| 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 |
1,195 |
542 |
$15K |
| 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 |
161 |
93 |
$3K |
| B9002 |
Enteral nutrition infusion pump, any type |
38 |
36 |
$428.81 |
| A4338 |
Indwelling catheter; foley type, two-way latex with coating (teflon, silicone, silicone elastomer, or hydrophilic, etc.), each |
622 |
621 |
$114.36 |
| A4357 |
Bedside drainage bag, day or night, with or without anti-reflux device, with or without tube, each |
635 |
634 |
$113.10 |
| A4314 |
Insertion tray with drainage bag with indwelling catheter, foley type, two-way latex with coating (teflon, silicone, silicone elastomer or hydrophilic, etc.) |
159 |
159 |
$58.68 |
| A4310 |
Insertion tray without drainage bag and without catheter (accessories only) |
674 |
673 |
$49.28 |