| 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 |
2,750 |
2,113 |
$397K |
| A4223 |
Infusion supplies not used with external infusion pump, per cassette or bag (list drugs separately) |
846 |
377 |
$92K |
| B9002 |
Enteral nutrition infusion pump, any type |
435 |
379 |
$27K |
| 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 |
1,027 |
582 |
$25K |
| B4088 |
Gastrostomy/jejunostomy tube, low-profile, any material, any type, each |
164 |
131 |
$17K |
| B4034 |
Enteral feeding supply kit; syringe fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
102 |
81 |
$11K |
| A4927 |
Gloves, non-sterile, per 100 |
677 |
511 |
$7K |
| B9998 |
Noc for enteral supplies |
30 |
24 |
$3K |
| A4221 |
Supplies for maintenance of non-insulin drug infusion catheter, per week (list drugs separately) |
66 |
40 |
$2K |