| 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 |
231 |
230 |
$57K |
| A4322 |
Irrigation syringe, bulb or piston, each |
465 |
464 |
$47K |
| T4541 |
Incontinence product, disposable underpad, large, each |
491 |
491 |
$28K |
| B4036 |
Enteral feeding supply kit; gravity fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
77 |
77 |
$15K |
| A6402 |
Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
435 |
434 |
$10K |
| B9998 |
Noc for enteral supplies |
52 |
50 |
$5K |
| A4657 |
Syringe, with or without needle, each |
24 |
24 |
$2K |
| A6250 |
Skin sealants, protectants, moisturizers, ointments, any type, any size |
132 |
132 |
$2K |
| A4335 |
Incontinence supply; miscellaneous |
128 |
128 |
$1K |
| A4402 |
Lubricant, per ounce |
145 |
145 |
$699.85 |
| 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 |
110 |
110 |
$608.99 |