| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| B4035 |
Enteral feed supp pump per d |
30,166 |
29,328 |
$3.73M |
| B9998 |
Enteral supp not otherwise c |
55,021 |
37,369 |
$2.98M |
| S9342 |
Hit enteral pump diem |
3,964 |
3,870 |
$2.65M |
| B4088 |
Gastro/jejuno tube, low-pro |
16,902 |
16,713 |
$2.29M |
| A4223 |
Infusion supplies w/o pump |
16,576 |
4,228 |
$605K |
| T5999 |
Supply, nos |
2,665 |
2,480 |
$377K |
| A4322 |
Irrigation syringe |
29,218 |
28,617 |
$352K |
| B9002 |
Enter nutr inf pump any type |
3,928 |
3,922 |
$333K |
| B9999 |
Parenteral supp not othrws c |
10,887 |
3,336 |
$275K |
| A6402 |
Sterile gauze <= 16 sq in |
32,962 |
30,752 |
$142K |
| B4036 |
Enteral feed sup kit grav by |
3,247 |
3,058 |
$134K |
| B4160 |
Ef ped caloric dense>/=0.7kc |
1,946 |
1,732 |
$132K |
| B4161 |
Ef ped hydrolyzed/amino acid |
678 |
621 |
$125K |
| A4657 |
Syringe w/wo needle |
33,419 |
24,426 |
$120K |
| E0781 |
External ambulatory infus pu |
2,810 |
773 |
$114K |
| T4529 |
Ped size brief/diaper sm/med |
808 |
786 |
$85K |
| T4541 |
Large disposable underpad |
1,306 |
1,279 |
$72K |
| A4248 |
Chlorhexidine antisept |
12,817 |
3,652 |
$61K |
| A4215 |
Sterile needle |
1,379 |
1,225 |
$44K |
| T4535 |
Disposable liner/shield/pad |
852 |
829 |
$43K |
| A4930 |
Sterile, gloves per pair |
6,532 |
3,312 |
$43K |
| A4212 |
Non coring needle or stylet |
1,630 |
1,078 |
$37K |
| B4150 |
Ef complet w/intact nutrient |
161 |
153 |
$24K |
| T4522 |
Adult size brief/diaper med |
220 |
215 |
$22K |
| T4521 |
Adult size brief/diaper sm |
186 |
183 |
$17K |
| A6258 |
Transparent film >16<=48 in |
4,354 |
2,532 |
$16K |
| E0776 |
Iv pole |
272 |
272 |
$13K |
| S1015 |
Iv tubing extension set |
1,530 |
883 |
$13K |
| A4245 |
Alcohol wipes per box |
3,233 |
3,147 |
$6K |
| B4155 |
Ef incomplete/modular |
688 |
578 |
$4K |
| B4082 |
Enteral ng tubing w/o stylet |
304 |
300 |
$4K |
| A6257 |
Transparent film <= 16 sq in |
1,031 |
913 |
$4K |
| A6250 |
Skin seal protect moisturizr |
860 |
696 |
$3K |
| A4335 |
Incontinence supply |
701 |
682 |
$2K |
| A4209 |
5+ cc sterile syringe&needle |
376 |
127 |
$635.67 |
| A4206 |
1 cc sterile syringe&needle |
41 |
38 |
$230.28 |
| S9345 |
Hit anti-hemophil diem |
175 |
161 |
$0.00 |
| 0250 |
|
35 |
21 |
$0.00 |