| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| B4161 |
Ef ped hydrolyzed/amino acid |
2,414 |
1,796 |
$660K |
| B4160 |
Ef ped caloric dense>/=0.7kc |
5,887 |
4,616 |
$412K |
| B4035 |
Enteral feed supp pump per d |
2,376 |
2,108 |
$396K |
| B9998 |
Enteral supp not otherwise c |
2,681 |
1,632 |
$126K |
| B4152 |
Ef calorie dense>/=1.5kcal |
741 |
668 |
$99K |
| B4103 |
Ef ped fluid and electrolyte |
513 |
450 |
$71K |
| B4149 |
Ef blenderized foods |
215 |
195 |
$60K |
| B4150 |
Ef complet w/intact nutrient |
636 |
576 |
$47K |
| B9002 |
Enter nutr inf pump any type |
961 |
822 |
$32K |
| B4155 |
Ef incomplete/modular |
645 |
589 |
$28K |
| B4034 |
Enter feed supkit syr by day |
255 |
221 |
$22K |
| B4088 |
Gastro/jejuno tube, low-pro |
723 |
685 |
$22K |
| B4158 |
Ef ped complete intact nut |
119 |
96 |
$21K |
| E0776 |
Iv pole |
565 |
510 |
$6K |