| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 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 |
159 |
155 |
$6K |
| B4035 |
Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
93 |
88 |
$3K |
| B9002 |
Enteral nutrition infusion pump, any type |
72 |
72 |
$2K |
| B4034 |
Enteral feeding supply kit; syringe fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
107 |
102 |
$2K |
| E0776 |
Iv pole |
78 |
77 |
$230.78 |