| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| B4161 |
Ef ped hydrolyzed/amino acid |
2,494 |
497 |
$152K |
| B9002 |
Enter nutr inf pump any type |
490 |
280 |
$66K |
| B4035 |
Enteral feed supp pump per d |
2,546 |
636 |
$57K |
| B9998 |
Enteral supp not otherwise c |
2,568 |
538 |
$54K |
| B4160 |
Ef ped caloric dense>/=0.7kc |
2,533 |
494 |
$36K |
| 99601 |
|
895 |
305 |
$15K |
| S9500 |
Hit antibiotic q24h diem |
530 |
84 |
$14K |
| S9342 |
Hit enteral pump diem |
803 |
258 |
$11K |
| B4152 |
Ef calorie dense>/=1.5kcal |
459 |
61 |
$5K |
| J0696 |
Ceftriaxone sodium injection |
83 |
12 |
$3K |
| A4305 |
Drug delivery system >=50 ml |
61 |
12 |
$2K |
| B4034 |
Enter feed supkit syr by day |
307 |
115 |
$2K |
| B4088 |
Gastro/jejuno tube, low-pro |
261 |
119 |
$2K |
| A4221 |
Supp non-insulin inf cath/wk |
318 |
70 |
$1K |
| A4213 |
20+ cc syringe only |
792 |
329 |
$613.27 |
| A4216 |
Sterile water/saline, 10 ml |
200 |
45 |
$575.80 |
| J1642 |
Inj heparin sodium per 10 u |
208 |
39 |
$499.66 |
| A4333 |
Urinary cath anchor device |
324 |
113 |
$348.89 |
| A4657 |
Syringe w/wo needle |
765 |
294 |
$320.81 |
| A4217 |
Sterile water/saline, 500 ml |
138 |
26 |
$156.98 |
| A4245 |
Alcohol wipes per box |
197 |
56 |
$127.58 |
| A4649 |
Surgical supplies |
64 |
14 |
$0.00 |