| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| B4161 |
Ef ped hydrolyzed/amino acid |
8,014 |
6,631 |
$3.52M |
| B4035 |
Enteral feed supp pump per d |
9,258 |
8,219 |
$2.63M |
| B4087 |
Gastro/jejuno tube, std |
8,364 |
7,717 |
$1.34M |
| B4149 |
Ef blenderized foods |
5,765 |
4,131 |
$1.25M |
| B4160 |
Ef ped caloric dense>/=0.7kc |
6,428 |
5,152 |
$656K |
| B9002 |
Enter nutr inf pump any type |
5,477 |
5,199 |
$576K |
| B4088 |
Gastro/jejuno tube, low-pro |
2,651 |
2,618 |
$247K |
| B4034 |
Enter feed supkit syr by day |
1,057 |
999 |
$158K |
| A4222 |
Infusion supplies with pump |
394 |
149 |
$142K |
| B4155 |
Ef incomplete/modular |
1,932 |
1,691 |
$102K |
| B4036 |
Enteral feed sup kit grav by |
417 |
391 |
$92K |
| B4100 |
Food thickener oral |
2,031 |
1,684 |
$90K |
| B4152 |
Ef calorie dense>/=1.5kcal |
697 |
583 |
$79K |
| 99601 |
|
664 |
334 |
$79K |
| B4103 |
Ef ped fluid and electrolyte |
711 |
552 |
$64K |
| A4221 |
Supp non-insulin inf cath/wk |
1,262 |
599 |
$35K |
| B4081 |
Enteral ng tubing w/ stylet |
530 |
474 |
$24K |
| 90378 |
|
16 |
12 |
$20K |
| B4150 |
Ef complet w/intact nutrient |
143 |
109 |
$14K |
| E0776 |
Iv pole |
462 |
453 |
$12K |
| T4533 |
Youth size brief/diaper |
259 |
234 |
$9K |
| B4158 |
Ef ped complete intact nut |
13 |
12 |
$968.36 |
| 96372 |
|
19 |
17 |
$60.27 |