| 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 |
165 |
103 |
$17K |
| E1390 |
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate |
179 |
160 |
$11K |
| B9998 |
Noc for enteral supplies |
182 |
89 |
$7K |
| A7000 |
Canister, disposable, used with suction pump, each |
260 |
241 |
$5K |
| A4606 |
Oxygen probe for use with oximeter device, replacement |
55 |
36 |
$5K |
| B9002 |
Enteral nutrition infusion pump, any type |
43 |
26 |
$3K |
| A7002 |
Tubing, used with suction pump, each |
302 |
285 |
$2K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
79 |
61 |
$901.23 |
| A4628 |
Oral and/or oropharyngeal suction catheter, each |
325 |
302 |
$614.14 |
| A4322 |
Irrigation syringe, bulb or piston, each |
96 |
69 |
$525.30 |
| A4554 |
Disposable underpads, all sizes |
35 |
25 |
$502.43 |
| A7526 |
Tracheostomy tube collar/holder, each |
28 |
26 |
$502.20 |
| A4629 |
Tracheostomy care kit for established tracheostomy |
13 |
12 |
$390.60 |
| A6402 |
Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
98 |
67 |
$345.20 |
| A4216 |
Sterile water, saline and/or dextrose, diluent/flush, 10 ml |
26 |
24 |
$180.00 |
| T1999 |
Miscellaneous therapeutic items and supplies, retail purchases, not otherwise classified; identify product in "remarks" |
99 |
34 |
$143.16 |
| A4335 |
Incontinence supply; miscellaneous |
38 |
27 |
$89.46 |