| 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 |
844 |
527 |
$131K |
| 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 |
416 |
220 |
$63K |
| B4088 |
Gastrostomy/jejunostomy tube, low-profile, any material, any type, each |
66 |
43 |
$1K |
| A4216 |
Sterile water, saline and/or dextrose, diluent/flush, 10 ml |
203 |
52 |
$357.89 |
| J7030 |
Infusion, normal saline solution , 1000 cc |
149 |
38 |
$172.12 |
| A4221 |
Supplies for maintenance of non-insulin drug infusion catheter, per week (list drugs separately) |
51 |
12 |
$88.72 |