| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A4211 |
Supplies for self-administered injections |
8,936 |
3,251 |
$1.29M |
| 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 |
9,378 |
6,084 |
$1.02M |
| B4035 |
Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
7,105 |
4,459 |
$952K |
| B4224 |
Parenteral nutrition administration kit, per day |
5,813 |
1,736 |
$567K |
| B4220 |
Parenteral nutrition supply kit; premix, per day |
17,116 |
6,188 |
$519K |
| 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 |
1,866 |
963 |
$406K |
| 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 |
958 |
723 |
$376K |
| 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 |
4,406 |
2,953 |
$372K |
| A4305 |
Disposable drug delivery system, flow rate of 50 ml or greater per hour |
5,957 |
2,110 |
$299K |
| B4154 |
Enteral formula, nutritionally complete, for special metabolic needs, excludes inherited disease of metabolism, includes altered composition of proteins, fats, carbohydrates, vitamins and/or minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit |
1,351 |
978 |
$291K |
| A4222 |
Infusion supplies for external drug infusion pump, per cassette or bag (list drugs separately) |
2,310 |
898 |
$287K |
| A4306 |
Disposable drug delivery system, flow rate of less than 50 ml per hour |
1,863 |
671 |
$183K |
| B4034 |
Enteral feeding supply kit; syringe fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
2,052 |
1,508 |
$168K |
| B4036 |
Enteral feeding supply kit; gravity fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
1,248 |
728 |
$101K |
| 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 |
1,205 |
970 |
$100K |
| B9998 |
Noc for enteral supplies |
1,835 |
1,423 |
$84K |
| B9002 |
Enteral nutrition infusion pump, any type |
1,275 |
1,158 |
$82K |
| 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 |
156 |
91 |
$71K |
| B4088 |
Gastrostomy/jejunostomy tube, low-profile, any material, any type, each |
619 |
496 |
$69K |
| B9004 |
Parenteral nutrition infusion pump, portable |
277 |
268 |
$57K |
| E0781 |
Ambulatory infusion pump, single or multiple channels, electric or battery operated, with administrative equipment, worn by patient |
211 |
203 |
$44K |
| E0776 |
Iv pole |
479 |
411 |
$34K |
| A4221 |
Supplies for maintenance of non-insulin drug infusion catheter, per week (list drugs separately) |
447 |
341 |
$21K |
| 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 |
16 |
12 |
$4K |
| A9901 |
Dme delivery, set up, and/or dispensing service component of another hcpcs code |
178 |
130 |
$2K |