| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| B4035 |
Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
6,814 |
5,171 |
$1.11M |
| 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 |
1,740 |
1,267 |
$958K |
| B4224 |
Parenteral nutrition administration kit, per day |
8,684 |
2,016 |
$877K |
| 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 |
1,497 |
1,173 |
$462K |
| B4220 |
Parenteral nutrition supply kit; premix, per day |
8,402 |
2,009 |
$266K |
| A4222 |
Infusion supplies for external drug infusion pump, per cassette or bag (list drugs separately) |
2,265 |
876 |
$206K |
| A4221 |
Supplies for maintenance of non-insulin drug infusion catheter, per week (list drugs separately) |
7,034 |
2,987 |
$157K |
| B4088 |
Gastrostomy/jejunostomy tube, low-profile, any material, any type, each |
1,712 |
1,276 |
$147K |
| 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 |
1,879 |
1,047 |
$131K |
| A4211 |
Supplies for self-administered injections |
11,214 |
2,751 |
$107K |
| 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 |
248 |
198 |
$59K |
| B4034 |
Enteral feeding supply kit; syringe fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
431 |
305 |
$24K |
| E0781 |
Ambulatory infusion pump, single or multiple channels, electric or battery operated, with administrative equipment, worn by patient |
111 |
73 |
$21K |
| 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 |
311 |
183 |
$16K |
| B9998 |
Noc for enteral supplies |
746 |
421 |
$12K |
| 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 |
21 |
12 |
$6K |
| B4158 |
Enteral formula, for pediatrics, nutritionally complete with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber and/or iron, administered through an enteral feeding tube, 100 calories = 1 unit |
20 |
12 |
$4K |
| A4305 |
Disposable drug delivery system, flow rate of 50 ml or greater per hour |
31 |
13 |
$1K |
| A9901 |
Dme delivery, set up, and/or dispensing service component of another hcpcs code |
132 |
93 |
$574.27 |