| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| B4035 |
Enteral feed supp pump per d |
45,946 |
38,967 |
$10.22M |
| A4222 |
Infusion supplies with pump |
9,018 |
3,344 |
$4.41M |
| B9002 |
Enter nutr inf pump any type |
119,754 |
36,316 |
$3.65M |
| B4161 |
Ef ped hydrolyzed/amino acid |
9,992 |
8,670 |
$2.90M |
| A4223 |
Infusion supplies w/o pump |
13,189 |
5,421 |
$2.22M |
| B4149 |
Ef blenderized foods |
7,992 |
6,837 |
$1.84M |
| B4034 |
Enter feed supkit syr by day |
10,837 |
9,271 |
$1.79M |
| B4160 |
Ef ped caloric dense>/=0.7kc |
17,502 |
15,101 |
$1.71M |
| B4185 |
Pn soln nos 10 grams lipids |
9,402 |
2,290 |
$1.31M |
| B4153 |
Ef hydrolyzed/amino acids |
4,315 |
3,582 |
$1.16M |
| A4305 |
Drug delivery system >=50 ml |
11,894 |
3,863 |
$841K |
| B4150 |
Ef complet w/intact nutrient |
10,547 |
8,688 |
$744K |
| B4100 |
Food thickener oral |
7,235 |
6,604 |
$722K |
| B4189 |
Parenteral sol amino acid & |
2,524 |
647 |
$689K |
| A4221 |
Supp non-insulin inf cath/wk |
16,586 |
6,704 |
$689K |
| E0781 |
External ambulatory infus pu |
7,435 |
3,097 |
$525K |
| B4088 |
Gastro/jejuno tube, low-pro |
8,767 |
8,205 |
$505K |
| B4152 |
Ef calorie dense>/=1.5kcal |
5,289 |
4,318 |
$434K |
| S5520 |
Hit picc insert kit |
16,905 |
7,778 |
$258K |
| B4197 |
Parenteral sol 74-100 gm pro |
635 |
158 |
$221K |
| B4162 |
Ef ped specmetabolic inherit |
815 |
471 |
$211K |
| B4154 |
Ef spec metabolic noninherit |
1,708 |
1,332 |
$201K |
| B4155 |
Ef incomplete/modular |
3,896 |
3,089 |
$181K |
| B4036 |
Enteral feed sup kit grav by |
1,291 |
1,157 |
$156K |
| S9342 |
Hit enteral pump diem |
1,489 |
1,378 |
$94K |
| B4224 |
Parenteral administration ki |
9,204 |
2,122 |
$70K |
| B4216 |
Parenteral nutrition additiv |
971 |
464 |
$58K |
| E0776 |
Iv pole |
2,087 |
1,923 |
$49K |
| A4216 |
Sterile water/saline, 10 ml |
291 |
166 |
$46K |
| J1559 |
Hizentra injection |
30 |
12 |
$46K |
| B4220 |
Parenteral supply kit premix |
9,174 |
2,109 |
$45K |
| J7030 |
Normal saline solution infus |
1,272 |
578 |
$41K |
| J1955 |
Inj levocarnitine per 1 gm |
3,413 |
766 |
$36K |
| J3490 |
Drugs unclassified injection |
1,654 |
503 |
$26K |
| B4199 |
Parenteral sol > 100gm prote |
45 |
12 |
$22K |
| B9998 |
Enteral supp not otherwise c |
1,312 |
1,109 |
$17K |
| J2997 |
Alteplase recombinant |
116 |
65 |
$11K |
| S9435 |
Medical foods for inborn err |
12 |
12 |
$7K |
| 99214 |
|
56 |
52 |
$4K |
| S9343 |
Hit enteral bolus nurs |
101 |
98 |
$2K |
| E0779 |
Amb infusion pump mechanical |
273 |
134 |
$2K |
| J3411 |
Thiamine hcl 100 mg |
22 |
12 |
$435.34 |
| K0552 |
Sup/ext non-ins inf pump syr |
94 |
50 |
$390.63 |
| B4081 |
Enteral ng tubing w/ stylet |
180 |
163 |
$364.74 |
| J7120 |
Ringers lactate infusion |
58 |
25 |
$297.30 |
| B4158 |
Ef ped complete intact nut |
12 |
12 |
$241.21 |
| 90686 |
|
12 |
12 |
$0.00 |
| J3475 |
Inj magnesium sulfate |
42 |
14 |
$0.00 |