| 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 |
89 |
78 |
$25K |
| T2029 |
Specialized medical equipment, not otherwise specified, waiver |
64 |
59 |
$18K |
| A4425 |
Ostomy pouch, drainable; for use on barrier with non-locking flange, with filter (2 piece system), each |
192 |
177 |
$8K |
| A4414 |
Ostomy skin barrier, with flange (solid, flexible or accordion), without built-in convexity, 4 x 4 inches or smaller, each |
114 |
106 |
$8K |
| B9002 |
Enteral nutrition infusion pump, any type |
71 |
70 |
$7K |
| A4409 |
Ostomy skin barrier, with flange (solid, flexible or accordion), extended wear, without built-in convexity, 4 x 4 inches or smaller, each |
114 |
101 |
$4K |
| A4362 |
Skin barrier; solid, 4 x 4 or equivalent; each |
127 |
112 |
$4K |
| A4385 |
Ostomy skin barrier, solid 4 x 4 or equivalent, extended wear, without built-in convexity, each |
203 |
187 |
$4K |
| 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 |
13 |
12 |
$4K |
| A4406 |
Ostomy skin barrier, pectin-based, paste, per ounce |
96 |
89 |
$1K |
| A4407 |
Ostomy skin barrier, with flange (solid, flexible, or accordion), extended wear, with built-in convexity, 4 x 4 inches or smaller, each |
13 |
13 |
$799.57 |
| A4357 |
Bedside drainage bag, day or night, with or without anti-reflux device, with or without tube, each |
85 |
74 |
$330.71 |
| A4371 |
Ostomy skin barrier, powder, per oz |
74 |
70 |
$210.08 |
| A5120 |
Skin barrier, wipes or swabs, each |
46 |
42 |
$189.64 |
| A4367 |
Ostomy belt, each |
28 |
25 |
$99.28 |