| 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 |
1,861 |
265 |
$77K |
| B9002 |
Enteral nutrition infusion pump, any type |
205 |
191 |
$22K |
| B4088 |
Gastrostomy/jejunostomy tube, low-profile, any material, any type, each |
527 |
444 |
$13K |
| E0445 |
Oximeter device for measuring blood oxygen levels non-invasively |
94 |
87 |
$11K |
| E1390 |
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate |
114 |
103 |
$11K |
| B9998 |
Noc for enteral supplies |
342 |
145 |
$7K |
| A6197 |
Alginate or other fiber gelling dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., each dressing |
13 |
13 |
$7K |
| A6251 |
Specialty absorptive dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
91 |
50 |
$6K |
| A4213 |
Syringe, sterile, 20 cc or greater, each |
458 |
393 |
$4K |
| A6196 |
Alginate or other fiber gelling dressing, wound cover, sterile, pad size 16 sq. in. or less, each dressing |
13 |
13 |
$3K |
| A6252 |
Specialty absorptive dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing |
13 |
13 |
$1K |
| A6402 |
Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
114 |
99 |
$840.22 |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
45 |
36 |
$756.26 |
| A4450 |
Tape, non-waterproof, per 18 square inches |
160 |
140 |
$358.34 |
| E1399 |
Durable medical equipment, miscellaneous |
39 |
27 |
$0.00 |
| A4606 |
Oxygen probe for use with oximeter device, replacement |
26 |
25 |
$0.00 |