| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 90378 |
|
242 |
231 |
$946K |
| 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 |
1,456 |
1,249 |
$666K |
| E0601 |
Continuous positive airway pressure (cpap) device |
3,592 |
3,579 |
$200K |
| E0603 |
Breast pump, electric (ac and/or dc), any type |
725 |
725 |
$128K |
| 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 |
148 |
106 |
$86K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
1,157 |
1,157 |
$83K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
3,487 |
3,483 |
$58K |
| K0553 |
Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service |
145 |
139 |
$34K |
| K0001 |
Standard wheelchair |
1,201 |
1,200 |
$32K |
| A4239 |
Supply allowance for non-adjunctive, non-implanted continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service |
155 |
153 |
$30K |
| 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 |
67 |
27 |
$25K |
| 99601 |
|
211 |
133 |
$19K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
221 |
221 |
$14K |
| A7035 |
Headgear used with positive airway pressure device |
676 |
676 |
$14K |
| 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 |
161 |
69 |
$11K |
| E0990 |
Wheelchair accessory, elevating leg rest, complete assembly, each |
580 |
580 |
$10K |
| S5502 |
Home infusion therapy, catheter care / maintenance, implanted access device, includes administrative services, professional pharmacy services, care coordination and all necessary supplies and equipment, (drugs and nursing visits coded separately), per diem (use this code for interim maintenance of vascular access not currently in use) |
82 |
56 |
$8K |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
104 |
104 |
$5K |
| 99602 |
Nursing care in home rn |
53 |
37 |
$4K |
| E0163 |
Commode chair, mobile or stationary, with fixed arms |
51 |
51 |
$4K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
666 |
652 |
$3K |
| 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 |
17 |
12 |
$3K |
| S9562 |
Home injectable therapy, palivizumab or other monoclonal antibody for rsv, including administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem |
288 |
271 |
$2K |
| A7032 |
Cushion for use on nasal mask interface, replacement only, each |
38 |
37 |
$2K |
| E0247 |
Transfer bench for tub or toilet with or without commode opening |
14 |
14 |
$1K |
| A7031 |
Face mask interface, replacement for full face mask, each |
24 |
24 |
$1K |
| E0114 |
Crutches underarm, other than wood, adjustable or fixed, pair, with pads, tips and handgrips |
13 |
13 |
$437.06 |
| B4035 |
Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
13 |
13 |
$436.96 |
| J0171 |
Injection, adrenalin, epinephrine, 0.1 mg |
29 |
28 |
$235.10 |
| S9542 |
Home injectable therapy, not otherwise classified, including administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem |
19 |
16 |
$184.00 |