| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A4223 |
Infusion supplies w/o pump |
20,624 |
4,090 |
$1.10M |
| E0791 |
Parenteral infusion pump sta |
1,715 |
1,521 |
$485K |
| A4305 |
Drug delivery system >=50 ml |
628 |
419 |
$292K |
| B4035 |
Enteral feed supp pump per d |
579 |
536 |
$105K |
| A4322 |
Irrigation syringe |
1,881 |
1,644 |
$97K |
| B9998 |
Enteral supp not otherwise c |
1,196 |
925 |
$82K |
| E0776 |
Iv pole |
2,577 |
2,398 |
$51K |
| B9002 |
Enter nutr inf pump any type |
503 |
474 |
$47K |
| E0781 |
External ambulatory infus pu |
465 |
320 |
$36K |
| S9342 |
Hit enteral pump diem |
98 |
95 |
$32K |
| B9999 |
Parenteral supp not othrws c |
1,660 |
1,125 |
$26K |
| A6258 |
Transparent film >16<=48 in |
1,546 |
1,109 |
$24K |
| A6402 |
Sterile gauze <= 16 sq in |
1,750 |
1,490 |
$22K |
| A6457 |
Tubular dressing |
2,727 |
2,065 |
$20K |
| B4160 |
Ef ped caloric dense>/=0.7kc |
109 |
107 |
$15K |
| A4927 |
Non-sterile gloves |
1,909 |
1,654 |
$15K |
| B4036 |
Enteral feed sup kit grav by |
206 |
153 |
$13K |
| A6247 |
Hydrogel drg > 48 sq in w/b |
78 |
55 |
$6K |
| A4245 |
Alcohol wipes per box |
3,741 |
3,002 |
$6K |
| S1015 |
Iv tubing extension set |
1,004 |
771 |
$5K |
| A6224 |
Gauze > 48 in no w/sal w/o b |
412 |
286 |
$5K |
| A4209 |
5+ cc sterile syringe&needle |
383 |
204 |
$4K |
| B4034 |
Enter feed supkit syr by day |
13 |
12 |
$4K |
| S9343 |
Hit enteral bolus nurs |
12 |
12 |
$2K |
| A4657 |
Syringe w/wo needle |
284 |
170 |
$1K |
| A4215 |
Sterile needle |
106 |
72 |
$1K |
| A5200 |
Percutaneous catheter anchor |
17 |
14 |
$829.20 |