| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| B4035 |
Enteral feed supp pump per d |
12,518 |
4,715 |
$168K |
| A4629 |
Tracheostomy care kit |
3,236 |
2,739 |
$135K |
| B4152 |
Ef calorie dense>/=1.5kcal |
8,801 |
3,566 |
$107K |
| A6219 |
Gauze <= 16 sq in w/border |
2,472 |
1,950 |
$76K |
| A4623 |
Tracheostomy inner cannula |
4,792 |
4,097 |
$70K |
| B4150 |
Ef complet w/intact nutrient |
4,858 |
2,027 |
$64K |
| B4154 |
Ef spec metabolic noninherit |
3,779 |
1,330 |
$62K |
| A7526 |
Tracheostomy tube collar |
4,451 |
3,839 |
$44K |
| B4036 |
Enteral feed sup kit grav by |
3,076 |
1,315 |
$42K |
| B4034 |
Enter feed supkit syr by day |
3,547 |
1,411 |
$29K |
| A6196 |
Alginate dressing <=16 sq in |
2,566 |
2,080 |
$27K |
| A6220 |
Gauze >16 <=48 sq in w/bordr |
802 |
657 |
$26K |
| B9002 |
Enter nutr inf pump any type |
1,846 |
1,574 |
$16K |
| A4357 |
Bedside drainage bag |
5,983 |
5,086 |
$8K |
| E0776 |
Iv pole |
4,775 |
4,268 |
$8K |
| A7521 |
Trach/laryn tube cuffed |
1,166 |
980 |
$7K |
| A4314 |
Cath w/drainage 2-way latex |
4,798 |
4,061 |
$4K |
| A6212 |
Foam drg <=16 sq in w/border |
231 |
193 |
$4K |
| A4421 |
Ostomy supply misc |
125 |
125 |
$3K |
| A4333 |
Urinary cath anchor device |
2,739 |
2,323 |
$3K |
| A4334 |
Urinary cath leg strap |
2,108 |
1,593 |
$2K |
| A4358 |
Urinary leg or abdomen bag |
2,023 |
1,579 |
$2K |
| B4087 |
Gastro/jejuno tube, std |
512 |
465 |
$2K |
| A4456 |
Adhesive remover, wipes |
289 |
246 |
$2K |
| B4155 |
Ef incomplete/modular |
200 |
179 |
$2K |
| A4385 |
Ost skn barrier sld ext wear |
224 |
194 |
$1K |
| A4349 |
Disposable male external cat |
484 |
426 |
$669.64 |
| A6197 |
Alginate drsg >16 <=48 sq in |
29 |
26 |
$655.62 |
| A4624 |
Tracheal suction tube |
118 |
116 |
$432.60 |
| A5120 |
Skin barrier, wipe or swab |
147 |
122 |
$367.86 |
| A6222 |
Gauze <=16 in no w/sal w/o b |
13 |
12 |
$312.72 |
| A4406 |
Pectin based ostomy paste |
277 |
235 |
$309.82 |
| A4217 |
Sterile water/saline, 500 ml |
20 |
17 |
$91.29 |
| A4362 |
Solid skin barrier |
203 |
173 |
$44.38 |
| A5054 |
Clsd ostomy pouch w/flange |
12 |
12 |
$14.16 |
| A4371 |
Skin barrier powder per oz |
231 |
198 |
$5.85 |
| A4414 |
Ost sknbar w/o conv<=4 sq in |
51 |
37 |
$0.00 |
| A4425 |
Ost pch drain for barrier fl |
32 |
25 |
$0.00 |