| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| B4035 |
Enteral feed supp pump per d |
5,803 |
5,650 |
$1.31M |
| B9998 |
Enteral supp not otherwise c |
6,932 |
6,692 |
$858K |
| T4541 |
Large disposable underpad |
14,455 |
14,391 |
$728K |
| A4322 |
Irrigation syringe |
8,523 |
8,236 |
$644K |
| A4657 |
Syringe w/wo needle |
5,909 |
5,749 |
$463K |
| B4088 |
Gastro/jejuno tube, low-pro |
1,337 |
1,296 |
$410K |
| T4535 |
Disposable liner/shield/pad |
8,086 |
7,605 |
$339K |
| B4036 |
Enteral feed sup kit grav by |
1,912 |
1,910 |
$307K |
| B4160 |
Ef ped caloric dense>/=0.7kc |
2,295 |
2,247 |
$243K |
| T4523 |
Adult size brief/diaper lg |
1,778 |
1,777 |
$192K |
| B4161 |
Ef ped hydrolyzed/amino acid |
1,096 |
1,073 |
$189K |
| B4154 |
Ef spec metabolic noninherit |
1,397 |
1,384 |
$187K |
| T4527 |
Adult size pull-on lg |
2,747 |
2,740 |
$180K |
| T4522 |
Adult size brief/diaper med |
2,009 |
2,002 |
$172K |
| A6402 |
Sterile gauze <= 16 sq in |
7,141 |
7,098 |
$128K |
| A6250 |
Skin seal protect moisturizr |
7,116 |
7,091 |
$107K |
| T4526 |
Adult size pull-on med |
1,588 |
1,578 |
$85K |
| 99429 |
|
413 |
388 |
$81K |
| T4528 |
Adult size pull-on xl |
1,218 |
1,213 |
$74K |
| A4335 |
Incontinence supply |
6,144 |
6,126 |
$63K |
| T4524 |
Adult size brief/diaper xl |
698 |
698 |
$61K |
| T4536 |
Reusable pull-on any size |
3,628 |
3,617 |
$40K |
| B4150 |
Ef complet w/intact nutrient |
290 |
288 |
$25K |
| A4402 |
Lubricant per ounce |
2,610 |
2,606 |
$10K |
| A4927 |
Non-sterile gloves |
1,351 |
1,318 |
$10K |
| T4537 |
Reusable underpad bed size |
141 |
136 |
$4K |
| E1399 |
Durable medical equipment mi |
1,544 |
1,540 |
$4K |
| T4525 |
Adult size pull-on sm |
36 |
36 |
$2K |
| B4155 |
Ef incomplete/modular |
13 |
13 |
$315.81 |