| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A4333 |
Urinary catheter anchoring device, adhesive skin attachment, each |
1,782 |
1,777 |
$6K |
| A4357 |
Bedside drainage bag, day or night, with or without anti-reflux device, with or without tube, each |
2,508 |
2,503 |
$5K |
| A4314 |
Insertion tray with drainage bag with indwelling catheter, foley type, two-way latex with coating (teflon, silicone, silicone elastomer or hydrophilic, etc.) |
1,530 |
1,530 |
$4K |
| A4358 |
Urinary drainage bag, leg or abdomen, vinyl, with or without tube, with straps, each |
1,388 |
1,381 |
$3K |
| B4035 |
Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
217 |
149 |
$2K |
| A4315 |
Insertion tray with drainage bag with indwelling catheter, foley type, two-way, all silicone |
220 |
219 |
$620.05 |
| A4320 |
Irrigation tray with bulb or piston syringe, any purpose |
823 |
822 |
$501.71 |
| B4152 |
Enteral formula, nutritionally complete, calorically dense (equal to or greater than 1.5 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 |
19 |
12 |
$288.45 |
| A4456 |
Adhesive remover, wipes, any type, each |
107 |
107 |
$271.86 |
| A6240 |
Hydrocolloid dressing, wound filler, paste, sterile, per ounce |
27 |
12 |
$200.83 |
| A4334 |
Urinary catheter anchoring device, leg strap, each |
293 |
292 |
$149.20 |
| A6219 |
Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing |
138 |
77 |
$122.11 |
| A5120 |
Skin barrier, wipes or swabs, each |
69 |
69 |
$91.47 |
| A4394 |
Ostomy deodorant, with or without lubricant, for use in ostomy pouch, per fluid ounce |
27 |
27 |
$17.12 |