| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| B4035 |
Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
6,039 |
5,754 |
$2.10M |
| B4161 |
Enteral formula, for pediatrics, hydrolyzed/amino acids and peptide chain proteins, includes fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit |
1,259 |
1,158 |
$967K |
| B4087 |
Gastrostomy/jejunostomy tube, standard, any material, any type, each |
5,986 |
5,829 |
$911K |
| 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 |
5,125 |
4,805 |
$896K |
| B4149 |
Enteral formula, manufactured blenderized natural foods with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit |
868 |
822 |
$452K |
| B4034 |
Enteral feeding supply kit; syringe fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
1,408 |
1,355 |
$237K |
| B9002 |
Enteral nutrition infusion pump, any type |
1,241 |
1,192 |
$158K |
| B4150 |
Enteral formula, nutritionally complete with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit |
639 |
609 |
$147K |
| B4152 |
Enteral formula, nutritionally complete, calorically dense (equal to or greater than 1.5 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 |
707 |
661 |
$146K |
| B4088 |
Gastrostomy/jejunostomy tube, low-profile, any material, any type, each |
940 |
886 |
$87K |
| 97803 |
|
1,464 |
1,444 |
$67K |
| B4100 |
Food thickener, administered orally, per ounce |
230 |
223 |
$10K |
| B4158 |
Enteral formula, for pediatrics, nutritionally complete with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber and/or iron, administered through an enteral feeding tube, 100 calories = 1 unit |
78 |
74 |
$8K |
| B4082 |
Nasogastric tubing without stylet |
100 |
92 |
$4K |