| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 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 |
295 |
121 |
$139K |
| A4223 |
Infusion supplies not used with external infusion pump, per cassette or bag (list drugs separately) |
1,540 |
611 |
$136K |
| 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 |
943 |
549 |
$60K |
| A4221 |
Supplies for maintenance of non-insulin drug infusion catheter, per week (list drugs separately) |
2,249 |
988 |
$44K |
| J1335 |
Injection, ertapenem sodium, 500 mg |
28 |
13 |
$10K |
| B4035 |
Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
76 |
50 |
$8K |
| A4222 |
Infusion supplies for external drug infusion pump, per cassette or bag (list drugs separately) |
38 |
16 |
$6K |
| B4034 |
Enteral feeding supply kit; syringe fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
132 |
80 |
$5K |
| J3370 |
Injection, vancomycin hcl, 500 mg |
41 |
12 |
$2K |
| E0781 |
Ambulatory infusion pump, single or multiple channels, electric or battery operated, with administrative equipment, worn by patient |
166 |
13 |
$1K |
| J9190 |
Injection, fluorouracil, 500 mg |
51 |
26 |
$536.06 |