| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| B4035 |
Enteral feed supp pump per d |
2,205 |
1,975 |
$269K |
| J1569 |
Gammagard liquid injection |
88 |
50 |
$255K |
| B4152 |
Ef calorie dense>/=1.5kcal |
979 |
884 |
$117K |
| B4150 |
Ef complet w/intact nutrient |
1,034 |
968 |
$111K |
| B4160 |
Ef ped caloric dense>/=0.7kc |
351 |
320 |
$57K |
| S9500 |
Hit antibiotic q24h diem |
748 |
140 |
$49K |
| B4161 |
Ef ped hydrolyzed/amino acid |
128 |
118 |
$47K |
| B9002 |
Enter nutr inf pump any type |
689 |
678 |
$43K |
| B4149 |
Ef blenderized foods |
149 |
134 |
$36K |
| J1559 |
Hizentra injection |
67 |
24 |
$35K |
| 99601 |
|
481 |
184 |
$29K |
| B4088 |
Gastro/jejuno tube, low-pro |
225 |
224 |
$18K |
| S9338 |
Hit immunotherapy diem |
787 |
412 |
$18K |
| B4087 |
Gastro/jejuno tube, std |
309 |
297 |
$14K |
| B4034 |
Enter feed supkit syr by day |
287 |
244 |
$11K |
| B4154 |
Ef spec metabolic noninherit |
42 |
37 |
$6K |
| B4185 |
Pn soln nos 10 grams lipids |
30 |
12 |
$6K |
| B4153 |
Ef hydrolyzed/amino acids |
14 |
13 |
$4K |
| B4155 |
Ef incomplete/modular |
25 |
24 |
$2K |