| 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 |
1,669 |
1,489 |
$950K |
| 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 |
2,892 |
2,222 |
$906K |
| B4035 |
Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
6,460 |
4,880 |
$792K |
| B4185 |
Parenteral nutrition solution, not otherwise specified, 10 grams lipids |
2,216 |
560 |
$495K |
| A4222 |
Infusion supplies for external drug infusion pump, per cassette or bag (list drugs separately) |
1,901 |
536 |
$261K |
| B4224 |
Parenteral nutrition administration kit, per day |
2,139 |
488 |
$242K |
| A4223 |
Infusion supplies not used with external infusion pump, per cassette or bag (list drugs separately) |
1,447 |
605 |
$241K |
| 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 |
2,006 |
1,687 |
$214K |
| 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 |
2,121 |
1,774 |
$193K |
| 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 |
1,789 |
1,538 |
$190K |
| B4087 |
Gastrostomy/jejunostomy tube, standard, any material, any type, each |
1,503 |
1,335 |
$139K |
| B9002 |
Enteral nutrition infusion pump, any type |
1,870 |
1,751 |
$123K |
| 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 |
96 |
24 |
$114K |
| B4034 |
Enteral feeding supply kit; syringe fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
1,748 |
1,465 |
$109K |
| A4221 |
Supplies for maintenance of non-insulin drug infusion catheter, per week (list drugs separately) |
4,341 |
1,908 |
$85K |
| B4220 |
Parenteral nutrition supply kit; premix, per day |
1,986 |
475 |
$73K |
| E0781 |
Ambulatory infusion pump, single or multiple channels, electric or battery operated, with administrative equipment, worn by patient |
333 |
296 |
$64K |
| B4088 |
Gastrostomy/jejunostomy tube, low-profile, any material, any type, each |
992 |
943 |
$57K |
| S9460 |
Diabetic management program, nurse visit |
367 |
185 |
$45K |
| 99601 |
|
316 |
128 |
$39K |
| B4100 |
Food thickener, administered orally, per ounce |
534 |
442 |
$17K |
| 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 |
19 |
12 |
$9K |
| 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 |
160 |
150 |
$7K |
| 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 |
25 |
24 |
$5K |
| B9004 |
Parenteral nutrition infusion pump, portable |
15 |
12 |
$5K |