| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A4223 |
Infusion supplies w/o pump |
7,265 |
3,376 |
$5.01M |
| J1745 |
Infliximab not biosimil 10mg |
591 |
567 |
$1.66M |
| J3380 |
Inj vedolizumab iv 1 mg |
162 |
148 |
$1.04M |
| A4222 |
Infusion supplies with pump |
4,962 |
2,715 |
$582K |
| B4035 |
Enteral feed supp pump per d |
3,201 |
2,682 |
$521K |
| 99601 |
|
4,426 |
2,277 |
$511K |
| A4221 |
Supp non-insulin inf cath/wk |
11,588 |
6,432 |
$243K |
| B4152 |
Ef calorie dense>/=1.5kcal |
1,382 |
1,147 |
$136K |
| B4150 |
Ef complet w/intact nutrient |
1,278 |
1,119 |
$126K |
| B4034 |
Enter feed supkit syr by day |
1,282 |
933 |
$94K |
| B4185 |
Pn soln nos 10 grams lipids |
352 |
92 |
$75K |
| B4224 |
Parenteral administration ki |
341 |
89 |
$40K |
| B4154 |
Ef spec metabolic noninherit |
74 |
61 |
$22K |
| B4220 |
Parenteral supply kit premix |
394 |
101 |
$15K |
| B4088 |
Gastro/jejuno tube, low-pro |
123 |
120 |
$8K |
| B9002 |
Enter nutr inf pump any type |
83 |
81 |
$7K |
| B4153 |
Ef hydrolyzed/amino acids |
13 |
12 |
$4K |
| E0776 |
Iv pole |
29 |
27 |
$3K |
| J1200 |
Diphenhydramine hcl injectio |
16 |
13 |
$189.64 |
| 99072 |
|
54 |
40 |
$0.00 |