parenteral supply kit premix |
3,599 |
950 |
$61K |
| S1015 |
Iv tubing extension set |
9,332 |
2,691 |
$54K |
| B4150 |
Ef complet w/intact nutrient |
877 |
836 |
$51K |
| A4322 |
Irrigation syringe |
1,245 |
1,173 |
$31K |
| B4152 |
Ef calorie dense>/=1.5kcal |
615 |
599 |
$30K |
| B4035 |
Enteral feed supp pump per d |
423 |
382 |
$30K |
| J3490 |
Drugs unclassified injection |
3,613 |
971 |
$29K |
| B4185 |
Pn soln nos 10 grams lipids |
1,741 |
464 |
$27K |
| B4155 |
Ef incomplete/modular |
657 |
639 |
$19K |
| E0776 |
Iv pole |
1,984 |
1,900 |
$16K |
| A6402 |
Sterile gauze <= 16 sq in |
2,601 |
1,591 |
$9K |
| B4197 |
Parenteral sol 74-100 gm pro |
33 |
12 |
$395.75 |
| A4222 |
Infusion supplies with pump |
73 |
15 |
$81.48 |
| A4245 |
Alcohol wipes per box |
646 |
263 |
$72.82 |