| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A4305 |
Drug delivery system >=50 ml |
3,177 |
1,002 |
$346K |
| S9500 |
Hit antibiotic q24h diem |
1,251 |
209 |
$90K |
| A4223 |
Infusion supplies w/o pump |
1,362 |
481 |
$77K |
| A4216 |
Sterile water/saline, 10 ml |
3,236 |
1,101 |
$37K |
| A4221 |
Supp non-insulin inf cath/wk |
2,781 |
1,074 |
$31K |
| A4222 |
Infusion supplies with pump |
321 |
94 |
$20K |
| A4927 |
Non-sterile gloves |
220 |
64 |
$14K |
| S1015 |
Iv tubing extension set |
787 |
256 |
$11K |
| A4245 |
Alcohol wipes per box |
1,647 |
716 |
$9K |
| 99601 |
|
195 |
117 |
$8K |
| A5200 |
Percutaneous catheter anchor |
1,254 |
448 |
$7K |
| A6209 |
Foam drsg <=16 sq in w/o bdr |
1,082 |
389 |
$4K |
| A6457 |
Tubular dressing |
1,869 |
695 |
$4K |
| S5501 |
Hit complex cath care |
157 |
66 |
$1K |
| J7030 |
Normal saline solution infus |
492 |
178 |
$984.38 |
| J1642 |
Inj heparin sodium per 10 u |
2,166 |
839 |
$807.76 |
| S9502 |
Hit antibiotic q8h diem |
83 |
13 |
$495.00 |
| A4210 |
Nonneedle injection device |
742 |
323 |
$388.27 |
| B9999 |
Parenteral supp not othrws c |
87 |
29 |
$88.42 |
| A4649 |
Surgical supplies |
515 |
206 |
$27.25 |