| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| J0135 |
Adalimumab injection |
109 |
104 |
$388K |
| A4215 |
Sterile needle |
4,280 |
4,025 |
$266K |
| J3590 |
Unclassified biologics |
315 |
303 |
$147K |
| B4035 |
Enteral feed supp pump per d |
948 |
797 |
$92K |
| B4088 |
Gastro/jejuno tube, low-pro |
384 |
311 |
$53K |
| B9998 |
Enteral supp not otherwise c |
970 |
763 |
$53K |
| J3490 |
Drugs unclassified injection |
27 |
24 |
$11K |
| B4160 |
Ef ped caloric dense>/=0.7kc |
36 |
25 |
$10K |
| S9342 |
Hit enteral pump diem |
35 |
29 |
$8K |
| B9002 |
Enter nutr inf pump any type |
49 |
37 |
$5K |
| 99213 |
|
125 |
117 |
$2K |
| 90686 |
|
46 |
46 |
$2K |
| 90715 |
|
14 |
14 |
$777.02 |
| A4657 |
Syringe w/wo needle |
123 |
36 |
$424.03 |
| A4209 |
5+ cc sterile syringe&needle |
62 |
40 |
$332.88 |
| A6402 |
Sterile gauze <= 16 sq in |
92 |
51 |
$313.08 |
| A6258 |
Transparent film >16<=48 in |
22 |
15 |
$126.01 |
| 0250 |
|
50 |
38 |
$76.69 |
| A0429 |
Bls-emergency |
365 |
351 |
$0.00 |
| 0760 |
|
92 |
87 |
$0.00 |
| 0515 |
|
266 |
263 |
$0.00 |