| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| B4035 |
Enteral feed supp pump per d |
26,708 |
3,297 |
$784K |
| B4161 |
Ef ped hydrolyzed/amino acid |
2,528 |
1,185 |
$630K |
| B9998 |
Enteral supp not otherwise c |
3,029 |
2,487 |
$529K |
| A4222 |
Infusion supplies with pump |
1,255 |
421 |
$278K |
| B4160 |
Ef ped caloric dense>/=0.7kc |
1,931 |
958 |
$235K |
| B9002 |
Enter nutr inf pump any type |
934 |
910 |
$184K |
| S9342 |
Hit enteral pump diem |
2,550 |
742 |
$167K |
| S9500 |
Hit antibiotic q24h diem |
1,343 |
236 |
$105K |
| 99601 |
|
2,547 |
928 |
$100K |
| B4152 |
Ef calorie dense>/=1.5kcal |
2,503 |
422 |
$98K |
| B4088 |
Gastro/jejuno tube, low-pro |
1,183 |
1,011 |
$81K |
| A4221 |
Supp non-insulin inf cath/wk |
3,897 |
1,240 |
$80K |
| A4245 |
Alcohol wipes per box |
800 |
337 |
$65K |
| A4305 |
Drug delivery system >=50 ml |
383 |
154 |
$61K |
| B4034 |
Enter feed supkit syr by day |
3,344 |
365 |
$49K |
| A4213 |
20+ cc syringe only |
2,678 |
2,207 |
$35K |
| A4657 |
Syringe w/wo needle |
2,386 |
1,673 |
$26K |
| A4216 |
Sterile water/saline, 10 ml |
2,006 |
772 |
$23K |
| B4150 |
Ef complet w/intact nutrient |
93 |
39 |
$11K |
| J1642 |
Inj heparin sodium per 10 u |
1,395 |
423 |
$9K |
| A4217 |
Sterile water/saline, 500 ml |
1,046 |
439 |
$8K |
| A4452 |
Waterproof tape |
696 |
591 |
$5K |
| A4333 |
Urinary cath anchor device |
562 |
480 |
$4K |
| A4649 |
Surgical supplies |
126 |
114 |
$3K |
| J0696 |
Ceftriaxone sodium injection |
179 |
25 |
$2K |
| A6402 |
Sterile gauze <= 16 sq in |
106 |
102 |
$722.46 |
| B4155 |
Ef incomplete/modular |
14 |
12 |
$404.57 |
| A4927 |
Non-sterile gloves |
46 |
43 |
$289.36 |