| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| B4035 |
Enteral feed supp pump per d |
14,089 |
9,272 |
$1.83M |
| B4161 |
Ef ped hydrolyzed/amino acid |
3,822 |
2,580 |
$1.20M |
| 90378 |
|
295 |
207 |
$480K |
| B4160 |
Ef ped caloric dense>/=0.7kc |
4,786 |
3,624 |
$420K |
| B4088 |
Gastro/jejuno tube, low-pro |
3,490 |
3,026 |
$356K |
| B9002 |
Enter nutr inf pump any type |
4,680 |
4,466 |
$336K |
| E0600 |
Suction pump portab hom modl |
1,067 |
1,020 |
$323K |
| E0570 |
Nebulizer with compression |
1,675 |
1,604 |
$203K |
| B4149 |
Ef blenderized foods |
781 |
543 |
$202K |
| T4530 |
Ped size brief/diaper lg |
1,065 |
916 |
$99K |
| B9998 |
Enteral supp not otherwise c |
1,619 |
1,094 |
$98K |
| E0619 |
Apnea monitor w recorder |
396 |
391 |
$95K |
| A6210 |
Foam drg >16<=48 sq in w/o b |
651 |
561 |
$90K |
| B4100 |
Food thickener oral |
1,008 |
848 |
$89K |
| B4150 |
Ef complet w/intact nutrient |
396 |
249 |
$42K |
| A4628 |
Oropharyngeal suction cath |
2,371 |
2,168 |
$23K |
| B4034 |
Enter feed supkit syr by day |
233 |
197 |
$21K |
| B4081 |
Enteral ng tubing w/ stylet |
474 |
397 |
$15K |
| A7003 |
Nebulizer administration set |
2,631 |
2,077 |
$14K |
| B4153 |
Ef hydrolyzed/amino acids |
31 |
24 |
$13K |
| A6234 |
Hydrocolld drg <=16 w/o bdr |
258 |
220 |
$12K |
| A4221 |
Supp non-insulin inf cath/wk |
605 |
356 |
$11K |
| A7015 |
Aerosol mask used w nebulize |
2,638 |
2,094 |
$10K |
| B4155 |
Ef incomplete/modular |
192 |
144 |
$9K |
| A7000 |
Disposable canister for pump |
996 |
913 |
$7K |
| S9542 |
Ht inj noc per diem |
166 |
91 |
$6K |
| A4322 |
Irrigation syringe |
847 |
730 |
$6K |
| B4152 |
Ef calorie dense>/=1.5kcal |
58 |
26 |
$5K |
| A6402 |
Sterile gauze <= 16 sq in |
392 |
335 |
$5K |
| A4927 |
Non-sterile gloves |
237 |
205 |
$3K |
| E0776 |
Iv pole |
29 |
25 |
$2K |
| A6257 |
Transparent film <= 16 sq in |
193 |
162 |
$2K |
| A4450 |
Non-waterproof tape |
406 |
347 |
$533.90 |
| T4541 |
Large disposable underpad |
12 |
12 |
$441.00 |
| A5120 |
Skin barrier, wipe or swab |
70 |
67 |
$365.33 |
| A4455 |
Adhesive remover per ounce |
26 |
24 |
$60.06 |