| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| B4105 |
In-line cartridge containing digestive enzyme(s) for enteral feeding, each |
1,127 |
619 |
$2.83M |
| 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 |
17,360 |
2,510 |
$2.50M |
| 99601 |
|
10,140 |
3,864 |
$979K |
| S9502 |
Home infusion therapy, antibiotic, antiviral, or antifungal therapy; once every 8 hours, administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem |
5,489 |
752 |
$837K |
| 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 |
16,367 |
1,177 |
$793K |
| A4223 |
Infusion supplies not used with external infusion pump, per cassette or bag (list drugs separately) |
13,005 |
3,577 |
$634K |
| B4185 |
Parenteral nutrition solution, not otherwise specified, 10 grams lipids |
5,431 |
1,094 |
$603K |
| 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 |
2,688 |
391 |
$374K |
| 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 |
6,130 |
2,089 |
$307K |
| S9379 |
Home infusion therapy, infusion therapy, not otherwise classified; administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem |
1,777 |
627 |
$292K |
| B4035 |
Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
7,525 |
1,489 |
$274K |
| S9367 |
Home infusion therapy, total parenteral nutrition (tpn); more than two liters but no more than three liters per day, administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment including standard tpn formula (lipids, specialty amino acid formulas, drugs other than in standard formula and nursing visits coded separately), per diem |
1,292 |
86 |
$232K |
| S9366 |
Home infusion therapy, total parenteral nutrition (tpn); more than one liter but no more than two liters per day, administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment including standard tpn formula (lipids, specialty amino acid formulas, drugs other than in standard formula and nursing visits coded separately), per diem |
1,172 |
88 |
$221K |
| J3490 |
Unclassified drugs |
700 |
84 |
$185K |
| 99602 |
Nursing care in home rn |
2,092 |
934 |
$182K |
| J1335 |
Injection, ertapenem sodium, 500 mg |
325 |
132 |
$178K |
| B4224 |
Parenteral nutrition administration kit, per day |
11,365 |
652 |
$164K |
| J3380 |
Injection, vedolizumab, intravenous, 1 mg |
25 |
24 |
$145K |
| 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 |
1,626 |
772 |
$131K |
| G0299 |
Direct skilled nursing services of a registered nurse (rn) in the home health or hospice setting, each 15 minutes |
1,776 |
703 |
$90K |
| J3370 |
Injection, vancomycin hcl, 500 mg |
768 |
197 |
$76K |
| 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 |
1,170 |
94 |
$62K |
| 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 |
303 |
106 |
$58K |
| A4222 |
Infusion supplies for external drug infusion pump, per cassette or bag (list drugs separately) |
359 |
159 |
$52K |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
531 |
173 |
$51K |
| B4220 |
Parenteral nutrition supply kit; premix, per day |
7,078 |
603 |
$49K |
| A4221 |
Supplies for maintenance of non-insulin drug infusion catheter, per week (list drugs separately) |
2,316 |
1,221 |
$45K |
| 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 |
810 |
289 |
$43K |
| B4034 |
Enteral feeding supply kit; syringe fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
3,510 |
526 |
$43K |
| 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 |
408 |
246 |
$38K |
| 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 |
284 |
51 |
$36K |
| B4088 |
Gastrostomy/jejunostomy tube, low-profile, any material, any type, each |
195 |
129 |
$25K |
| 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 |
202 |
42 |
$16K |
| S9359 |
Home infusion therapy, anti-tumor necrosis factor intravenous therapy; (e.g., infliximab); administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem |
203 |
166 |
$12K |
| A4216 |
Sterile water, saline and/or dextrose, diluent/flush, 10 ml |
310 |
122 |
$11K |
| A4305 |
Disposable drug delivery system, flow rate of 50 ml or greater per hour |
672 |
63 |
$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 |
93 |
12 |
$3K |
| J7030 |
Infusion, normal saline solution , 1000 cc |
186 |
95 |
$2K |
| E0776 |
Iv pole |
16 |
13 |
$908.52 |
| J1642 |
Injection, heparin sodium, (heparin lock flush), per 10 units |
35 |
15 |
$304.50 |
| A4217 |
Sterile water/saline, 500 ml |
19 |
12 |
$45.95 |