| 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 |
6,067 |
5,743 |
$722K |
| A4223 |
Infusion supplies not used with external infusion pump, per cassette or bag (list drugs separately) |
20,975 |
2,578 |
$644K |
| B9999 |
Noc for parenteral supplies |
9,252 |
1,527 |
$321K |
| B9998 |
Noc for enteral supplies |
5,720 |
5,333 |
$292K |
| B4088 |
Gastrostomy/jejunostomy tube, low-profile, any material, any type, each |
2,220 |
2,167 |
$259K |
| T5999 |
Supply, not otherwise specified |
8,744 |
3,244 |
$149K |
| B9002 |
Enteral nutrition infusion pump, any type |
1,104 |
1,078 |
$91K |
| S1015 |
Iv tubing extension set |
5,104 |
1,270 |
$66K |
| E0781 |
Ambulatory infusion pump, single or multiple channels, electric or battery operated, with administrative equipment, worn by patient |
294 |
270 |
$49K |
| A4657 |
Syringe, with or without needle, each |
24,395 |
7,100 |
$49K |
| A4248 |
Chlorhexidine containing antiseptic, 1 ml |
3,983 |
1,799 |
$31K |
| A6258 |
Transparent film, sterile, more than 16 sq. in. but less than or equal to 48 sq. in., each dressing |
1,951 |
1,111 |
$25K |
| A6402 |
Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
3,993 |
3,434 |
$24K |
| A6234 |
Hydrocolloid dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
356 |
341 |
$9K |
| B4081 |
Nasogastric tubing with stylet |
202 |
194 |
$7K |
| A4245 |
Alcohol wipes, per box |
2,380 |
2,079 |
$5K |
| A4215 |
Needle, sterile, any size, each |
3,012 |
1,081 |
$4K |
| A4456 |
Adhesive remover, wipes, any type, each |
1,695 |
1,026 |
$4K |
| A4927 |
Gloves, non-sterile, per 100 |
313 |
295 |
$3K |
| A5120 |
Skin barrier, wipes or swabs, each |
1,029 |
648 |
$1K |
| A4212 |
Non-coring needle or stylet with or without catheter |
13 |
12 |
$429.33 |
| B4036 |
Enteral feeding supply kit; gravity fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
13 |
13 |
$139.91 |
| A4332 |
Lubricant, individual sterile packet, each |
942 |
923 |
$84.24 |
| A4211 |
Supplies for self-administered injections |
29 |
13 |
$9.04 |