| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 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 |
3,357 |
757 |
$2.97M |
| B4185 |
Parenteral nutrition solution, not otherwise specified, 10 grams lipids |
20,828 |
1,302 |
$1.21M |
| B4224 |
Parenteral nutrition administration kit, per day |
6,804 |
1,438 |
$902K |
| A4305 |
Disposable drug delivery system, flow rate of 50 ml or greater per hour |
2,467 |
975 |
$417K |
| B4220 |
Parenteral nutrition supply kit; premix, per day |
5,923 |
1,439 |
$286K |
| A4222 |
Infusion supplies for external drug infusion pump, per cassette or bag (list drugs separately) |
2,498 |
781 |
$282K |
| B4035 |
Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
2,526 |
1,105 |
$251K |
| 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 |
485 |
347 |
$217K |
| B9998 |
Noc for enteral supplies |
695 |
566 |
$51K |
| B4034 |
Enteral feeding supply kit; syringe fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
1,386 |
353 |
$25K |
| B9004 |
Parenteral nutrition infusion pump, portable |
145 |
138 |
$23K |
| A4216 |
Sterile water, saline and/or dextrose, diluent/flush, 10 ml |
2,571 |
1,500 |
$22K |
| 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 |
45 |
37 |
$5K |
| A4930 |
Gloves, sterile, per pair |
722 |
633 |
$1K |
| A4927 |
Gloves, non-sterile, per 100 |
234 |
199 |
$1K |
| 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 |
12 |
12 |
$1K |
| A6209 |
Foam dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
25 |
12 |
$325.27 |
| A4245 |
Alcohol wipes, per box |
22 |
16 |
$25.88 |