| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| B4035 |
Enteral feed supp pump per d |
6,067 |
5,743 |
$722K |
| A4223 |
Infusion supplies w/o pump |
20,975 |
2,578 |
$644K |
| B9999 |
Parenteral supp not othrws c |
9,252 |
1,527 |
$321K |
| B9998 |
Enteral supp not otherwise c |
5,720 |
5,333 |
$292K |
| B4088 |
Gastro/jejuno tube, low-pro |
2,220 |
2,167 |
$259K |
| T5999 |
Supply, nos |
8,744 |
3,244 |
$149K |
| B9002 |
Enter nutr inf pump any type |
1,104 |
1,078 |
$91K |
| S1015 |
Iv tubing extension set |
5,104 |
1,270 |
$66K |
| E0781 |
External ambulatory infus pu |
294 |
270 |
$49K |
| A4657 |
Syringe w/wo needle |
24,395 |
7,100 |
$49K |
| A4248 |
Chlorhexidine antisept |
3,983 |
1,799 |
$31K |
| A6258 |
Transparent film >16<=48 in |
1,951 |
1,111 |
$25K |
| A6402 |
Sterile gauze <= 16 sq in |
3,993 |
3,434 |
$24K |
| A6234 |
Hydrocolld drg <=16 w/o bdr |
356 |
341 |
$9K |
| B4081 |
Enteral ng tubing w/ stylet |
202 |
194 |
$7K |
| A4245 |
Alcohol wipes per box |
2,380 |
2,079 |
$5K |
| A4215 |
Sterile needle |
3,012 |
1,081 |
$4K |
| A4456 |
Adhesive remover, wipes |
1,695 |
1,026 |
$4K |
| A4927 |
Non-sterile gloves |
313 |
295 |
$3K |
| A5120 |
Skin barrier, wipe or swab |
1,029 |
648 |
$1K |
| A4212 |
Non coring needle or stylet |
13 |
12 |
$429.33 |
| B4036 |
Enteral feed sup kit grav by |
13 |
13 |
$139.91 |
| A4332 |
Lube sterile packet |
942 |
923 |
$84.24 |
| A4211 |
Supp for self-adm injections |
29 |
13 |
$9.04 |