| 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 |
3,476 |
3,002 |
$2.27M |
| B4035 |
Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
11,885 |
7,242 |
$1.41M |
| 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 |
1,860 |
1,618 |
$927K |
| 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 |
3,426 |
2,802 |
$679K |
| B9002 |
Enteral nutrition infusion pump, any type |
2,767 |
2,614 |
$263K |
| B9998 |
Noc for enteral supplies |
2,441 |
1,802 |
$218K |
| B4034 |
Enteral feeding supply kit; syringe fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
3,909 |
2,461 |
$215K |
| B4088 |
Gastrostomy/jejunostomy tube, low-profile, any material, any type, each |
1,410 |
1,315 |
$214K |
| A4222 |
Infusion supplies for external drug infusion pump, per cassette or bag (list drugs separately) |
724 |
294 |
$129K |
| 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 |
671 |
574 |
$86K |
| 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 |
397 |
342 |
$56K |
| 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 |
39 |
36 |
$31K |
| A4221 |
Supplies for maintenance of non-insulin drug infusion catheter, per week (list drugs separately) |
1,335 |
683 |
$23K |
| A5200 |
Percutaneous catheter/tube anchoring device, adhesive skin attachment |
508 |
296 |
$15K |
| A4216 |
Sterile water, saline and/or dextrose, diluent/flush, 10 ml |
726 |
385 |
$6K |
| 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 |
21 |
12 |
$2K |
| E0776 |
Iv pole |
281 |
259 |
$2K |
| J1642 |
Injection, heparin sodium, (heparin lock flush), per 10 units |
336 |
166 |
$1K |