| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| B4161 |
Ef ped hydrolyzed/amino acid |
3,832 |
2,335 |
$3.57M |
| B4035 |
Enteral feed supp pump per d |
20,680 |
10,026 |
$2.25M |
| A4222 |
Infusion supplies with pump |
7,330 |
2,321 |
$1.51M |
| B4160 |
Ef ped caloric dense>/=0.7kc |
6,033 |
2,417 |
$1.24M |
| A4223 |
Infusion supplies w/o pump |
2,612 |
1,314 |
$1.04M |
| B4152 |
Ef calorie dense>/=1.5kcal |
7,404 |
3,912 |
$504K |
| A4221 |
Supp non-insulin inf cath/wk |
16,949 |
7,241 |
$334K |
| B4185 |
Pn soln nos 10 grams lipids |
2,751 |
591 |
$330K |
| A4305 |
Drug delivery system >=50 ml |
2,390 |
1,232 |
$315K |
| B4034 |
Enter feed supkit syr by day |
5,542 |
3,216 |
$288K |
| B4150 |
Ef complet w/intact nutrient |
3,675 |
2,018 |
$243K |
| B4224 |
Parenteral administration ki |
2,939 |
584 |
$206K |
| B9002 |
Enter nutr inf pump any type |
1,835 |
1,746 |
$141K |
| B4149 |
Ef blenderized foods |
1,462 |
390 |
$122K |
| B4153 |
Ef hydrolyzed/amino acids |
283 |
200 |
$106K |
| B4088 |
Gastro/jejuno tube, low-pro |
2,660 |
2,530 |
$78K |
| B4220 |
Parenteral supply kit premix |
2,941 |
585 |
$61K |
| E0781 |
External ambulatory infus pu |
83 |
81 |
$13K |
| B4155 |
Ef incomplete/modular |
270 |
145 |
$10K |
| E0776 |
Iv pole |
575 |
504 |
$2K |