| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A4223 |
Infusion supplies w/o pump |
2,787 |
1,121 |
$2.17M |
| B4035 |
Enteral feed supp pump per d |
6,705 |
5,188 |
$1.10M |
| B4150 |
Ef complet w/intact nutrient |
3,444 |
3,019 |
$449K |
| B4153 |
Ef hydrolyzed/amino acids |
914 |
764 |
$425K |
| A4222 |
Infusion supplies with pump |
2,791 |
1,649 |
$292K |
| 99601 |
|
1,995 |
1,091 |
$238K |
| B4034 |
Enter feed supkit syr by day |
2,742 |
2,109 |
$236K |
| B4152 |
Ef calorie dense>/=1.5kcal |
1,978 |
1,699 |
$223K |
| J1745 |
Infliximab not biosimil 10mg |
64 |
64 |
$169K |
| A4221 |
Supp non-insulin inf cath/wk |
5,537 |
3,137 |
$119K |
| B4088 |
Gastro/jejuno tube, low-pro |
767 |
758 |
$59K |
| B4185 |
Pn soln nos 10 grams lipids |
188 |
48 |
$58K |
| B9002 |
Enter nutr inf pump any type |
434 |
417 |
$34K |
| B4160 |
Ef ped caloric dense>/=0.7kc |
62 |
50 |
$8K |
| B4036 |
Enteral feed sup kit grav by |
39 |
36 |
$4K |
| J7030 |
Normal saline solution infus |
206 |
65 |
$1K |