| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| J3590 |
Unclassified biologics |
1,177 |
1,078 |
$3.85M |
| J3490 |
Unclassified drugs |
8,292 |
1,949 |
$3.11M |
| 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 |
8,373 |
7,042 |
$2.61M |
| 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 |
2,795 |
2,269 |
$1.67M |
| J0585 |
Injection, onabotulinumtoxina, 1 unit |
1,333 |
1,292 |
$1.57M |
| 99601 |
|
9,938 |
3,991 |
$1.20M |
| 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 |
2,366 |
642 |
$750K |
| 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 |
1,451 |
1,248 |
$577K |
| S9341 |
Home therapy; enteral nutrition via gravity; administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (enteral formula and nursing visits coded separately), per diem |
1,689 |
1,485 |
$522K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
5,196 |
4,811 |
$517K |
| B9998 |
Noc for enteral supplies |
3,112 |
2,200 |
$512K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
4,996 |
4,669 |
$446K |
| 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 |
7,192 |
4,609 |
$409K |
| 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 |
1,991 |
1,651 |
$334K |
| B4035 |
Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
2,398 |
1,616 |
$294K |
| 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 |
3,514 |
982 |
$261K |
| S9494 |
Home infusion therapy, antibiotic, antiviral, or antifungal therapy; administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem (do not use this code with home infusion codes for hourly dosing schedules s9497-s9504) |
502 |
139 |
$240K |
| T4541 |
Incontinence product, disposable underpad, large, each |
14,474 |
13,261 |
$226K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
2,398 |
2,205 |
$226K |
| 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 |
1,727 |
1,265 |
$209K |
| T4522 |
Adult sized disposable incontinence product, brief/diaper, medium, each |
2,023 |
1,847 |
$180K |
| S9343 |
Home therapy; enteral nutrition via bolus; administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (enteral formula and nursing visits coded separately), per diem |
663 |
570 |
$170K |
| B4088 |
Gastrostomy/jejunostomy tube, low-profile, any material, any type, each |
1,331 |
1,256 |
$161K |
| T4523 |
Adult sized disposable incontinence product, brief/diaper, large, each |
1,885 |
1,702 |
$161K |
| B4081 |
Nasogastric tubing with stylet |
2,871 |
2,423 |
$159K |
| A4927 |
Gloves, non-sterile, per 100 |
12,518 |
11,241 |
$146K |
| 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 |
1,506 |
1,005 |
$128K |
| B4036 |
Enteral feeding supply kit; gravity fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
5,566 |
3,311 |
$127K |
| T4534 |
Youth sized disposable incontinence product, protective underwear/pull-on, each |
1,413 |
1,203 |
$121K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
2,480 |
2,289 |
$118K |
| J7300 |
Intrauterine copper contraceptive (paragard) |
116 |
116 |
$96K |
| T4525 |
Adult sized disposable incontinence product, protective underwear/pull-on, small size, each |
1,027 |
953 |
$95K |
| J7307 |
Etonogestrel (contraceptive) implant system, including implant and supplies |
81 |
81 |
$89K |
| T4524 |
Adult sized disposable incontinence product, brief/diaper, extra large, each |
939 |
835 |
$85K |
| 99602 |
Nursing care in home rn |
780 |
459 |
$66K |
| A9270 |
Non-covered item or service |
3,919 |
3,568 |
$59K |
| 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 |
1,111 |
882 |
$49K |
| J1729 |
Injection, hydroxyprogesterone caproate, not otherwise specified, 10 mg |
15 |
12 |
$37K |
| T4521 |
Adult sized disposable incontinence product, brief/diaper, small, each |
395 |
341 |
$35K |
| A9901 |
Dme delivery, set up, and/or dispensing service component of another hcpcs code |
413 |
366 |
$34K |
| T4530 |
Pediatric sized disposable incontinence product, brief/diaper, large size, each |
178 |
149 |
$17K |
| A9276 |
Sensor; invasive (e.g., subcutaneous), disposable, for use with non-durable medical equipment interstitial continuous glucose monitoring system, one unit = 1 day supply |
27 |
27 |
$11K |
| A9274 |
External ambulatory insulin delivery system, disposable, each, includes all supplies and accessories |
14 |
14 |
$10K |
| B4034 |
Enteral feeding supply kit; syringe fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
165 |
120 |
$7K |
| B9002 |
Enteral nutrition infusion pump, any type |
103 |
100 |
$7K |
| A4335 |
Incontinence supply; miscellaneous |
3,322 |
2,842 |
$4K |
| A4649 |
Surgical supply; miscellaneous |
301 |
45 |
$2K |
| T4532 |
Pediatric sized disposable incontinence product, protective underwear/pull-on, large size, each |
12 |
12 |
$1K |
| J1642 |
Injection, heparin sodium, (heparin lock flush), per 10 units |
34 |
12 |
$1K |
| E1399 |
Durable medical equipment, miscellaneous |
38 |
27 |
$1K |
| A4520 |
Incontinence garment, any type, (e.g., brief, diaper), each |
80 |
71 |
$930.62 |
| S9562 |
Home injectable therapy, palivizumab or other monoclonal antibody for rsv, including administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem |
70 |
64 |
$914.00 |
| A4216 |
Sterile water, saline and/or dextrose, diluent/flush, 10 ml |
68 |
25 |
$749.18 |
| A6216 |
Gauze, non-impregnated, non-sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
52 |
47 |
$580.80 |
| A4554 |
Disposable underpads, all sizes |
118 |
101 |
$579.00 |
| E0776 |
Iv pole |
275 |
223 |
$453.42 |
| A4213 |
Syringe, sterile, 20 cc or greater, each |
17 |
14 |
$169.60 |
| A4657 |
Syringe, with or without needle, each |
54 |
44 |
$165.85 |
| A6457 |
Tubular dressing with or without elastic, any width, per linear yard |
21 |
14 |
$34.46 |
| S9999 |
Sales tax |
770 |
541 |
$14.71 |