| 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 |
593 |
541 |
$202K |
| B4149 |
Enteral formula, manufactured blenderized natural foods with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit |
180 |
170 |
$90K |
| B4161 |
Enteral formula, for pediatrics, hydrolyzed/amino acids and peptide chain proteins, includes fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit |
84 |
74 |
$62K |
| B4160 |
Enteral formula, for pediatrics, nutritionally complete calorically dense (equal to or greater than 0.7 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 |
211 |
203 |
$46K |
| 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 |
17 |
16 |
$13K |
| E0445 |
Oximeter device for measuring blood oxygen levels non-invasively |
13 |
13 |
$10K |
| E1390 |
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate |
108 |
108 |
$9K |
| B4034 |
Enteral feeding supply kit; syringe fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
44 |
38 |
$7K |
| B4036 |
Enteral feeding supply kit; gravity fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
31 |
23 |
$6K |
| B9002 |
Enteral nutrition infusion pump, any type |
38 |
38 |
$5K |
| B4088 |
Gastrostomy/jejunostomy tube, low-profile, any material, any type, each |
41 |
41 |
$4K |
| A4605 |
Tracheal suction catheter, closed system, each |
13 |
13 |
$4K |
| T4522 |
Adult sized disposable incontinence product, brief/diaper, medium, each |
26 |
25 |
$4K |
| 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 |
14 |
14 |
$4K |
| T4521 |
Adult sized disposable incontinence product, brief/diaper, small, each |
24 |
24 |
$4K |
| T4532 |
Pediatric sized disposable incontinence product, protective underwear/pull-on, large size, each |
18 |
18 |
$3K |
| A4351 |
Intermittent urinary catheter; straight tip, with or without coating (teflon, silicone, or silicone elastomer, etc.), each |
16 |
15 |
$3K |
| T4533 |
Youth sized disposable incontinence product, brief/diaper, each |
19 |
18 |
$3K |
| G0299 |
Direct skilled nursing services of a registered nurse (rn) in the home health or hospice setting, each 15 minutes |
27 |
12 |
$3K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
131 |
131 |
$2K |
| T4523 |
Adult sized disposable incontinence product, brief/diaper, large, each |
14 |
14 |
$2K |
| T4525 |
Adult sized disposable incontinence product, protective underwear/pull-on, small size, each |
12 |
12 |
$2K |
| A4627 |
Spacer, bag or reservoir, with or without mask, for use with metered dose inhaler |
39 |
39 |
$2K |
| E0601 |
Continuous positive airway pressure (cpap) device |
38 |
37 |
$1K |
| A7526 |
Tracheostomy tube collar/holder, each |
16 |
16 |
$1K |
| T4541 |
Incontinence product, disposable underpad, large, each |
22 |
22 |
$1K |
| 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 |
19 |
18 |
$1K |
| A4927 |
Gloves, non-sterile, per 100 |
37 |
34 |
$835.91 |
| A7520 |
Tracheostomy/laryngectomy tube, non-cuffed, polyvinylchloride (pvc), silicone or equal, each |
16 |
14 |
$769.60 |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
24 |
24 |
$705.06 |
| E0600 |
Respiratory suction pump, home model, portable or stationary, electric |
12 |
12 |
$566.28 |
| A4628 |
Oral and/or oropharyngeal suction catheter, each |
39 |
36 |
$440.52 |
| A7002 |
Tubing, used with suction pump, each |
36 |
35 |
$374.74 |
| A7000 |
Canister, disposable, used with suction pump, each |
19 |
19 |
$343.86 |
| A4332 |
Lubricant, individual sterile packet, each |
14 |
12 |
$131.37 |
| A7038 |
Filter, disposable, used with positive airway pressure device |
15 |
14 |
$71.10 |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
13 |
13 |
$46.90 |