| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| B4161 |
Ef ped hydrolyzed/amino acid |
1,609 |
1,228 |
$997K |
| B4153 |
Ef hydrolyzed/amino acids |
580 |
426 |
$275K |
| B4160 |
Ef ped caloric dense>/=0.7kc |
1,285 |
1,172 |
$263K |
| B4035 |
Enteral feed supp pump per d |
2,498 |
1,819 |
$244K |
| S9342 |
Hit enteral pump diem |
803 |
771 |
$232K |
| S9500 |
Hit antibiotic q24h diem |
4,963 |
579 |
$178K |
| B4149 |
Ef blenderized foods |
488 |
343 |
$176K |
| 99601 |
|
1,936 |
654 |
$150K |
| A4223 |
Infusion supplies w/o pump |
5,034 |
404 |
$134K |
| B4150 |
Ef complet w/intact nutrient |
1,367 |
1,093 |
$125K |
| B4152 |
Ef calorie dense>/=1.5kcal |
1,611 |
1,037 |
$96K |
| B4034 |
Enter feed supkit syr by day |
1,945 |
1,363 |
$82K |
| B4154 |
Ef spec metabolic noninherit |
368 |
268 |
$56K |
| S9501 |
Hit antibiotic q12h diem |
1,499 |
128 |
$44K |
| S9502 |
Hit antibiotic q8h diem |
931 |
97 |
$39K |
| B4155 |
Ef incomplete/modular |
331 |
277 |
$39K |
| B9002 |
Enter nutr inf pump any type |
1,310 |
1,140 |
$38K |
| B4185 |
Pn soln nos 10 grams lipids |
141 |
39 |
$23K |
| B4088 |
Gastro/jejuno tube, low-pro |
430 |
358 |
$22K |
| E0781 |
External ambulatory infus pu |
821 |
91 |
$15K |
| S9343 |
Hit enteral bolus nurs |
14 |
13 |
$4K |
| B9998 |
Enteral supp not otherwise c |
113 |
87 |
$2K |
| A4221 |
Supp non-insulin inf cath/wk |
166 |
53 |
$2K |