| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| B4035 |
Enteral feed supp pump per d |
4,272 |
4,134 |
$1.04M |
| B4087 |
Gastro/jejuno tube, std |
4,826 |
4,697 |
$613K |
| B4150 |
Ef complet w/intact nutrient |
2,010 |
1,948 |
$369K |
| B4088 |
Gastro/jejuno tube, low-pro |
1,236 |
1,214 |
$205K |
| B4149 |
Ef blenderized foods |
375 |
362 |
$122K |
| L3202 |
Oxford w/ supinat/pronator c |
1,281 |
1,223 |
$113K |
| B4153 |
Ef hydrolyzed/amino acids |
131 |
129 |
$93K |
| B4036 |
Enteral feed sup kit grav by |
326 |
320 |
$55K |
| B4161 |
Ef ped hydrolyzed/amino acid |
86 |
86 |
$35K |
| L2840 |
Tibial length sock fx or equ |
326 |
298 |
$30K |
| L1970 |
Afo plastic molded w/ankle j |
29 |
25 |
$23K |
| L2275 |
Plastic mod low ext pad/line |
101 |
97 |
$17K |
| B4155 |
Ef incomplete/modular |
550 |
534 |
$16K |
| L2820 |
Soft interface below knee se |
27 |
25 |
$2K |