| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A4305 |
Disposable drug delivery system, flow rate of 50 ml or greater per hour |
3,177 |
1,002 |
$346K |
| S9500 |
Home infusion therapy, antibiotic, antiviral, or antifungal therapy; once every 24 hours; administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem |
1,251 |
209 |
$90K |
| A4223 |
Infusion supplies not used with external infusion pump, per cassette or bag (list drugs separately) |
1,362 |
481 |
$77K |
| A4216 |
Sterile water, saline and/or dextrose, diluent/flush, 10 ml |
3,236 |
1,101 |
$37K |
| A4221 |
Supplies for maintenance of non-insulin drug infusion catheter, per week (list drugs separately) |
2,781 |
1,074 |
$31K |
| A4222 |
Infusion supplies for external drug infusion pump, per cassette or bag (list drugs separately) |
321 |
94 |
$20K |
| A4927 |
Gloves, non-sterile, per 100 |
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/tube anchoring device, adhesive skin attachment |
1,254 |
448 |
$7K |
| A6209 |
Foam dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
1,082 |
389 |
$4K |
| A6457 |
Tubular dressing with or without elastic, any width, per linear yard |
1,869 |
695 |
$4K |
| S5501 |
Home infusion therapy, catheter care / maintenance, complex (more than one lumen), includes administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem |
157 |
66 |
$1K |
| J7030 |
Infusion, normal saline solution , 1000 cc |
492 |
178 |
$984.38 |
| J1642 |
Injection, heparin sodium, (heparin lock flush), per 10 units |
2,166 |
839 |
$807.76 |
| S9502 |
Home infusion therapy, antibiotic, antiviral, or antifungal therapy; once every 8 hours, administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem |
83 |
13 |
$495.00 |
| A4210 |
Needle-free injection device, each |
742 |
323 |
$388.27 |
| B9999 |
Noc for parenteral supplies |
87 |
29 |
$88.42 |
| A4649 |
Surgical supply; miscellaneous |
515 |
206 |
$27.25 |