| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| B4152 |
Ef calorie dense>/=1.5kcal |
8,956 |
3,391 |
$452K |
| B4150 |
Ef complet w/intact nutrient |
7,667 |
2,467 |
$266K |
| B4160 |
Ef ped caloric dense>/=0.7kc |
1,821 |
1,378 |
$190K |
| B4154 |
Ef spec metabolic noninherit |
1,103 |
890 |
$146K |
| B4035 |
Enteral feed supp pump per d |
961 |
709 |
$120K |
| B9998 |
Enteral supp not otherwise c |
1,007 |
708 |
$44K |
| B4034 |
Enter feed supkit syr by day |
572 |
448 |
$33K |
| K0553 |
Ther cgm supply allowance |
1,049 |
845 |
$8K |
| A4223 |
Infusion supplies w/o pump |
35 |
13 |
$3K |
| A4221 |
Supp non-insulin inf cath/wk |
38 |
12 |
$498.35 |