| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 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 |
3,349 |
2,461 |
$2.66M |
| B4035 |
Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
13,762 |
7,438 |
$1.37M |
| 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 |
4,320 |
3,411 |
$1.13M |
| B9998 |
Noc for enteral supplies |
7,478 |
6,000 |
$666K |
| 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 |
2,083 |
1,533 |
$645K |
| A4223 |
Infusion supplies not used with external infusion pump, per cassette or bag (list drugs separately) |
7,934 |
2,176 |
$617K |
| 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 |
1,750 |
1,163 |
$587K |
| 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 |
1,222 |
791 |
$512K |
| 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 |
2,017 |
1,104 |
$474K |
| 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 |
4,826 |
3,589 |
$449K |
| 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 |
4,356 |
2,963 |
$344K |
| B4034 |
Enteral feeding supply kit; syringe fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
5,479 |
3,376 |
$237K |
| B9002 |
Enteral nutrition infusion pump, any type |
2,116 |
1,615 |
$120K |
| A4221 |
Supplies for maintenance of non-insulin drug infusion catheter, per week (list drugs separately) |
10,611 |
3,357 |
$93K |
| B4185 |
Parenteral nutrition solution, not otherwise specified, 10 grams lipids |
1,376 |
225 |
$78K |
| A4222 |
Infusion supplies for external drug infusion pump, per cassette or bag (list drugs separately) |
1,146 |
257 |
$63K |
| B4224 |
Parenteral nutrition administration kit, per day |
1,368 |
202 |
$49K |
| 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 |
1,334 |
994 |
$36K |
| B4088 |
Gastrostomy/jejunostomy tube, low-profile, any material, any type, each |
628 |
559 |
$30K |
| A4305 |
Disposable drug delivery system, flow rate of 50 ml or greater per hour |
322 |
77 |
$27K |
| B4220 |
Parenteral nutrition supply kit; premix, per day |
1,410 |
212 |
$23K |
| 99601 |
|
176 |
65 |
$20K |
| 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 |
64 |
24 |
$18K |
| E0776 |
Iv pole |
324 |
218 |
$18K |
| B4158 |
Enteral formula, for pediatrics, nutritionally complete with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber and/or iron, administered through an enteral feeding tube, 100 calories = 1 unit |
121 |
75 |
$14K |
| 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 |
73 |
24 |
$7K |
| E0781 |
Ambulatory infusion pump, single or multiple channels, electric or battery operated, with administrative equipment, worn by patient |
15 |
12 |
$1K |
| K0552 |
Supplies for external non-insulin drug infusion pump, syringe type cartridge, sterile, each |
218 |
129 |
$910.42 |
| A4211 |
Supplies for self-administered injections |
465 |
123 |
$328.64 |
| J7050 |
Infusion, normal saline solution, 250 cc |
33 |
12 |
$82.60 |