| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| B4035 |
Enteral feed supp pump per d |
6,814 |
5,171 |
$1.11M |
| B4161 |
Ef ped hydrolyzed/amino acid |
1,740 |
1,267 |
$958K |
| B4224 |
Parenteral administration ki |
8,684 |
2,016 |
$877K |
| B4160 |
Ef ped caloric dense>/=0.7kc |
1,497 |
1,173 |
$462K |
| B4220 |
Parenteral supply kit premix |
8,402 |
2,009 |
$266K |
| A4222 |
Infusion supplies with pump |
2,265 |
876 |
$206K |
| A4221 |
Supp non-insulin inf cath/wk |
7,034 |
2,987 |
$157K |
| B4088 |
Gastro/jejuno tube, low-pro |
1,712 |
1,276 |
$147K |
| B4152 |
Ef calorie dense>/=1.5kcal |
1,879 |
1,047 |
$131K |
| A4211 |
Supp for self-adm injections |
11,214 |
2,751 |
$107K |
| B4149 |
Ef blenderized foods |
248 |
198 |
$59K |
| B4034 |
Enter feed supkit syr by day |
431 |
305 |
$24K |
| E0781 |
External ambulatory infus pu |
111 |
73 |
$21K |
| B4150 |
Ef complet w/intact nutrient |
311 |
183 |
$16K |
| B9998 |
Enteral supp not otherwise c |
746 |
421 |
$12K |
| B4155 |
Ef incomplete/modular |
21 |
12 |
$6K |
| B4158 |
Ef ped complete intact nut |
20 |
12 |
$4K |
| A4305 |
Drug delivery system >=50 ml |
31 |
13 |
$1K |
| A9901 |
Delivery/set up/dispensing |
132 |
93 |
$574.27 |