| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| B4035 |
Enteral feed supp pump per d |
5,262 |
3,253 |
$109K |
| B4152 |
Ef calorie dense>/=1.5kcal |
6,791 |
4,188 |
$69K |
| B4150 |
Ef complet w/intact nutrient |
1,474 |
871 |
$22K |
| B4034 |
Enter feed supkit syr by day |
2,169 |
1,316 |
$16K |
| B4154 |
Ef spec metabolic noninherit |
907 |
505 |
$13K |
| B4087 |
Gastro/jejuno tube, std |
449 |
410 |
$1K |
| E0776 |
Iv pole |
515 |
471 |
$775.56 |
| A4414 |
Ost sknbar w/o conv<=4 sq in |
306 |
223 |
$537.44 |
| A5063 |
Drain ostomy pouch w/flange |
176 |
153 |
$431.55 |
| A4314 |
Cath w/drainage 2-way latex |
376 |
305 |
$305.67 |
| B9002 |
Enter nutr inf pump any type |
811 |
604 |
$148.42 |
| A4334 |
Urinary cath leg strap |
389 |
312 |
$19.72 |