| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| B4160 |
Enteral formula, for pediatrics, nutritionally complete calorically dense (equal to or greater than 0.7 kcal/ml) with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit |
454 |
361 |
$123K |
| B4035 |
Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
261 |
239 |
$43K |
| B4081 |
Nasogastric tubing with stylet |
344 |
309 |
$20K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
225 |
217 |
$9K |
| B4034 |
Enteral feeding supply kit; syringe fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
99 |
85 |
$5K |
| E0163 |
Commode chair, mobile or stationary, with fixed arms |
12 |
12 |
$527.52 |