| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| B4161 |
Ef ped hydrolyzed/amino acid |
3,188 |
2,793 |
$1.23M |
| B4160 |
Ef ped caloric dense>/=0.7kc |
6,719 |
6,030 |
$876K |
| B4035 |
Enteral feed supp pump per d |
6,471 |
5,212 |
$750K |
| B4149 |
Ef blenderized foods |
1,193 |
1,021 |
$299K |
| B9002 |
Enter nutr inf pump any type |
3,076 |
2,777 |
$220K |
| B4152 |
Ef calorie dense>/=1.5kcal |
1,401 |
1,156 |
$200K |
| A4223 |
Infusion supplies w/o pump |
542 |
237 |
$147K |
| B4150 |
Ef complet w/intact nutrient |
1,336 |
1,055 |
$123K |
| B4034 |
Enter feed supkit syr by day |
1,514 |
1,220 |
$107K |
| B4158 |
Ef ped complete intact nut |
361 |
329 |
$60K |
| B4088 |
Gastro/jejuno tube, low-pro |
1,505 |
1,437 |
$59K |
| A4221 |
Supp non-insulin inf cath/wk |
1,943 |
853 |
$53K |
| B9998 |
Enteral supp not otherwise c |
763 |
608 |
$42K |
| E0776 |
Iv pole |
15 |
13 |
$563.74 |