| Code | Description | Total Paid |
|---|
| B4035 |
Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
$1.31M |
| B9998 |
Noc for enteral supplies |
$858K |
| T4541 |
Incontinence product, disposable underpad, large, each |
$728K |
| A4322 |
Irrigation syringe, bulb or piston, each |
$644K |
| A4657 |
Syringe, with or without needle, each |
$463K |
| B4088 |
Gastrostomy/jejunostomy tube, low-profile, any material, any type, each |
$410K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
$339K |
| B4036 |
Enteral feeding supply kit; gravity fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
$307K |
| 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 |
$243K |
| T4523 |
Adult sized disposable incontinence product, brief/diaper, large, each |
$192K |