| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A4223 |
Infusion supplies w/o pump |
4,476 |
1,189 |
$404K |
| S9500 |
Hit antibiotic q24h diem |
2,445 |
807 |
$356K |
| S9366 |
Hit tpn 2 liter diem |
554 |
127 |
$346K |
| B4160 |
Ef ped caloric dense>/=0.7kc |
1,486 |
1,348 |
$250K |
| S9342 |
Hit enteral pump diem |
657 |
622 |
$213K |
| B4035 |
Enteral feed supp pump per d |
1,587 |
1,439 |
$212K |
| 99601 |
|
1,573 |
525 |
$140K |
| A4221 |
Supp non-insulin inf cath/wk |
1,022 |
514 |
$111K |
| S9374 |
Hit hydra 1 liter diem |
503 |
140 |
$85K |
| B4150 |
Ef complet w/intact nutrient |
578 |
531 |
$68K |
| B4034 |
Enter feed supkit syr by day |
443 |
396 |
$40K |
| B9002 |
Enter nutr inf pump any type |
556 |
546 |
$32K |
| B4161 |
Ef ped hydrolyzed/amino acid |
43 |
39 |
$28K |
| S9343 |
Hit enteral bolus nurs |
239 |
100 |
$25K |
| A4216 |
Sterile water/saline, 10 ml |
476 |
274 |
$20K |
| B4088 |
Gastro/jejuno tube, low-pro |
302 |
295 |
$19K |
| J1642 |
Inj heparin sodium per 10 u |
793 |
350 |
$15K |
| B4152 |
Ef calorie dense>/=1.5kcal |
130 |
117 |
$15K |
| S9502 |
Hit antibiotic q8h diem |
58 |
13 |
$10K |
| S9123 |
Nursing care in home rn |
181 |
50 |
$7K |
| A4222 |
Infusion supplies with pump |
30 |
12 |
$5K |
| B9998 |
Enteral supp not otherwise c |
124 |
115 |
$4K |
| B4154 |
Ef spec metabolic noninherit |
17 |
13 |
$4K |
| 99602 |
Nursing care in home rn |
43 |
27 |
$3K |
| E0776 |
Iv pole |
13 |
13 |
$909.69 |
| A4927 |
Non-sterile gloves |
729 |
665 |
$680.83 |
| A4245 |
Alcohol wipes per box |
955 |
463 |
$654.04 |
| A4209 |
5+ cc sterile syringe&needle |
297 |
109 |
$393.36 |