| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| B4161 |
Ef ped hydrolyzed/amino acid |
3,148 |
2,302 |
$1.29M |
| B4035 |
Enteral feed supp pump per d |
8,225 |
5,766 |
$655K |
| B4160 |
Ef ped caloric dense>/=0.7kc |
3,241 |
2,267 |
$537K |
| S9342 |
Hit enteral pump diem |
16,432 |
529 |
$283K |
| B4153 |
Ef hydrolyzed/amino acids |
495 |
292 |
$249K |
| B4152 |
Ef calorie dense>/=1.5kcal |
1,732 |
1,008 |
$226K |
| B9998 |
Enteral supp not otherwise c |
6,874 |
4,596 |
$155K |
| J1642 |
Inj heparin sodium per 10 u |
323 |
119 |
$123K |
| A4213 |
20+ cc syringe only |
556 |
510 |
$115K |
| B4150 |
Ef complet w/intact nutrient |
663 |
440 |
$96K |
| B4149 |
Ef blenderized foods |
207 |
148 |
$84K |
| B4100 |
Food thickener oral |
310 |
254 |
$35K |
| B4155 |
Ef incomplete/modular |
749 |
544 |
$25K |
| A4221 |
Supp non-insulin inf cath/wk |
676 |
313 |
$19K |
| B9002 |
Enter nutr inf pump any type |
316 |
213 |
$9K |
| A4222 |
Infusion supplies with pump |
20 |
12 |
$4K |
| E0776 |
Iv pole |
38 |
27 |
$2K |
| B4034 |
Enter feed supkit syr by day |
146 |
75 |
$2K |