| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A4221 |
Supplies for maintenance of non-insulin drug infusion catheter, per week (list drugs separately) |
8,521 |
2,190 |
$94K |
| B4035 |
Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
955 |
711 |
$82K |
| 99601 |
|
250 |
81 |
$36K |
| 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 |
533 |
395 |
$29K |
| A4222 |
Infusion supplies for external drug infusion pump, per cassette or bag (list drugs separately) |
270 |
85 |
$19K |
| B9002 |
Enteral nutrition infusion pump, any type |
182 |
164 |
$12K |
| B4034 |
Enteral feeding supply kit; syringe fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
290 |
224 |
$7K |
| 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 |
128 |
104 |
$6K |
| E0776 |
Iv pole |
352 |
308 |
$2K |
| K0552 |
Supplies for external non-insulin drug infusion pump, syringe type cartridge, sterile, each |
497 |
118 |
$981.88 |
| B9998 |
Noc for enteral supplies |
53 |
26 |
$140.40 |