| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| B4160 |
Ef ped caloric dense>/=0.7kc |
19,630 |
15,705 |
$3.78M |
| B4152 |
Ef calorie dense>/=1.5kcal |
20,835 |
15,594 |
$2.50M |
| T4534 |
Youth size pull-on |
11,795 |
11,104 |
$2.31M |
| B4154 |
Ef spec metabolic noninherit |
10,677 |
6,369 |
$1.70M |
| B4150 |
Ef complet w/intact nutrient |
11,155 |
7,855 |
$1.07M |
| B4161 |
Ef ped hydrolyzed/amino acid |
717 |
635 |
$547K |
| B4035 |
Enteral feed supp pump per d |
2,627 |
2,297 |
$501K |
| T4532 |
Ped size pull-on lg |
2,492 |
2,321 |
$469K |
| B9998 |
Enteral supp not otherwise c |
4,848 |
3,702 |
$389K |
| B4102 |
Ef adult fluids and electro |
3,674 |
2,431 |
$358K |
| T4530 |
Ped size brief/diaper lg |
3,178 |
2,955 |
$341K |
| T4527 |
Adult size pull-on lg |
1,600 |
1,493 |
$328K |
| T4526 |
Adult size pull-on med |
1,627 |
1,536 |
$292K |
| T4522 |
Adult size brief/diaper med |
2,186 |
2,038 |
$289K |
| T4521 |
Adult size brief/diaper sm |
1,957 |
1,798 |
$213K |
| B4034 |
Enter feed supkit syr by day |
2,101 |
1,878 |
$209K |
| T4525 |
Adult size pull-on sm |
880 |
842 |
$156K |
| B4155 |
Ef incomplete/modular |
1,372 |
1,150 |
$82K |
| T4523 |
Adult size brief/diaper lg |
394 |
358 |
$79K |
| T4528 |
Adult size pull-on xl |
272 |
249 |
$78K |
| B4153 |
Ef hydrolyzed/amino acids |
1,566 |
753 |
$52K |
| B9002 |
Enter nutr inf pump any type |
527 |
501 |
$40K |
| A4335 |
Incontinence supply |
1,158 |
1,059 |
$35K |
| T4535 |
Disposable liner/shield/pad |
873 |
807 |
$29K |
| T4541 |
Large disposable underpad |
295 |
281 |
$29K |
| T4524 |
Adult size brief/diaper xl |
51 |
50 |
$14K |
| B4088 |
Gastro/jejuno tube, low-pro |
189 |
132 |
$11K |
| T4537 |
Reusable underpad bed size |
57 |
56 |
$4K |
| E0776 |
Iv pole |
286 |
277 |
$2K |