| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| B4035 |
Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
45,946 |
38,967 |
$10.22M |
| A4222 |
Infusion supplies for external drug infusion pump, per cassette or bag (list drugs separately) |
9,018 |
3,344 |
$4.41M |
| B9002 |
Enteral nutrition infusion pump, any type |
119,754 |
36,316 |
$3.65M |
| 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 |
9,992 |
8,670 |
$2.90M |
| A4223 |
Infusion supplies not used with external infusion pump, per cassette or bag (list drugs separately) |
13,189 |
5,421 |
$2.22M |
| 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 |
7,992 |
6,837 |
$1.84M |
| B4034 |
Enteral feeding supply kit; syringe fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
10,837 |
9,271 |
$1.79M |
| 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 |
17,502 |
15,101 |
$1.71M |
| B4185 |
Parenteral nutrition solution, not otherwise specified, 10 grams lipids |
9,402 |
2,290 |
$1.31M |
| 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 |
4,315 |
3,582 |
$1.16M |
| A4305 |
Disposable drug delivery system, flow rate of 50 ml or greater per hour |
11,894 |
3,863 |
$841K |
| 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 |
10,547 |
8,688 |
$744K |
| B4100 |
Food thickener, administered orally, per ounce |
7,235 |
6,604 |
$722K |
| B4189 |
Parenteral nutrition solution; compounded amino acid and carbohydrates with electrolytes, trace elements, and vitamins, including preparation, any strength, 10 to 51 grams of protein - premix |
2,524 |
647 |
$689K |
| A4221 |
Supplies for maintenance of non-insulin drug infusion catheter, per week (list drugs separately) |
16,586 |
6,704 |
$689K |
| E0781 |
Ambulatory infusion pump, single or multiple channels, electric or battery operated, with administrative equipment, worn by patient |
7,435 |
3,097 |
$525K |
| B4088 |
Gastrostomy/jejunostomy tube, low-profile, any material, any type, each |
8,767 |
8,205 |
$505K |
| 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 |
5,289 |
4,318 |
$434K |
| S5520 |
Home infusion therapy, all supplies (including catheter) necessary for a peripherally inserted central venous catheter (picc) line insertion |
16,905 |
7,778 |
$258K |
| B4197 |
Parenteral nutrition solution; compounded amino acid and carbohydrates with electrolytes, trace elements and vitamins, including preparation, any strength, 74 to 100 grams of protein - premix |
635 |
158 |
$221K |
| B4162 |
Enteral formula, for pediatrics, special metabolic needs for inherited disease of metabolism, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit |
815 |
471 |
$211K |
| 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 |
1,708 |
1,332 |
$201K |
| 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 |
3,896 |
3,089 |
$181K |
| B4036 |
Enteral feeding supply kit; gravity fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
1,291 |
1,157 |
$156K |
| 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 |
1,489 |
1,378 |
$94K |
| B4224 |
Parenteral nutrition administration kit, per day |
9,204 |
2,122 |
$70K |
| B4216 |
Parenteral nutrition; additives (vitamins, trace elements, heparin, electrolytes), home mix, per day |
971 |
464 |
$58K |
| E0776 |
Iv pole |
2,087 |
1,923 |
$49K |
| A4216 |
Sterile water, saline and/or dextrose, diluent/flush, 10 ml |
291 |
166 |
$46K |
| J1559 |
Injection, immune globulin (hizentra), 100 mg |
30 |
12 |
$46K |
| B4220 |
Parenteral nutrition supply kit; premix, per day |
9,174 |
2,109 |
$45K |
| J7030 |
Infusion, normal saline solution , 1000 cc |
1,272 |
578 |
$41K |
| J1955 |
Injection, levocarnitine, per 1 gm |
3,413 |
766 |
$36K |
| J3490 |
Unclassified drugs |
1,654 |
503 |
$26K |
| B4199 |
Parenteral nutrition solution; compounded amino acid and carbohydrates with electrolytes, trace elements and vitamins, including preparation, any strength, over 100 grams of protein - premix |
45 |
12 |
$22K |
| B9998 |
Noc for enteral supplies |
1,312 |
1,109 |
$17K |
| J2997 |
Injection, alteplase recombinant, 1 mg |
116 |
65 |
$11K |
| S9435 |
Medical foods for inborn errors of metabolism |
12 |
12 |
$7K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
56 |
52 |
$4K |
| 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 |
101 |
98 |
$2K |
| E0779 |
Ambulatory infusion pump, mechanical, reusable, for infusion 8 hours or greater |
273 |
134 |
$2K |
| J3411 |
Injection, thiamine hcl, 100 mg |
22 |
12 |
$435.34 |
| K0552 |
Supplies for external non-insulin drug infusion pump, syringe type cartridge, sterile, each |
94 |
50 |
$390.63 |
| B4081 |
Nasogastric tubing with stylet |
180 |
163 |
$364.74 |
| J7120 |
Ringers lactate infusion, up to 1000 cc |
58 |
25 |
$297.30 |
| 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 |
12 |
12 |
$241.21 |
| 90686 |
|
12 |
12 |
$0.00 |
| J3475 |
Injection, magnesium sulfate, per 500 mg |
42 |
14 |
$0.00 |