| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| B4035 |
Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
14,089 |
9,272 |
$1.83M |
| 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 |
3,822 |
2,580 |
$1.20M |
| 90378 |
|
295 |
207 |
$480K |
| 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 |
4,786 |
3,624 |
$420K |
| B4088 |
Gastrostomy/jejunostomy tube, low-profile, any material, any type, each |
3,490 |
3,026 |
$356K |
| B9002 |
Enteral nutrition infusion pump, any type |
4,680 |
4,466 |
$336K |
| E0600 |
Respiratory suction pump, home model, portable or stationary, electric |
1,067 |
1,020 |
$323K |
| E0570 |
Nebulizer, with compressor |
1,675 |
1,604 |
$203K |
| 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 |
781 |
543 |
$202K |
| T4530 |
Pediatric sized disposable incontinence product, brief/diaper, large size, each |
1,065 |
916 |
$99K |
| B9998 |
Noc for enteral supplies |
1,619 |
1,094 |
$98K |
| E0619 |
Apnea monitor, with recording feature |
396 |
391 |
$95K |
| A6210 |
Foam dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing |
651 |
561 |
$90K |
| B4100 |
Food thickener, administered orally, per ounce |
1,008 |
848 |
$89K |
| 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 |
396 |
249 |
$42K |
| A4628 |
Oral and/or oropharyngeal suction catheter, each |
2,371 |
2,168 |
$23K |
| B4034 |
Enteral feeding supply kit; syringe fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
233 |
197 |
$21K |
| B4081 |
Nasogastric tubing with stylet |
474 |
397 |
$15K |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
2,631 |
2,077 |
$14K |
| 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 |
31 |
24 |
$13K |
| A6234 |
Hydrocolloid dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
258 |
220 |
$12K |
| A4221 |
Supplies for maintenance of non-insulin drug infusion catheter, per week (list drugs separately) |
605 |
356 |
$11K |
| A7015 |
Aerosol mask, used with dme nebulizer |
2,638 |
2,094 |
$10K |
| 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 |
192 |
144 |
$9K |
| A7000 |
Canister, disposable, used with suction pump, each |
996 |
913 |
$7K |
| 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 |
166 |
91 |
$6K |
| A4322 |
Irrigation syringe, bulb or piston, each |
847 |
730 |
$6K |
| 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 |
58 |
26 |
$5K |
| A6402 |
Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
392 |
335 |
$5K |
| A4927 |
Gloves, non-sterile, per 100 |
237 |
205 |
$3K |
| E0776 |
Iv pole |
29 |
25 |
$2K |
| A6257 |
Transparent film, sterile, 16 sq. in. or less, each dressing |
193 |
162 |
$2K |
| A4450 |
Tape, non-waterproof, per 18 square inches |
406 |
347 |
$533.90 |
| T4541 |
Incontinence product, disposable underpad, large, each |
12 |
12 |
$441.00 |
| A5120 |
Skin barrier, wipes or swabs, each |
70 |
67 |
$365.33 |
| A4455 |
Adhesive remover or solvent (for tape, cement or other adhesive), per ounce |
26 |
24 |
$60.06 |