| 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 |
8,696 |
7,835 |
$3.91M |
| 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 |
19,916 |
18,273 |
$2.48M |
| B4035 |
Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
11,012 |
9,698 |
$1.60M |
| 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 |
3,556 |
3,226 |
$1.15M |
| B4185 |
Parenteral nutrition solution, not otherwise specified, 10 grams lipids |
2,760 |
439 |
$489K |
| 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 |
3,276 |
2,776 |
$471K |
| 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 |
4,054 |
3,564 |
$434K |
| A4223 |
Infusion supplies not used with external infusion pump, per cassette or bag (list drugs separately) |
1,376 |
470 |
$356K |
| B9002 |
Enteral nutrition infusion pump, any type |
4,354 |
4,097 |
$288K |
| B4224 |
Parenteral nutrition administration kit, per day |
1,976 |
463 |
$253K |
| 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 |
1,190 |
1,094 |
$205K |
| B4088 |
Gastrostomy/jejunostomy tube, low-profile, any material, any type, each |
3,213 |
3,081 |
$149K |
| B4034 |
Enteral feeding supply kit; syringe fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
2,257 |
1,977 |
$147K |
| 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 |
298 |
253 |
$106K |
| B9998 |
Noc for enteral supplies |
1,922 |
1,759 |
$84K |
| A4221 |
Supplies for maintenance of non-insulin drug infusion catheter, per week (list drugs separately) |
3,279 |
1,369 |
$73K |
| B4220 |
Parenteral nutrition supply kit; premix, per day |
1,908 |
447 |
$72K |
| 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 |
435 |
384 |
$64K |
| 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 |
773 |
716 |
$42K |
| B4103 |
Enteral formula, for pediatrics, used to replace fluids and electrolytes (e.g., clear liquids), 500 ml = 1 unit |
429 |
401 |
$38K |
| B4036 |
Enteral feeding supply kit; gravity fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
303 |
224 |
$31K |
| A4211 |
Supplies for self-administered injections |
98 |
40 |
$31K |
| B4100 |
Food thickener, administered orally, per ounce |
702 |
653 |
$18K |
| E0776 |
Iv pole |
196 |
188 |
$16K |
| B4082 |
Nasogastric tubing without stylet |
112 |
39 |
$1K |
| 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 |
73 |
51 |
$0.00 |