| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| B4035 |
Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
1,021 |
609 |
$91K |
| 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 |
547 |
296 |
$32K |
| T4523 |
Adult sized disposable incontinence product, brief/diaper, large, each |
80 |
65 |
$5K |
| B4034 |
Enteral feeding supply kit; syringe fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
25 |
24 |
$490.98 |
| A5120 |
Skin barrier, wipes or swabs, each |
16 |
16 |
$106.08 |
| 90686 |
|
75 |
74 |
$57.09 |
| Q2035 |
Influenza virus vaccine, split virus, when administered to individuals 3 years of age and older, for intramuscular use (afluria) |
45 |
44 |
$18.24 |
| T4541 |
Incontinence product, disposable underpad, large, each |
13 |
13 |
$0.00 |
| A4520 |
Incontinence garment, any type, (e.g., brief, diaper), each |
33 |
33 |
$0.00 |
| G0008 |
Administration of influenza virus vaccine |
142 |
139 |
$0.00 |