| 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 |
25,205 |
18,453 |
$4.52M |
| 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 |
4,120 |
3,378 |
$1.86M |
| 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 |
4,526 |
1,169 |
$1.17M |
| B4185 |
Parenteral nutrition solution, not otherwise specified, 10 grams lipids |
7,952 |
1,624 |
$1.16M |
| A4223 |
Infusion supplies not used with external infusion pump, per cassette or bag (list drugs separately) |
2,538 |
1,070 |
$1.12M |
| 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 |
2,315 |
1,892 |
$1.02M |
| 99601 |
|
8,802 |
3,774 |
$937K |
| 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 |
5,550 |
4,496 |
$892K |
| 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 |
8,083 |
5,992 |
$887K |
| 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 |
2,574 |
1,942 |
$868K |
| S9366 |
Home infusion therapy, total parenteral nutrition (tpn); more than one liter but no more than two liters per day, administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment including standard tpn formula (lipids, specialty amino acid formulas, drugs other than in standard formula and nursing visits coded separately), per diem |
993 |
231 |
$683K |
| B4034 |
Enteral feeding supply kit; syringe fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
8,135 |
5,820 |
$649K |
| 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 |
6,864 |
5,073 |
$575K |
| 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 |
10,113 |
1,095 |
$391K |
| S9379 |
Home infusion therapy, infusion therapy, not otherwise classified; administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem |
3,238 |
898 |
$363K |
| 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 |
1,514 |
1,074 |
$316K |
| S9502 |
Home infusion therapy, antibiotic, antiviral, or antifungal therapy; once every 8 hours, administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem |
1,026 |
238 |
$293K |
| B4088 |
Gastrostomy/jejunostomy tube, low-profile, any material, any type, each |
4,168 |
3,890 |
$266K |
| B4036 |
Enteral feeding supply kit; gravity fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
2,287 |
1,610 |
$199K |
| B4158 |
Enteral formula, for pediatrics, nutritionally complete with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber and/or iron, administered through an enteral feeding tube, 100 calories = 1 unit |
988 |
811 |
$109K |
| A4221 |
Supplies for maintenance of non-insulin drug infusion catheter, per week (list drugs separately) |
3,010 |
1,547 |
$73K |
| 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 |
2,659 |
2,067 |
$59K |
| B9002 |
Enteral nutrition infusion pump, any type |
1,104 |
915 |
$51K |
| B4224 |
Parenteral nutrition administration kit, per day |
361 |
74 |
$20K |
| B9998 |
Noc for enteral supplies |
487 |
459 |
$20K |
| B4082 |
Nasogastric tubing without stylet |
432 |
364 |
$14K |
| 99602 |
Nursing care in home rn |
151 |
131 |
$13K |
| A4222 |
Infusion supplies for external drug infusion pump, per cassette or bag (list drugs separately) |
141 |
68 |
$10K |
| B4220 |
Parenteral nutrition supply kit; premix, per day |
329 |
73 |
$6K |
| J0690 |
Injection, cefazolin sodium, 500 mg |
102 |
24 |
$3K |
| B4087 |
Gastrostomy/jejunostomy tube, standard, any material, any type, each |
109 |
93 |
$1K |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
76 |
28 |
$1K |
| E0776 |
Iv pole |
13 |
12 |
$1K |