| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| B4035 |
Enteral feed supp pump per d |
50,654 |
45,422 |
$2.58M |
| B4161 |
Ef ped hydrolyzed/amino acid |
3,798 |
2,434 |
$1.26M |
| B4152 |
Ef calorie dense>/=1.5kcal |
26,342 |
24,701 |
$1.16M |
| B4154 |
Ef spec metabolic noninherit |
14,086 |
13,156 |
$1.15M |
| B4160 |
Ef ped caloric dense>/=0.7kc |
6,006 |
4,527 |
$1.03M |
| B4153 |
Ef hydrolyzed/amino acids |
4,801 |
4,345 |
$715K |
| B4150 |
Ef complet w/intact nutrient |
14,417 |
13,061 |
$659K |
| B4034 |
Enter feed supkit syr by day |
13,025 |
12,435 |
$358K |
| B4100 |
Food thickener oral |
4,672 |
3,590 |
$339K |
| B9998 |
Enteral supp not otherwise c |
8,855 |
6,952 |
$209K |
| B9002 |
Enter nutr inf pump any type |
10,480 |
9,879 |
$161K |
| A4554 |
Disposable underpads |
1,787 |
1,727 |
$153K |
| A4213 |
20+ cc syringe only |
1,630 |
1,347 |
$102K |
| B4155 |
Ef incomplete/modular |
4,725 |
3,603 |
$96K |
| B4036 |
Enteral feed sup kit grav by |
1,808 |
1,652 |
$86K |
| B4149 |
Ef blenderized foods |
290 |
181 |
$78K |
| T4522 |
Adult size brief/diaper med |
772 |
684 |
$68K |
| E0776 |
Iv pole |
9,444 |
9,311 |
$26K |
| T4524 |
Adult size brief/diaper xl |
320 |
246 |
$22K |
| A4335 |
Incontinence supply |
2,275 |
2,213 |
$20K |
| A4357 |
Bedside drainage bag |
3,795 |
3,651 |
$11K |
| A4414 |
Ost sknbar w/o conv<=4 sq in |
476 |
454 |
$10K |
| A4314 |
Cath w/drainage 2-way latex |
3,596 |
3,483 |
$9K |
| A5061 |
Pouch drainable w barrier at |
396 |
381 |
$8K |
| A5063 |
Drain ostomy pouch w/flange |
323 |
298 |
$4K |
| T4535 |
Disposable liner/shield/pad |
177 |
156 |
$4K |
| A4629 |
Tracheostomy care kit |
494 |
442 |
$3K |
| A4623 |
Tracheostomy inner cannula |
169 |
141 |
$2K |
| B4087 |
Gastro/jejuno tube, std |
210 |
210 |
$2K |
| T4521 |
Adult size brief/diaper sm |
14 |
13 |
$1K |
| A4927 |
Non-sterile gloves |
97 |
90 |
$1K |
| T4523 |
Adult size brief/diaper lg |
13 |
12 |
$1K |
| A6250 |
Skin seal protect moisturizr |
28 |
25 |
$177.52 |
| B4088 |
Gastro/jejuno tube, low-pro |
33 |
30 |
$166.74 |