| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A4223 |
Infusion supplies not used with external infusion pump, per cassette or bag (list drugs separately) |
9,433 |
3,983 |
$7.70M |
| B4035 |
Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
10,930 |
8,608 |
$1.86M |
| B4185 |
Parenteral nutrition solution, not otherwise specified, 10 grams lipids |
4,423 |
1,096 |
$1.13M |
| A4222 |
Infusion supplies for external drug infusion pump, per cassette or bag (list drugs separately) |
5,697 |
2,285 |
$1.03M |
| 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 |
1,641 |
1,411 |
$813K |
| 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 |
6,698 |
5,782 |
$780K |
| 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 |
5,256 |
4,569 |
$695K |
| B4197 |
Parenteral nutrition solution; compounded amino acid and carbohydrates with electrolytes, trace elements and vitamins, including preparation, any strength, 74 to 100 grams of protein - premix |
580 |
154 |
$676K |
| B4224 |
Parenteral nutrition administration kit, per day |
4,738 |
1,174 |
$637K |
| 99601 |
|
5,375 |
2,687 |
$624K |
| 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 |
1,723 |
1,486 |
$586K |
| B4034 |
Enteral feeding supply kit; syringe fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
6,563 |
5,235 |
$566K |
| 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 |
1,864 |
1,590 |
$383K |
| A4221 |
Supplies for maintenance of non-insulin drug infusion catheter, per week (list drugs separately) |
12,650 |
6,104 |
$269K |
| B4220 |
Parenteral nutrition supply kit; premix, per day |
4,672 |
1,172 |
$204K |
| B4036 |
Enteral feeding supply kit; gravity fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
1,908 |
1,668 |
$165K |
| J3380 |
Injection, vedolizumab, intravenous, 1 mg |
27 |
27 |
$146K |
| J1745 |
Injection, infliximab, excludes biosimilar, 10 mg |
52 |
51 |
$110K |
| B4199 |
Parenteral nutrition solution; compounded amino acid and carbohydrates with electrolytes, trace elements and vitamins, including preparation, any strength, over 100 grams of protein - premix |
55 |
13 |
$109K |
| B4088 |
Gastrostomy/jejunostomy tube, low-profile, any material, any type, each |
1,298 |
1,260 |
$97K |
| 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 |
640 |
519 |
$94K |
| B9002 |
Enteral nutrition infusion pump, any type |
1,140 |
1,096 |
$64K |
| 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 |
2,700 |
97 |
$46K |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
1,600 |
473 |
$32K |
| 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 |
1,093 |
952 |
$31K |
| E0781 |
Ambulatory infusion pump, single or multiple channels, electric or battery operated, with administrative equipment, worn by patient |
168 |
158 |
$30K |
| J3370 |
Injection, vancomycin hcl, 500 mg |
249 |
73 |
$20K |
| J0878 |
Injection, daptomycin, 1 mg |
33 |
13 |
$11K |
| J1335 |
Injection, ertapenem sodium, 500 mg |
38 |
12 |
$11K |
| 99602 |
Nursing care in home rn |
82 |
60 |
$10K |
| E0776 |
Iv pole |
114 |
108 |
$9K |
| J7030 |
Infusion, normal saline solution , 1000 cc |
199 |
63 |
$4K |
| 99072 |
|
48 |
40 |
$0.00 |