| 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 |
1,385 |
1,276 |
$273K |
| T4522 |
Adult sized disposable incontinence product, brief/diaper, medium, each |
1,892 |
1,555 |
$199K |
| 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 |
857 |
797 |
$121K |
| A4554 |
Disposable underpads, all sizes |
2,426 |
2,205 |
$106K |
| B4034 |
Enteral feeding supply kit; syringe fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
423 |
374 |
$40K |
| T4523 |
Adult sized disposable incontinence product, brief/diaper, large, each |
385 |
304 |
$40K |
| B9998 |
Noc for enteral supplies |
1,513 |
1,253 |
$37K |
| B4088 |
Gastrostomy/jejunostomy tube, low-profile, any material, any type, each |
210 |
166 |
$24K |
| A4322 |
Irrigation syringe, bulb or piston, each |
433 |
359 |
$7K |
| A6402 |
Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
339 |
333 |
$5K |
| T4533 |
Youth sized disposable incontinence product, brief/diaper, each |
13 |
12 |
$1K |
| A4657 |
Syringe, with or without needle, each |
699 |
616 |
$1K |
| A7000 |
Canister, disposable, used with suction pump, each |
65 |
64 |
$278.89 |