| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 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 |
3,112 |
2,743 |
$1.36M |
| B4035 |
Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
5,941 |
5,227 |
$1.34M |
| 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 |
1,266 |
322 |
$1.33M |
| 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 |
1,699 |
1,542 |
$1.20M |
| B4224 |
Parenteral nutrition administration kit, per day |
2,532 |
633 |
$379K |
| B4185 |
Parenteral nutrition solution, not otherwise specified, 10 grams lipids |
2,055 |
536 |
$366K |
| B4088 |
Gastrostomy/jejunostomy tube, low-profile, any material, any type, each |
1,671 |
1,606 |
$241K |
| 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 |
625 |
578 |
$154K |
| B4220 |
Parenteral nutrition supply kit; premix, per day |
2,619 |
640 |
$121K |
| B4034 |
Enteral feeding supply kit; syringe fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
905 |
845 |
$115K |
| A4221 |
Supplies for maintenance of non-insulin drug infusion catheter, per week (list drugs separately) |
2,882 |
1,409 |
$75K |
| A4223 |
Infusion supplies not used with external infusion pump, per cassette or bag (list drugs separately) |
996 |
542 |
$74K |
| A4222 |
Infusion supplies for external drug infusion pump, per cassette or bag (list drugs separately) |
175 |
116 |
$35K |