| 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 |
37,945 |
4,480 |
$1.97M |
| 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 |
1,545 |
1,424 |
$923K |
| 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 |
1,560 |
1,413 |
$833K |
| J1561 |
Injection, immune globulin, (gamunex-c/gammaked), non-lyophilized (e.g., liquid), 500 mg |
98 |
76 |
$703K |
| J1569 |
Injection, immune globulin, (gammagard liquid), non-lyophilized, (e.g., liquid), 500 mg |
164 |
111 |
$612K |
| 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 |
3,121 |
2,834 |
$369K |
| 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 |
1,941 |
1,786 |
$369K |
| 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 |
1,195 |
1,097 |
$339K |
| B4035 |
Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
4,039 |
3,685 |
$336K |
| 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 |
2,668 |
2,438 |
$311K |
| 99602 |
Nursing care in home rn |
1,681 |
967 |
$288K |
| B4088 |
Gastrostomy/jejunostomy tube, low-profile, any material, any type, each |
1,705 |
1,677 |
$239K |
| 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 |
2,738 |
550 |
$184K |
| 99601 |
|
1,939 |
1,114 |
$168K |
| 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 |
674 |
607 |
$129K |
| S9338 |
Home infusion therapy, immunotherapy, administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem |
1,422 |
917 |
$92K |
| B4034 |
Enteral feeding supply kit; syringe fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
2,037 |
1,914 |
$83K |
| 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 |
598 |
559 |
$27K |
| B4036 |
Enteral feeding supply kit; gravity fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
192 |
177 |
$11K |
| B9002 |
Enteral nutrition infusion pump, any type |
434 |
423 |
$7K |
| A4216 |
Sterile water, saline and/or dextrose, diluent/flush, 10 ml |
252 |
187 |
$607.15 |
| B4087 |
Gastrostomy/jejunostomy tube, standard, any material, any type, each |
50 |
50 |
$297.00 |
| J7030 |
Infusion, normal saline solution , 1000 cc |
78 |
49 |
$241.27 |
| J7050 |
Infusion, normal saline solution, 250 cc |
16 |
12 |
$30.13 |