| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 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 |
2,651 |
852 |
$384K |
| B4035 |
Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
3,549 |
1,653 |
$381K |
| B4220 |
Parenteral nutrition supply kit; premix, per day |
8,514 |
2,690 |
$239K |
| 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 |
546 |
300 |
$228K |
| A4211 |
Supplies for self-administered injections |
1,474 |
503 |
$216K |
| B4224 |
Parenteral nutrition administration kit, per day |
2,129 |
569 |
$158K |
| 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 |
2,097 |
951 |
$145K |
| B4088 |
Gastrostomy/jejunostomy tube, low-profile, any material, any type, each |
1,042 |
811 |
$122K |
| A4222 |
Infusion supplies for external drug infusion pump, per cassette or bag (list drugs separately) |
604 |
277 |
$80K |
| B9998 |
Noc for enteral supplies |
1,499 |
1,107 |
$78K |
| 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 |
2,078 |
611 |
$56K |
| 99601 |
|
111 |
39 |
$15K |
| 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 |
351 |
97 |
$11K |
| A4305 |
Disposable drug delivery system, flow rate of 50 ml or greater per hour |
117 |
41 |
$7K |
| A9901 |
Dme delivery, set up, and/or dispensing service component of another hcpcs code |
289 |
210 |
$5K |
| E0781 |
Ambulatory infusion pump, single or multiple channels, electric or battery operated, with administrative equipment, worn by patient |
29 |
24 |
$5K |
| B4034 |
Enteral feeding supply kit; syringe fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
215 |
37 |
$3K |