| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| B4100 |
Food thickener, administered orally, per ounce |
1,973 |
1,618 |
$328K |
| B4152 |
Enteral formula, nutritionally complete, calorically dense (equal to or greater than 1.5 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 |
97 |
62 |
$12K |
| A6533 |
Gradient compression stocking, thigh length, 18-30 mmhg, each |
121 |
94 |
$9K |
| A6530 |
Gradient compression stocking, below knee, 18-30 mmhg, each |
43 |
24 |
$2K |