| 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 |
1,420 |
794 |
$93K |
| B9002 |
Enteral nutrition infusion pump, any type |
1,210 |
638 |
$64K |
| 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 |
429 |
209 |
$58K |
| 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 |
1,169 |
487 |
$55K |
| B4034 |
Enteral feeding supply kit; syringe fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
1,136 |
649 |
$34K |
| A4221 |
Supplies for maintenance of non-insulin drug infusion catheter, per week (list drugs separately) |
3,348 |
1,114 |
$30K |
| A4222 |
Infusion supplies for external drug infusion pump, per cassette or bag (list drugs separately) |
345 |
114 |
$12K |
| 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 |
223 |
138 |
$10K |
| E0776 |
Iv pole |
200 |
142 |
$698.20 |
| B4088 |
Gastrostomy/jejunostomy tube, low-profile, any material, any type, each |
60 |
40 |
$666.25 |
| 99601 |
|
203 |
97 |
$0.00 |
| S9123 |
Nursing care, in the home; by registered nurse, per hour (use for general nursing care only, not to be used when cpt codes 99500-99602 can be used) |
71 |
40 |
$0.00 |