| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| B4154 |
Ef spec metabolic noninherit |
3,498 |
3,139 |
$243K |
| B4035 |
Enteral feed supp pump per d |
7,288 |
6,485 |
$140K |
| B4152 |
Ef calorie dense>/=1.5kcal |
3,667 |
3,280 |
$136K |
| B4150 |
Ef complet w/intact nutrient |
2,053 |
1,833 |
$81K |
| B9002 |
Enter nutr inf pump any type |
3,099 |
2,845 |
$39K |
| B4034 |
Enter feed supkit syr by day |
1,989 |
1,802 |
$21K |
| A4314 |
Cath w/drainage 2-way latex |
3,996 |
3,765 |
$13K |
| E0776 |
Iv pole |
7,248 |
6,978 |
$8K |
| A5063 |
Drain ostomy pouch w/flange |
936 |
849 |
$4K |
| A4409 |
Ost skn barr convex <=4 sq i |
281 |
247 |
$951.24 |
| A6021 |
Collagen dressing <=16 sq in |
61 |
60 |
$932.31 |
| A6196 |
Alginate dressing <=16 sq in |
93 |
86 |
$851.01 |
| A6446 |
Conform band s w>=3" <5"/yd |
25 |
25 |
$340.08 |
| A4338 |
Indwelling catheter latex |
102 |
100 |
$222.63 |
| A4310 |
Insert tray w/o bag/cath |
134 |
125 |
$100.16 |
| A6212 |
Foam drg <=16 sq in w/border |
39 |
39 |
$78.69 |
| A6219 |
Gauze <= 16 sq in w/border |
212 |
211 |
$71.40 |
| A4357 |
Bedside drainage bag |
70 |
68 |
$68.68 |
| A4311 |
Catheter w/o bag 2-way latex |
14 |
14 |
$10.24 |