| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 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 |
689 |
485 |
$172K |
| 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 |
438 |
414 |
$152K |
| E1390 |
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate |
957 |
946 |
$87K |
| 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 |
642 |
596 |
$52K |
| E0601 |
Continuous positive airway pressure (cpap) device |
899 |
897 |
$44K |
| 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 |
193 |
71 |
$44K |
| 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 |
132 |
116 |
$43K |
| E0603 |
Breast pump, electric (ac and/or dc), any type |
175 |
175 |
$37K |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
227 |
221 |
$36K |
| B4088 |
Gastrostomy/jejunostomy tube, low-profile, any material, any type, each |
264 |
226 |
$35K |
| H0035 |
Mental health partial hospitalization, treatment, less than 24 hours |
118 |
17 |
$34K |
| A7030 |
Full face mask used with positive airway pressure device, each |
328 |
326 |
$33K |
| 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 |
274 |
252 |
$33K |
| E0465 |
Home ventilator, any type, used with invasive interface, (e.g., tracheostomy tube) |
65 |
65 |
$28K |
| S9374 |
Home infusion therapy, hydration therapy; one liter per day, administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem |
184 |
43 |
$27K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
430 |
427 |
$26K |
| E0570 |
Nebulizer, with compressor |
322 |
322 |
$25K |
| E0471 |
Respiratory assist device, bi-level pressure capability, with back-up rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device) |
112 |
110 |
$24K |
| 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 |
203 |
188 |
$22K |
| 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 |
103 |
80 |
$22K |
| 87631 |
|
196 |
191 |
$22K |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
120 |
114 |
$22K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
125 |
111 |
$20K |
| E0470 |
Respiratory assist device, bi-level pressure capability, without backup rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device) |
176 |
174 |
$18K |
| K0738 |
Portable gaseous oxygen system, rental; home compressor used to fill portable oxygen cylinders; includes portable containers, regulator, flowmeter, humidifier, cannula or mask, and tubing |
678 |
675 |
$18K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
544 |
541 |
$18K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
242 |
241 |
$16K |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
217 |
217 |
$15K |
| 86803 |
|
83 |
83 |
$9K |
| 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 |
28 |
26 |
$9K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
428 |
425 |
$9K |
| 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 |
88 |
66 |
$9K |
| 96413 |
Chemotherapy administration, intravenous infusion; up to 1 hour, single or initial substance |
25 |
15 |
$8K |
| 83655 |
|
422 |
418 |
$8K |
| A7035 |
Headgear used with positive airway pressure device |
401 |
399 |
$8K |
| A7037 |
Tubing used with positive airway pressure device |
361 |
361 |
$8K |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
208 |
205 |
$8K |
| S9501 |
Home infusion therapy, antibiotic, antiviral, or antifungal therapy; once every 12 hours; administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem |
26 |
12 |
$7K |
| B4158 |
Enteral formula, for pediatrics, nutritionally complete with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber and/or iron, administered through an enteral feeding tube, 100 calories = 1 unit |
36 |
32 |
$7K |
| T4530 |
Pediatric sized disposable incontinence product, brief/diaper, large size, each |
64 |
60 |
$7K |
| 86780 |
|
94 |
94 |
$7K |
| T4541 |
Incontinence product, disposable underpad, large, each |
135 |
133 |
$7K |
| 86140 |
|
129 |
123 |
$7K |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
69 |
18 |
$7K |
| T4523 |
Adult sized disposable incontinence product, brief/diaper, large, each |
48 |
47 |
$6K |
| A7005 |
Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable |
271 |
270 |
$6K |
| 92507 |
Treatment of speech, language, voice, communication, and/or auditory processing disorder |
46 |
17 |
$6K |
| A4624 |
Tracheal suction catheter, any type other than closed system, each |
84 |
75 |
$6K |
| 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 |
92 |
85 |
$5K |
| 99601 |
|
62 |
34 |
$5K |
| A7031 |
Face mask interface, replacement for full face mask, each |
179 |
145 |
$5K |
| T4521 |
Adult sized disposable incontinence product, brief/diaper, small, each |
49 |
47 |
$5K |
| 83516 |
|
74 |
73 |
$4K |
| 86003 |
|
60 |
54 |
$4K |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
114 |
114 |
$4K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
182 |
180 |
$4K |
| 84443 |
Thyroid stimulating hormone (TSH) |
373 |
367 |
$4K |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
22 |
22 |
$4K |
| T4522 |
Adult sized disposable incontinence product, brief/diaper, medium, each |
34 |
29 |
$4K |
| A7032 |
Cushion for use on nasal mask interface, replacement only, each |
83 |
83 |
$4K |
| 83718 |
|
123 |
123 |
$4K |
| 87081 |
|
522 |
508 |
$4K |
| 84439 |
|
247 |
243 |
$4K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
533 |
505 |
$4K |
| B4035 |
Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
80 |
76 |
$4K |
| A7520 |
Tracheostomy/laryngectomy tube, non-cuffed, polyvinylchloride (pvc), silicone or equal, each |
78 |
64 |
$3K |
| 83550 |
|
95 |
95 |
$3K |
| G0378 |
Hospital observation service, per hour |
20 |
17 |
$3K |
| 82728 |
|
131 |
129 |
$3K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
588 |
576 |
$3K |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
262 |
261 |
$3K |
| 87480 |
|
53 |
53 |
$3K |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
46 |
42 |
$3K |
| 76770 |
|
12 |
12 |
$3K |
| 80061 |
Lipid panel |
247 |
245 |
$2K |
| A7526 |
Tracheostomy tube collar/holder, each |
87 |
81 |
$2K |
| A4629 |
Tracheostomy care kit for established tracheostomy |
55 |
49 |
$2K |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
315 |
295 |
$2K |
| K0003 |
Lightweight wheelchair |
33 |
31 |
$2K |
| A7033 |
Pillow for use on nasal cannula type interface, replacement only, pair |
73 |
73 |
$2K |
| A4217 |
Sterile water/saline, 500 ml |
92 |
74 |
$2K |
| 87340 |
|
48 |
48 |
$2K |
| A4628 |
Oral and/or oropharyngeal suction catheter, each |
209 |
173 |
$2K |
| 82784 |
|
68 |
67 |
$2K |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
12 |
12 |
$2K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
114 |
114 |
$2K |
| 85027 |
|
252 |
240 |
$2K |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
19 |
18 |
$2K |
| 86618 |
|
15 |
15 |
$2K |
| 88175 |
Cytopathology, cervical or vaginal, any reporting system; collected in preservative fluid, automated thin layer |
79 |
79 |
$2K |
| 80053 |
Comprehensive metabolic panel |
208 |
202 |
$2K |
| 83540 |
|
106 |
106 |
$1K |
| 71046 |
Radiologic examination, chest; 2 views |
52 |
51 |
$1K |
| 82465 |
|
122 |
122 |
$1K |
| S9490 |
Home infusion therapy, corticosteroid infusion; administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem |
12 |
12 |
$1K |
| 86664 |
|
13 |
13 |
$1K |
| E0600 |
Respiratory suction pump, home model, portable or stationary, electric |
59 |
58 |
$1K |
| B4034 |
Enteral feeding supply kit; syringe fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
48 |
45 |
$1K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
15 |
14 |
$1K |
| A4927 |
Gloves, non-sterile, per 100 |
156 |
113 |
$1K |
| A6402 |
Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
81 |
71 |
$1K |
| 82607 |
|
99 |
99 |
$1K |
| E0445 |
Oximeter device for measuring blood oxygen levels non-invasively |
13 |
13 |
$1K |
| 87147 |
|
180 |
180 |
$1K |
| 86317 |
|
16 |
16 |
$1K |
| 82947 |
|
135 |
131 |
$1K |
| 82785 |
|
32 |
31 |
$1K |
| 81001 |
|
282 |
269 |
$1K |
| 80050 |
General health panel |
113 |
113 |
$978.10 |
| A7000 |
Canister, disposable, used with suction pump, each |
215 |
200 |
$974.91 |
| 80051 |
|
110 |
92 |
$973.66 |
| K0001 |
Standard wheelchair |
25 |
25 |
$953.87 |
| 87624 |
Infectious agent detection by nucleic acid; human papillomavirus (HPV), high-risk types |
48 |
48 |
$855.99 |
| 80048 |
Basic metabolic panel (calcium, ionized) |
109 |
107 |
$855.00 |
| 84450 |
|
124 |
121 |
$844.30 |
| 87510 |
|
53 |
53 |
$832.70 |
| 84460 |
|
137 |
134 |
$732.70 |
| 86665 |
|
13 |
13 |
$717.70 |
| 86850 |
|
12 |
12 |
$699.50 |
| 82565 |
|
157 |
139 |
$662.38 |
| 82570 |
|
82 |
80 |
$647.74 |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
48 |
47 |
$636.96 |
| 87186 |
|
97 |
94 |
$635.52 |
| 82746 |
|
23 |
23 |
$626.11 |
| 85652 |
|
141 |
136 |
$617.04 |
| 80076 |
|
72 |
70 |
$601.10 |
| 84520 |
|
121 |
104 |
$566.20 |
| 87660 |
|
53 |
53 |
$558.22 |
| 87088 |
|
119 |
113 |
$531.08 |
| A7002 |
Tubing, used with suction pump, each |
235 |
200 |
$471.05 |
| 85018 |
|
66 |
66 |
$447.76 |
| 87205 |
|
56 |
55 |
$397.45 |
| 87077 |
|
104 |
101 |
$373.68 |
| 84153 |
|
12 |
12 |
$352.12 |
| 84146 |
|
13 |
13 |
$299.82 |
| 87070 |
|
65 |
64 |
$290.60 |
| 82248 |
|
42 |
41 |
$280.57 |
| A7012 |
Water collection device, used with large volume nebulizer |
50 |
49 |
$277.84 |
| 83721 |
|
17 |
17 |
$261.83 |
| A7015 |
Aerosol mask, used with dme nebulizer |
192 |
187 |
$259.73 |
| 84156 |
|
28 |
26 |
$245.98 |
| A7010 |
Corrugated tubing, disposable, used with large volume nebulizer, 100 feet |
12 |
12 |
$238.88 |
| 84403 |
|
15 |
15 |
$222.60 |
| 83735 |
|
30 |
29 |
$218.69 |
| 82040 |
|
15 |
15 |
$216.66 |
| 84702 |
|
15 |
13 |
$213.22 |
| 82043 |
|
53 |
53 |
$189.49 |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
106 |
106 |
$170.50 |
| 83690 |
|
12 |
12 |
$163.90 |
| 80069 |
|
15 |
15 |
$130.48 |
| 84100 |
|
12 |
12 |
$112.61 |
| A7036 |
Chinstrap used with positive airway pressure device |
13 |
13 |
$107.09 |
| 87206 |
|
16 |
16 |
$96.85 |
| 81025 |
|
14 |
13 |
$89.04 |
| 86900 |
|
12 |
12 |
$67.86 |
| A7525 |
Tracheostomy mask, each |
56 |
54 |
$65.43 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
50 |
50 |
$56.24 |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
40 |
39 |
$56.24 |
| 85610 |
|
17 |
14 |
$55.90 |
| A7013 |
Filter, disposable, used with aerosol compressor or ultrasonic generator |
73 |
72 |
$50.58 |
| 85045 |
|
13 |
12 |
$45.64 |
| 86901 |
|
12 |
12 |
$37.06 |
| 82247 |
|
41 |
34 |
$16.14 |
| 96375 |
Therapeutic injection; each additional sequential IV push |
17 |
13 |
$0.00 |
| 36415 |
Collection of venous blood by venipuncture |
1,336 |
1,264 |
$0.00 |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
19 |
18 |
$0.00 |
| 36416 |
|
215 |
209 |
$0.00 |
| J2704 |
Injection, propofol, 10 mg |
33 |
33 |
$0.00 |
| J0690 |
Injection, cefazolin sodium, 500 mg |
17 |
13 |
$0.00 |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
20 |
20 |
$0.00 |
| 82962 |
|
18 |
14 |
$0.00 |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
20 |
20 |
$0.00 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
22 |
20 |
$0.00 |
| J1170 |
Injection, hydromorphone, up to 4 mg |
22 |
12 |
$0.00 |
| 84075 |
|
15 |
14 |
$0.00 |