| Code | Description | Claims | Beneficiaries | Total Paid |
| A4223 |
Infusion supplies not used with external infusion pump, per cassette or bag (list drugs separately) |
20,624 |
4,090 |
$1.10M |
| E0791 |
Parenteral infusion pump, stationary, single or multi-channel |
1,715 |
1,521 |
$485K |
| A4305 |
Disposable drug delivery system, flow rate of 50 ml or greater per hour |
628 |
419 |
$292K |
| B4035 |
Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
579 |
536 |
$105K |
| A4322 |
Irrigation syringe, bulb or piston, each |
1,881 |
1,644 |
$97K |
| B9998 |
Noc for enteral supplies |
1,196 |
925 |
$82K |
| E0776 |
Iv pole |
2,577 |
2,398 |
$51K |
| B9002 |
Enteral nutrition infusion pump, any type |
503 |
474 |
$47K |
| E0781 |
Ambulatory infusion pump, single or multiple channels, electric or battery operated, with administrative equipment, worn by patient |
465 |
320 |
$36K |
| S9342 |
Home therapy; enteral nutrition via pump; administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (enteral formula and nursing visits coded separately), per diem |
98 |
95 |
$32K |
| B9999 |
Noc for parenteral supplies |
1,660 |
1,125 |
$26K |
| A6258 |
Transparent film, sterile, more than 16 sq. in. but less than or equal to 48 sq. in., each dressing |
1,546 |
1,109 |
$24K |
| A6402 |
Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
1,750 |
1,490 |
$22K |
| A6457 |
Tubular dressing with or without elastic, any width, per linear yard |
2,727 |
2,065 |
$20K |
| 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 |
109 |
107 |
$15K |
| A4927 |
Gloves, non-sterile, per 100 |
1,909 |
1,654 |
$15K |
| B4036 |
Enteral feeding supply kit; gravity fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
206 |
153 |
$13K |
| A6247 |
Hydrogel dressing, wound cover, sterile, pad size more than 48 sq. in., with any size adhesive border, each dressing |
78 |
55 |
$6K |
| A4245 |
Alcohol wipes, per box |
3,741 |
3,002 |
$6K |
| S1015 |
Iv tubing extension set |
1,004 |
771 |
$5K |
| A6224 |
Gauze, impregnated with other than water, normal saline, or hydrogel, sterile, pad size more than 48 sq. in., without adhesive border, each dressing |
412 |
286 |
$5K |
| A4209 |
Syringe with needle, sterile 5 cc or greater, each |
383 |
204 |
$4K |
| B4034 |
Enteral feeding supply kit; syringe fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
13 |
12 |
$4K |
| S9343 |
Home therapy; enteral nutrition via bolus; administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (enteral formula and nursing visits coded separately), per diem |
12 |
12 |
$2K |
| A4657 |
Syringe, with or without needle, each |
284 |
170 |
$1K |
| A4215 |
Needle, sterile, any size, each |
106 |
72 |
$1K |
| A5200 |
Percutaneous catheter/tube anchoring device, adhesive skin attachment |
17 |
14 |
$829.20 |