| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| B4035 |
Enteral feed supp pump per d |
1,446 |
1,063 |
$34K |
| B4150 |
Ef complet w/intact nutrient |
848 |
579 |
$19K |
| B4152 |
Ef calorie dense>/=1.5kcal |
474 |
376 |
$11K |
| B4154 |
Ef spec metabolic noninherit |
194 |
126 |
$7K |
| A4623 |
Tracheostomy inner cannula |
238 |
228 |
$2K |
| A4357 |
Bedside drainage bag |
1,154 |
1,110 |
$1K |
| B4034 |
Enter feed supkit syr by day |
66 |
40 |
$784.20 |
| A4414 |
Ost sknbar w/o conv<=4 sq in |
14 |
14 |
$732.33 |
| A4338 |
Indwelling catheter latex |
457 |
449 |
$531.95 |
| A4344 |
Cath indw foley 2 way silicn |
354 |
354 |
$438.24 |
| A4310 |
Insert tray w/o bag/cath |
871 |
855 |
$436.96 |
| A4349 |
Disposable male external cat |
163 |
163 |
$427.69 |
| A6212 |
Foam drg <=16 sq in w/border |
16 |
12 |
$382.85 |
| A5063 |
Drain ostomy pouch w/flange |
13 |
13 |
$374.59 |
| B4155 |
Ef incomplete/modular |
36 |
34 |
$269.86 |
| A4333 |
Urinary cath anchor device |
527 |
526 |
$235.15 |
| A6402 |
Sterile gauze <= 16 sq in |
65 |
53 |
$182.30 |
| A4358 |
Urinary leg or abdomen bag |
321 |
316 |
$122.05 |
| A4452 |
Waterproof tape |
14 |
13 |
$101.04 |
| A7526 |
Tracheostomy tube collar |
200 |
195 |
$82.42 |
| A7521 |
Trach/laryn tube cuffed |
13 |
12 |
$75.28 |
| A4334 |
Urinary cath leg strap |
356 |
350 |
$55.92 |