| 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 |
87,436 |
42,761 |
$1.25M |
| B4154 |
Enteral formula, nutritionally complete, for special metabolic needs, excludes inherited disease of metabolism, includes altered composition of proteins, fats, carbohydrates, vitamins and/or minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit |
27,714 |
13,851 |
$811K |
| 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 |
44,604 |
22,154 |
$655K |
| B4150 |
Enteral formula, nutritionally complete with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit |
19,067 |
9,628 |
$316K |
| B9002 |
Enteral nutrition infusion pump, any type |
20,878 |
20,616 |
$206K |
| B4153 |
Enteral formula, nutritionally complete, hydrolyzed proteins (amino acids and peptide chain), includes fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit |
3,678 |
1,869 |
$185K |
| A4623 |
Tracheostomy, inner cannula |
17,422 |
17,000 |
$144K |
| B4155 |
Enteral formula, nutritionally incomplete/modular nutrients, includes specific nutrients, carbohydrates (e.g., glucose polymers), proteins/amino acids (e.g., glutamine, arginine), fat (e.g., medium chain triglycerides) or combination, administered through an enteral feeding tube, 100 calories = 1 unit |
11,018 |
9,909 |
$80K |
| B4034 |
Enteral feeding supply kit; syringe fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
9,005 |
4,496 |
$68K |
| A4629 |
Tracheostomy care kit for established tracheostomy |
10,349 |
10,054 |
$48K |
| E0776 |
Iv pole |
41,930 |
41,677 |
$45K |
| A4417 |
Ostomy pouch, closed, with barrier attached, with built-in convexity, with filter (1 piece), each |
2,594 |
2,565 |
$44K |
| A7521 |
Tracheostomy/laryngectomy tube, cuffed, polyvinylchloride (pvc), silicone or equal, each |
4,937 |
4,917 |
$24K |
| A4357 |
Bedside drainage bag, day or night, with or without anti-reflux device, with or without tube, each |
27,536 |
26,954 |
$22K |
| A7526 |
Tracheostomy tube collar/holder, each |
9,956 |
9,719 |
$20K |
| A4419 |
Ostomy pouch, closed; for use on barrier with non-locking flange, with filter (2 piece), each |
2,717 |
2,671 |
$17K |
| A4314 |
Insertion tray with drainage bag with indwelling catheter, foley type, two-way latex with coating (teflon, silicone, silicone elastomer or hydrophilic, etc.) |
25,444 |
24,964 |
$14K |
| A4414 |
Ostomy skin barrier, with flange (solid, flexible or accordion), without built-in convexity, 4 x 4 inches or smaller, each |
5,795 |
5,667 |
$13K |
| A4409 |
Ostomy skin barrier, with flange (solid, flexible or accordion), extended wear, without built-in convexity, 4 x 4 inches or smaller, each |
2,603 |
2,530 |
$8K |
| A4425 |
Ostomy pouch, drainable; for use on barrier with non-locking flange, with filter (2 piece system), each |
2,341 |
2,285 |
$8K |
| A4333 |
Urinary catheter anchoring device, adhesive skin attachment, each |
5,728 |
5,599 |
$7K |
| A7520 |
Tracheostomy/laryngectomy tube, non-cuffed, polyvinylchloride (pvc), silicone or equal, each |
1,226 |
1,223 |
$6K |
| A4432 |
Ostomy pouch, urinary; for use on barrier with non-locking flange, with faucet-type tap with valve (2 piece), each |
939 |
887 |
$5K |
| A5063 |
Ostomy pouch, drainable; for use on barrier with flange (2 piece system), each |
3,345 |
3,300 |
$5K |
| A5061 |
Ostomy pouch, drainable; with barrier attached, (1 piece), each |
605 |
587 |
$4K |
| A4385 |
Ostomy skin barrier, solid 4 x 4 or equivalent, extended wear, without built-in convexity, each |
773 |
751 |
$3K |
| A4416 |
Ostomy pouch, closed, with barrier attached, with filter (1 piece), each |
558 |
536 |
$3K |
| A4407 |
Ostomy skin barrier, with flange (solid, flexible, or accordion), extended wear, with built-in convexity, 4 x 4 inches or smaller, each |
698 |
678 |
$2K |
| A4358 |
Urinary drainage bag, leg or abdomen, vinyl, with or without tube, with straps, each |
3,280 |
3,214 |
$1K |
| B4087 |
Gastrostomy/jejunostomy tube, standard, any material, any type, each |
338 |
337 |
$395.31 |
| A5056 |
Ostomy pouch, drainable, with extended wear barrier attached, with filter, (1 piece), each |
24 |
24 |
$51.32 |
| A4412 |
Ostomy pouch, drainable, high output, for use on a barrier with flange (2 piece system), without filter, each |
12 |
12 |
$43.68 |
| A4362 |
Skin barrier; solid, 4 x 4 or equivalent; each |
12 |
12 |
$40.62 |
| A4371 |
Ostomy skin barrier, powder, per oz |
112 |
111 |
$23.65 |
| A4340 |
Indwelling catheter; specialty type, (e.g., coude, mushroom, wing, etc.), each |
12 |
12 |
$1.22 |