| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A4223 |
Infusion supplies not used with external infusion pump, per cassette or bag (list drugs separately) |
2,043 |
757 |
$1.38M |
| B4105 |
In-line cartridge containing digestive enzyme(s) for enteral feeding, each |
364 |
265 |
$1.36M |
| A4222 |
Infusion supplies for external drug infusion pump, per cassette or bag (list drugs separately) |
5,960 |
2,084 |
$569K |
| B4035 |
Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
4,355 |
2,331 |
$359K |
| B4185 |
Parenteral nutrition solution, not otherwise specified, 10 grams lipids |
2,604 |
556 |
$308K |
| 99601 |
|
2,394 |
1,045 |
$221K |
| J0878 |
Injection, daptomycin, 1 mg |
893 |
63 |
$165K |
| 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 |
348 |
185 |
$124K |
| B4224 |
Parenteral nutrition administration kit, per day |
1,417 |
276 |
$119K |
| 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 |
2,170 |
1,246 |
$116K |
| 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 |
2,464 |
1,355 |
$105K |
| A4305 |
Disposable drug delivery system, flow rate of 50 ml or greater per hour |
787 |
271 |
$83K |
| A4221 |
Supplies for maintenance of non-insulin drug infusion catheter, per week (list drugs separately) |
5,996 |
2,252 |
$79K |
| B4034 |
Enteral feeding supply kit; syringe fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
1,936 |
1,213 |
$79K |
| 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 |
951 |
103 |
$63K |
| B4220 |
Parenteral nutrition supply kit; premix, per day |
1,000 |
195 |
$37K |
| 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 |
109 |
52 |
$16K |
| 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 |
151 |
75 |
$16K |
| 99602 |
Nursing care in home rn |
165 |
89 |
$13K |
| 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 |
337 |
49 |
$11K |
| 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 |
20 |
12 |
$6K |
| A4213 |
Syringe, sterile, 20 cc or greater, each |
673 |
249 |
$5K |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
232 |
55 |
$4K |
| B4088 |
Gastrostomy/jejunostomy tube, low-profile, any material, any type, each |
16 |
13 |
$283.34 |