| 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 |
5,803 |
5,650 |
$1.31M |
| B9998 |
Noc for enteral supplies |
6,932 |
6,692 |
$858K |
| T4541 |
Incontinence product, disposable underpad, large, each |
14,455 |
14,391 |
$728K |
| A4322 |
Irrigation syringe, bulb or piston, each |
8,523 |
8,236 |
$644K |
| A4657 |
Syringe, with or without needle, each |
5,909 |
5,749 |
$463K |
| B4088 |
Gastrostomy/jejunostomy tube, low-profile, any material, any type, each |
1,337 |
1,296 |
$410K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
8,086 |
7,605 |
$339K |
| B4036 |
Enteral feeding supply kit; gravity fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
1,912 |
1,910 |
$307K |
| 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 |
2,295 |
2,247 |
$243K |
| T4523 |
Adult sized disposable incontinence product, brief/diaper, large, each |
1,778 |
1,777 |
$192K |
| B4161 |
Enteral formula, for pediatrics, hydrolyzed/amino acids and peptide chain proteins, includes fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit |
1,096 |
1,073 |
$189K |
| B4154 |
Enteral formula, nutritionally complete, for special metabolic needs, excludes inherited disease of metabolism, includes altered composition of proteins, fats, carbohydrates, vitamins and/or minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit |
1,397 |
1,384 |
$187K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
2,747 |
2,740 |
$180K |
| T4522 |
Adult sized disposable incontinence product, brief/diaper, medium, each |
2,009 |
2,002 |
$172K |
| A6402 |
Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
7,141 |
7,098 |
$128K |
| A6250 |
Skin sealants, protectants, moisturizers, ointments, any type, any size |
7,116 |
7,091 |
$107K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
1,588 |
1,578 |
$85K |
| 99429 |
|
413 |
388 |
$81K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
1,218 |
1,213 |
$74K |
| A4335 |
Incontinence supply; miscellaneous |
6,144 |
6,126 |
$63K |
| T4524 |
Adult sized disposable incontinence product, brief/diaper, extra large, each |
698 |
698 |
$61K |
| T4536 |
Incontinence product, protective underwear/pull-on, reusable, any size, each |
3,628 |
3,617 |
$40K |
| 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 |
290 |
288 |
$25K |
| A4402 |
Lubricant, per ounce |
2,610 |
2,606 |
$10K |
| A4927 |
Gloves, non-sterile, per 100 |
1,351 |
1,318 |
$10K |
| T4537 |
Incontinence product, protective underpad, reusable, bed size, each |
141 |
136 |
$4K |
| E1399 |
Durable medical equipment, miscellaneous |
1,544 |
1,540 |
$4K |
| T4525 |
Adult sized disposable incontinence product, protective underwear/pull-on, small size, each |
36 |
36 |
$2K |
| B4155 |
Enteral formula, nutritionally incomplete/modular nutrients, includes specific nutrients, carbohydrates (e.g., glucose polymers), proteins/amino acids (e.g., glutamine, arginine), fat (e.g., medium chain triglycerides) or combination, administered through an enteral feeding tube, 100 calories = 1 unit |
13 |
13 |
$315.81 |