| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| B4161 |
Enteral formula, for pediatrics, hydrolyzed/amino acids and peptide chain proteins, includes fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit |
7,103 |
2,647 |
$2.75M |
| A4223 |
Infusion supplies not used with external infusion pump, per cassette or bag (list drugs separately) |
5,399 |
2,015 |
$2.11M |
| B4035 |
Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
106,067 |
7,267 |
$1.75M |
| S9342 |
Home therapy; enteral nutrition via pump; administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (enteral formula and nursing visits coded separately), per diem |
3,482 |
2,182 |
$1.18M |
| B4160 |
Enteral formula, for pediatrics, nutritionally complete calorically dense (equal to or greater than 0.7 kcal/ml) with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit |
4,305 |
1,681 |
$615K |
| A4222 |
Infusion supplies for external drug infusion pump, per cassette or bag (list drugs separately) |
3,021 |
863 |
$552K |
| B4034 |
Enteral feeding supply kit; syringe fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
29,055 |
3,026 |
$540K |
| B4152 |
Enteral formula, nutritionally complete, calorically dense (equal to or greater than 1.5 kcal/ml) with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit |
6,279 |
3,516 |
$465K |
| B4150 |
Enteral formula, nutritionally complete with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit |
3,701 |
1,689 |
$224K |
| A4221 |
Supplies for maintenance of non-insulin drug infusion catheter, per week (list drugs separately) |
10,782 |
4,341 |
$211K |
| B4153 |
Enteral formula, nutritionally complete, hydrolyzed proteins (amino acids and peptide chain), includes fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit |
1,373 |
383 |
$203K |
| B4149 |
Enteral formula, manufactured blenderized natural foods with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit |
3,191 |
559 |
$188K |
| A4305 |
Disposable drug delivery system, flow rate of 50 ml or greater per hour |
1,172 |
320 |
$170K |
| B4088 |
Gastrostomy/jejunostomy tube, low-profile, any material, any type, each |
2,892 |
2,350 |
$166K |
| B4185 |
Parenteral nutrition solution, not otherwise specified, 10 grams lipids |
743 |
127 |
$86K |
| B4155 |
Enteral formula, nutritionally incomplete/modular nutrients, includes specific nutrients, carbohydrates (e.g., glucose polymers), proteins/amino acids (e.g., glutamine, arginine), fat (e.g., medium chain triglycerides) or combination, administered through an enteral feeding tube, 100 calories = 1 unit |
2,255 |
1,389 |
$53K |
| S9343 |
Home therapy; enteral nutrition via bolus; administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (enteral formula and nursing visits coded separately), per diem |
256 |
173 |
$33K |
| J7030 |
Infusion, normal saline solution , 1000 cc |
5,603 |
755 |
$29K |
| B4036 |
Enteral feeding supply kit; gravity fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
927 |
97 |
$16K |
| B9002 |
Enteral nutrition infusion pump, any type |
369 |
171 |
$5K |
| 99601 |
|
25 |
15 |
$2K |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
173 |
12 |
$2K |
| E0776 |
Iv pole |
506 |
216 |
$686.45 |