| 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 |
10,153 |
3,436 |
$964K |
| 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 |
5,827 |
4,034 |
$786K |
| 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 |
994 |
594 |
$634K |
| B4035 |
Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
8,487 |
4,460 |
$552K |
| A4223 |
Infusion supplies not used with external infusion pump, per cassette or bag (list drugs separately) |
1,638 |
617 |
$516K |
| 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 |
3,600 |
2,828 |
$375K |
| 99601 |
|
2,399 |
871 |
$331K |
| 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 |
1,364 |
523 |
$226K |
| 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 |
768 |
160 |
$185K |
| B4185 |
Parenteral nutrition solution, not otherwise specified, 10 grams lipids |
559 |
139 |
$165K |
| 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 |
1,424 |
643 |
$129K |
| B4036 |
Enteral feeding supply kit; gravity fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
1,671 |
942 |
$91K |
| 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 |
704 |
391 |
$79K |
| B4088 |
Gastrostomy/jejunostomy tube, low-profile, any material, any type, each |
1,388 |
989 |
$77K |
| S9341 |
Home therapy; enteral nutrition via gravity; administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (enteral formula and nursing visits coded separately), per diem |
1,402 |
357 |
$55K |
| 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 |
1,308 |
855 |
$55K |
| B4034 |
Enteral feeding supply kit; syringe fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
1,518 |
835 |
$54K |
| T1999 |
Miscellaneous therapeutic items and supplies, retail purchases, not otherwise classified; identify product in "remarks" |
3,099 |
626 |
$36K |
| S9330 |
Home infusion therapy, continuous (twenty-four hours or more) chemotherapy infusion; administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem |
332 |
140 |
$32K |
| 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 |
51 |
36 |
$18K |
| 99602 |
Nursing care in home rn |
144 |
84 |
$18K |
| 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 |
43 |
25 |
$12K |
| B9998 |
Noc for enteral supplies |
167 |
124 |
$7K |
| 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 |
31 |
12 |
$3K |
| J9190 |
Injection, fluorouracil, 500 mg |
370 |
140 |
$2K |
| A4213 |
Syringe, sterile, 20 cc or greater, each |
160 |
104 |
$799.81 |
| J7030 |
Infusion, normal saline solution , 1000 cc |
108 |
52 |
$542.52 |
| A4221 |
Supplies for maintenance of non-insulin drug infusion catheter, per week (list drugs separately) |
26 |
12 |
$433.41 |
| B9002 |
Enteral nutrition infusion pump, any type |
38 |
37 |
$394.27 |
| A6402 |
Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
13 |
12 |
$244.86 |
| S1015 |
Iv tubing extension set |
18 |
12 |
$81.00 |
| A4216 |
Sterile water, saline and/or dextrose, diluent/flush, 10 ml |
24 |
12 |
$62.70 |
| A4452 |
Tape, waterproof, per 18 square inches |
35 |
27 |
$60.30 |