| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A4222 |
Infusion supplies for external drug infusion pump, per cassette or bag (list drugs separately) |
3,753 |
1,925 |
$784K |
| A4221 |
Supplies for maintenance of non-insulin drug infusion catheter, per week (list drugs separately) |
4,982 |
2,642 |
$141K |
| E0779 |
Ambulatory infusion pump, mechanical, reusable, for infusion 8 hours or greater |
2,038 |
1,052 |
$55K |
| J9190 |
Injection, fluorouracil, 500 mg |
1,412 |
765 |
$37K |
| B4035 |
Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
24 |
18 |
$1K |
| B4088 |
Gastrostomy/jejunostomy tube, low-profile, any material, any type, each |
22 |
16 |
$512.02 |
| 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 |
280 |
191 |
$240.07 |
| J1580 |
Injection, garamycin, gentamicin, up to 80 mg |
16 |
13 |
$195.27 |
| A4216 |
Sterile water, saline and/or dextrose, diluent/flush, 10 ml |
15 |
13 |
$120.46 |
| 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 |
20 |
13 |
$0.00 |