| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| B4035 |
Enteral feed supp pump per d |
54,462 |
31,877 |
$830K |
| B4152 |
Ef calorie dense>/=1.5kcal |
35,604 |
21,927 |
$609K |
| B4154 |
Ef spec metabolic noninherit |
16,257 |
8,911 |
$499K |
| B9002 |
Enter nutr inf pump any type |
25,130 |
20,214 |
$239K |
| B4150 |
Ef complet w/intact nutrient |
10,332 |
5,852 |
$181K |
| A4623 |
Tracheostomy inner cannula |
13,787 |
11,062 |
$100K |
| A4314 |
Cath w/drainage 2-way latex |
61,360 |
46,553 |
$79K |
| B4034 |
Enter feed supkit syr by day |
7,343 |
4,904 |
$73K |
| B4153 |
Ef hydrolyzed/amino acids |
808 |
513 |
$57K |
| A4629 |
Tracheostomy care kit |
8,761 |
6,753 |
$47K |
| A4357 |
Bedside drainage bag |
65,929 |
49,034 |
$43K |
| E0776 |
Iv pole |
30,277 |
24,619 |
$37K |
| A7526 |
Tracheostomy tube collar |
11,681 |
9,172 |
$31K |
| A4414 |
Ost sknbar w/o conv<=4 sq in |
7,287 |
5,509 |
$28K |
| A4409 |
Ost skn barr convex <=4 sq i |
5,437 |
4,245 |
$25K |
| A5063 |
Drain ostomy pouch w/flange |
8,859 |
6,774 |
$18K |
| A4417 |
Ost pch w bar/bltinconv/fltr |
1,059 |
945 |
$17K |
| A4407 |
Ext wear ost skn barr <=4sq" |
2,232 |
1,672 |
$14K |
| A5061 |
Pouch drainable w barrier at |
3,691 |
2,632 |
$13K |
| A4425 |
Ost pch drain for barrier fl |
4,345 |
3,226 |
$13K |
| B4155 |
Ef incomplete/modular |
1,350 |
1,230 |
$12K |
| A4419 |
Ost pch for bar w flange/flt |
2,241 |
1,817 |
$12K |
| A5056 |
1 pc ost pouch w filter |
1,090 |
892 |
$10K |
| A7521 |
Trach/laryn tube cuffed |
2,621 |
2,327 |
$9K |
| A4388 |
Drainable pch w ex wear barr |
888 |
719 |
$8K |
| A4424 |
Ost pch drain w bar & filter |
1,429 |
1,085 |
$7K |
| A7520 |
Trach/laryn tube non-cuffed |
1,855 |
1,547 |
$6K |
| A4385 |
Ost skn barrier sld ext wear |
735 |
622 |
$5K |
| A4416 |
Ost pch clsd w barrier/filtr |
664 |
498 |
$4K |
| A6196 |
Alginate dressing <=16 sq in |
114 |
102 |
$4K |
| A4333 |
Urinary cath anchor device |
5,116 |
4,115 |
$4K |
| A4415 |
Ost skn barr w/o conv >4 sqi |
952 |
773 |
$3K |
| A4334 |
Urinary cath leg strap |
8,345 |
6,408 |
$3K |
| A4432 |
Os pch urine w bar/fange/tap |
923 |
701 |
$3K |
| A4358 |
Urinary leg or abdomen bag |
4,905 |
3,872 |
$3K |
| A4349 |
Disposable male external cat |
543 |
417 |
$2K |
| A5057 |
1 pc ost pou w built-in conv |
238 |
211 |
$2K |
| A4410 |
Ost skn barr extnd >4 sq |
645 |
499 |
$2K |
| A4406 |
Pectin based ostomy paste |
1,204 |
946 |
$2K |
| A4353 |
Intermittent urinary cath |
62 |
52 |
$2K |
| A4371 |
Skin barrier powder per oz |
693 |
584 |
$1K |
| B4087 |
Gastro/jejuno tube, std |
529 |
475 |
$1K |
| A4340 |
Indwelling catheter special |
837 |
665 |
$953.03 |
| A4354 |
Cath insertion tray w/bag |
1,035 |
845 |
$595.94 |
| A5120 |
Skin barrier, wipe or swab |
1,258 |
1,019 |
$581.73 |
| A4394 |
Ostomy pouch liq deodorant |
401 |
305 |
$426.23 |
| A4315 |
Cath w/drainage 2-way silcne |
175 |
146 |
$195.02 |
| A6219 |
Gauze <= 16 sq in w/border |
52 |
50 |
$129.88 |
| A5054 |
Clsd ostomy pouch w/flange |
46 |
36 |
$108.01 |
| A4338 |
Indwelling catheter latex |
68 |
60 |
$94.31 |
| A4311 |
Catheter w/o bag 2-way latex |
67 |
61 |
$59.37 |
| A4456 |
Adhesive remover, wipes |
179 |
149 |
$50.39 |
| A4362 |
Solid skin barrier |
14 |
12 |
$44.07 |
| A4373 |
Skin barrier with flange |
14 |
13 |
$27.10 |
| A4310 |
Insert tray w/o bag/cath |
93 |
60 |
$21.08 |