| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| B4105 |
In-line cartridge containing digestive enzyme(s) for enteral feeding, each |
225 |
186 |
$880K |
| B4185 |
Parenteral nutrition solution, not otherwise specified, 10 grams lipids |
1,916 |
464 |
$482K |
| S9500 |
Home infusion therapy, antibiotic, antiviral, or antifungal therapy; once every 24 hours; administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem |
7,039 |
542 |
$327K |
| B4035 |
Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
2,558 |
977 |
$78K |
| A4222 |
Infusion supplies for external drug infusion pump, per cassette or bag (list drugs separately) |
787 |
202 |
$54K |
| 99601 |
|
311 |
94 |
$36K |
| 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 |
507 |
454 |
$25K |
| 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 |
464 |
427 |
$21K |
| B4224 |
Parenteral nutrition administration kit, per day |
255 |
40 |
$19K |
| B4034 |
Enteral feeding supply kit; syringe fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
1,274 |
652 |
$19K |
| S9379 |
Home infusion therapy, infusion therapy, not otherwise classified; administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem |
143 |
37 |
$8K |
| B4220 |
Parenteral nutrition supply kit; premix, per day |
255 |
40 |
$6K |
| A4223 |
Infusion supplies not used with external infusion pump, per cassette or bag (list drugs separately) |
820 |
151 |
$5K |
| A4221 |
Supplies for maintenance of non-insulin drug infusion catheter, per week (list drugs separately) |
662 |
333 |
$3K |
| A4245 |
Alcohol wipes, per box |
440 |
271 |
$545.92 |
| A4216 |
Sterile water, saline and/or dextrose, diluent/flush, 10 ml |
65 |
40 |
$410.55 |
| S1015 |
Iv tubing extension set |
21 |
15 |
$302.92 |
| A5200 |
Percutaneous catheter/tube anchoring device, adhesive skin attachment |
18 |
13 |
$78.80 |