| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A4223 |
Infusion supplies w/o pump |
9,433 |
3,983 |
$7.70M |
| B4035 |
Enteral feed supp pump per d |
10,930 |
8,608 |
$1.86M |
| B4185 |
Pn soln nos 10 grams lipids |
4,423 |
1,096 |
$1.13M |
| A4222 |
Infusion supplies with pump |
5,697 |
2,285 |
$1.03M |
| B4153 |
Ef hydrolyzed/amino acids |
1,641 |
1,411 |
$813K |
| B4152 |
Ef calorie dense>/=1.5kcal |
6,698 |
5,782 |
$780K |
| B4150 |
Ef complet w/intact nutrient |
5,256 |
4,569 |
$695K |
| B4197 |
Parenteral sol 74-100 gm pro |
580 |
154 |
$676K |
| B4224 |
Parenteral administration ki |
4,738 |
1,174 |
$637K |
| 99601 |
|
5,375 |
2,687 |
$624K |
| B4149 |
Ef blenderized foods |
1,723 |
1,486 |
$586K |
| B4034 |
Enter feed supkit syr by day |
6,563 |
5,235 |
$566K |
| B4154 |
Ef spec metabolic noninherit |
1,864 |
1,590 |
$383K |
| A4221 |
Supp non-insulin inf cath/wk |
12,650 |
6,104 |
$269K |
| B4220 |
Parenteral supply kit premix |
4,672 |
1,172 |
$204K |
| B4036 |
Enteral feed sup kit grav by |
1,908 |
1,668 |
$165K |
| J3380 |
Inj vedolizumab iv 1 mg |
27 |
27 |
$146K |
| J1745 |
Infliximab not biosimil 10mg |
52 |
51 |
$110K |
| B4199 |
Parenteral sol > 100gm prote |
55 |
13 |
$109K |
| B4088 |
Gastro/jejuno tube, low-pro |
1,298 |
1,260 |
$97K |
| B4160 |
Ef ped caloric dense>/=0.7kc |
640 |
519 |
$94K |
| B9002 |
Enter nutr inf pump any type |
1,140 |
1,096 |
$64K |
| S9342 |
Hit enteral pump diem |
2,700 |
97 |
$46K |
| J0696 |
Ceftriaxone sodium injection |
1,600 |
473 |
$32K |
| B4155 |
Ef incomplete/modular |
1,093 |
952 |
$31K |
| E0781 |
External ambulatory infus pu |
168 |
158 |
$30K |
| J3370 |
Vancomycin hcl injection |
249 |
73 |
$20K |
| J0878 |
Daptomycin injection |
33 |
13 |
$11K |
| J1335 |
Ertapenem injection |
38 |
12 |
$11K |
| 99602 |
Nursing care in home rn |
82 |
60 |
$10K |
| E0776 |
Iv pole |
114 |
108 |
$9K |
| J7030 |
Normal saline solution infus |
199 |
63 |
$4K |
| 99072 |
|
48 |
40 |
$0.00 |