| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| B4161 |
Ef ped hydrolyzed/amino acid |
7,103 |
2,647 |
$2.75M |
| A4223 |
Infusion supplies w/o pump |
5,399 |
2,015 |
$2.11M |
| B4035 |
Enteral feed supp pump per d |
106,067 |
7,267 |
$1.75M |
| S9342 |
Hit enteral pump diem |
3,482 |
2,182 |
$1.18M |
| B4160 |
Ef ped caloric dense>/=0.7kc |
4,305 |
1,681 |
$615K |
| A4222 |
Infusion supplies with pump |
3,021 |
863 |
$552K |
| B4034 |
Enter feed supkit syr by day |
29,055 |
3,026 |
$540K |
| B4152 |
Ef calorie dense>/=1.5kcal |
6,279 |
3,516 |
$465K |
| B4150 |
Ef complet w/intact nutrient |
3,701 |
1,689 |
$224K |
| A4221 |
Supp non-insulin inf cath/wk |
10,782 |
4,341 |
$211K |
| B4153 |
Ef hydrolyzed/amino acids |
1,373 |
383 |
$203K |
| B4149 |
Ef blenderized foods |
3,191 |
559 |
$188K |
| A4305 |
Drug delivery system >=50 ml |
1,172 |
320 |
$170K |
| B4088 |
Gastro/jejuno tube, low-pro |
2,892 |
2,350 |
$166K |
| B4185 |
Pn soln nos 10 grams lipids |
743 |
127 |
$86K |
| B4155 |
Ef incomplete/modular |
2,255 |
1,389 |
$53K |
| S9343 |
Hit enteral bolus nurs |
256 |
173 |
$33K |
| J7030 |
Normal saline solution infus |
5,603 |
755 |
$29K |
| B4036 |
Enteral feed sup kit grav by |
927 |
97 |
$16K |
| B9002 |
Enter nutr inf pump any type |
369 |
171 |
$5K |
| 99601 |
|
25 |
15 |
$2K |
| J0696 |
Ceftriaxone sodium injection |
173 |
12 |
$2K |
| E0776 |
Iv pole |
506 |
216 |
$686.45 |