| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| Q5103 |
Injection, infliximab-dyyb, biosimilar, (inflectra), 10 mg |
995 |
948 |
$3.58M |
| 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 |
134,357 |
5,781 |
$2.75M |
| 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 |
1,989 |
1,618 |
$1.30M |
| 99601 |
|
7,831 |
3,346 |
$937K |
| 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 |
2,625 |
2,062 |
$907K |
| B4185 |
Parenteral nutrition solution, not otherwise specified, 10 grams lipids |
2,726 |
487 |
$551K |
| B4035 |
Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
1,416 |
1,102 |
$269K |
| 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 |
873 |
547 |
$229K |
| E0465 |
Home ventilator, any type, used with invasive interface, (e.g., tracheostomy tube) |
223 |
179 |
$219K |
| 99602 |
Nursing care in home rn |
1,129 |
988 |
$82K |
| A4606 |
Oxygen probe for use with oximeter device, replacement |
294 |
223 |
$68K |
| 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 |
606 |
39 |
$61K |
| S9359 |
Home infusion therapy, anti-tumor necrosis factor intravenous therapy; (e.g., infliximab); administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem |
1,128 |
1,071 |
$56K |
| E1390 |
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate |
196 |
187 |
$23K |
| 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 |
237 |
129 |
$22K |
| A4605 |
Tracheal suction catheter, closed system, each |
79 |
65 |
$15K |
| B4088 |
Gastrostomy/jejunostomy tube, low-profile, any material, any type, each |
275 |
258 |
$14K |
| E0445 |
Oximeter device for measuring blood oxygen levels non-invasively |
109 |
97 |
$13K |
| A7526 |
Tracheostomy tube collar/holder, each |
224 |
194 |
$12K |
| A4222 |
Infusion supplies for external drug infusion pump, per cassette or bag (list drugs separately) |
65 |
27 |
$11K |
| 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 |
52 |
37 |
$7K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
299 |
282 |
$7K |
| A4624 |
Tracheal suction catheter, any type other than closed system, each |
15 |
12 |
$3K |
| A7000 |
Canister, disposable, used with suction pump, each |
288 |
251 |
$2K |
| A4216 |
Sterile water, saline and/or dextrose, diluent/flush, 10 ml |
158 |
141 |
$2K |
| A4927 |
Gloves, non-sterile, per 100 |
55 |
40 |
$1K |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
148 |
135 |
$470.67 |
| A4217 |
Sterile water/saline, 500 ml |
14 |
12 |
$463.88 |
| A7002 |
Tubing, used with suction pump, each |
92 |
80 |
$320.14 |
| A4628 |
Oral and/or oropharyngeal suction catheter, each |
13 |
12 |
$117.68 |