| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A4211 |
Supp for self-adm injections |
8,936 |
3,251 |
$1.29M |
| B4152 |
Ef calorie dense>/=1.5kcal |
9,378 |
6,084 |
$1.02M |
| B4035 |
Enteral feed supp pump per d |
7,105 |
4,459 |
$952K |
| B4224 |
Parenteral administration ki |
5,813 |
1,736 |
$567K |
| B4220 |
Parenteral supply kit premix |
17,116 |
6,188 |
$519K |
| B4160 |
Ef ped caloric dense>/=0.7kc |
1,866 |
963 |
$406K |
| B4153 |
Ef hydrolyzed/amino acids |
958 |
723 |
$376K |
| B4150 |
Ef complet w/intact nutrient |
4,406 |
2,953 |
$372K |
| A4305 |
Drug delivery system >=50 ml |
5,957 |
2,110 |
$299K |
| B4154 |
Ef spec metabolic noninherit |
1,351 |
978 |
$291K |
| A4222 |
Infusion supplies with pump |
2,310 |
898 |
$287K |
| A4306 |
Drug delivery system <=50 ml |
1,863 |
671 |
$183K |
| B4034 |
Enter feed supkit syr by day |
2,052 |
1,508 |
$168K |
| B4036 |
Enteral feed sup kit grav by |
1,248 |
728 |
$101K |
| B4155 |
Ef incomplete/modular |
1,205 |
970 |
$100K |
| B9998 |
Enteral supp not otherwise c |
1,835 |
1,423 |
$84K |
| B9002 |
Enter nutr inf pump any type |
1,275 |
1,158 |
$82K |
| B4161 |
Ef ped hydrolyzed/amino acid |
156 |
91 |
$71K |
| B4088 |
Gastro/jejuno tube, low-pro |
619 |
496 |
$69K |
| B9004 |
Parenteral infus pump portab |
277 |
268 |
$57K |
| E0781 |
External ambulatory infus pu |
211 |
203 |
$44K |
| E0776 |
Iv pole |
479 |
411 |
$34K |
| A4221 |
Supp non-insulin inf cath/wk |
447 |
341 |
$21K |
| B4149 |
Ef blenderized foods |
16 |
12 |
$4K |
| A9901 |
Delivery/set up/dispensing |
178 |
130 |
$2K |