| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| S9340 |
Home therapy; enteral nutrition; administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (enteral formula and nursing visits coded separately), per diem |
639 |
469 |
$468K |
| 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 |
734 |
239 |
$329K |
| 99601 |
|
2,651 |
867 |
$256K |
| A4223 |
Infusion supplies not used with external infusion pump, per cassette or bag (list drugs separately) |
2,472 |
994 |
$219K |
| J1726 |
Injection, hydroxyprogesterone caproate, (makena), 10 mg |
186 |
64 |
$196K |
| 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 |
749 |
372 |
$160K |
| 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 |
2,625 |
1,197 |
$156K |
| B4035 |
Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
1,474 |
939 |
$111K |
| A4222 |
Infusion supplies for external drug infusion pump, per cassette or bag (list drugs separately) |
994 |
256 |
$62K |
| 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 |
1,117 |
566 |
$57K |
| B4034 |
Enteral feeding supply kit; syringe fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
1,549 |
872 |
$43K |
| J3370 |
Injection, vancomycin hcl, 500 mg |
133 |
38 |
$28K |
| B4185 |
Parenteral nutrition solution, not otherwise specified, 10 grams lipids |
178 |
37 |
$21K |
| S9501 |
Home infusion therapy, antibiotic, antiviral, or antifungal therapy; once every 12 hours; administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem |
27 |
13 |
$13K |
| A4305 |
Disposable drug delivery system, flow rate of 50 ml or greater per hour |
686 |
62 |
$9K |
| A4221 |
Supplies for maintenance of non-insulin drug infusion catheter, per week (list drugs separately) |
494 |
224 |
$8K |
| 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 |
21 |
12 |
$7K |
| 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 |
57 |
33 |
$4K |
| S9542 |
Home injectable therapy, not otherwise classified, including administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem |
59 |
24 |
$2K |
| A4209 |
Syringe with needle, sterile 5 cc or greater, each |
149 |
104 |
$1K |
| 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 |
33 |
24 |
$1K |
| S9560 |
Home injectable therapy; hormonal therapy (e.g.; leuprolide, goserelin), including administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem |
15 |
14 |
$960.00 |
| A4930 |
Gloves, sterile, per pair |
163 |
97 |
$457.05 |
| A6257 |
Transparent film, sterile, 16 sq. in. or less, each dressing |
163 |
98 |
$359.70 |
| J7030 |
Infusion, normal saline solution , 1000 cc |
79 |
39 |
$315.93 |
| A4216 |
Sterile water, saline and/or dextrose, diluent/flush, 10 ml |
59 |
31 |
$137.72 |
| A4322 |
Irrigation syringe, bulb or piston, each |
13 |
12 |
$73.60 |