| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| J1569 |
Injection, immune globulin, (gammagard liquid), non-lyophilized, (e.g., liquid), 500 mg |
973 |
617 |
$4.39M |
| 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 |
3,945 |
2,604 |
$1.57M |
| J1561 |
Injection, immune globulin, (gamunex-c/gammaked), non-lyophilized (e.g., liquid), 500 mg |
157 |
123 |
$661K |
| 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 |
1,663 |
452 |
$576K |
| 99601 |
|
6,648 |
2,809 |
$575K |
| 99602 |
Nursing care in home rn |
3,204 |
1,765 |
$515K |
| S9338 |
Home infusion therapy, immunotherapy, administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem |
2,682 |
1,588 |
$277K |
| 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 |
383 |
343 |
$191K |
| 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 |
678 |
573 |
$164K |
| B4035 |
Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
1,868 |
1,738 |
$157K |
| 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 |
1,207 |
1,111 |
$126K |
| B4185 |
Parenteral nutrition solution, not otherwise specified, 10 grams lipids |
449 |
144 |
$96K |
| 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 |
283 |
247 |
$80K |
| 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 |
788 |
667 |
$60K |
| S9343 |
Home therapy; enteral nutrition via bolus; administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (enteral formula and nursing visits coded separately), per diem |
218 |
106 |
$42K |
| B4034 |
Enteral feeding supply kit; syringe fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
762 |
716 |
$25K |
| S9374 |
Home infusion therapy, hydration therapy; one liter per day, administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem |
81 |
24 |
$18K |
| B4088 |
Gastrostomy/jejunostomy tube, low-profile, any material, any type, each |
159 |
157 |
$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 |
55 |
48 |
$7K |
| A4216 |
Sterile water, saline and/or dextrose, diluent/flush, 10 ml |
743 |
505 |
$3K |
| 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 |
12 |
12 |
$2K |
| J3490 |
Unclassified drugs |
24 |
13 |
$473.57 |
| J1200 |
Injection, diphenhydramine hcl, up to 50 mg |
22 |
12 |
$90.11 |
| 99080 |
|
70 |
39 |
$0.00 |