| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| J1599 |
Ivig non-lyophilized, nos |
4,589 |
767 |
$9.95M |
| 99602 |
Nursing care in home rn |
19,989 |
4,658 |
$2.29M |
| 99601 |
|
27,536 |
5,798 |
$1.60M |
| S9374 |
Hit hydra 1 liter diem |
2,502 |
1,622 |
$1.33M |
| S9351 |
Hit cont antiemetic diem |
1,584 |
1,108 |
$1.14M |
| S9370 |
Ht inj antiemetic diem |
1,596 |
987 |
$611K |
| S9338 |
Hit immunotherapy diem |
15,933 |
3,850 |
$575K |
| J1561 |
Gamunex-c/gammaked |
195 |
24 |
$306K |
| A4222 |
Infusion supplies with pump |
8,006 |
1,721 |
$241K |
| A4221 |
Supp non-insulin inf cath/wk |
12,622 |
3,328 |
$132K |
| E0781 |
External ambulatory infus pu |
842 |
648 |
$129K |
| J2550 |
Promethazine hcl injection |
1,136 |
312 |
$59K |
| A4223 |
Infusion supplies w/o pump |
612 |
339 |
$37K |
| J2405 |
Ondansetron hcl injection |
419 |
222 |
$31K |
| J2997 |
Alteplase recombinant |
80 |
46 |
$27K |
| E0779 |
Amb infusion pump mechanical |
679 |
534 |
$4K |
| K0552 |
Sup/ext non-ins inf pump syr |
520 |
167 |
$2K |
| S5517 |
Hit declotting kit |
112 |
70 |
$1K |