| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| B4035 |
Enteral feed supp pump per d |
19,298 |
3,068 |
$671K |
| B4161 |
Ef ped hydrolyzed/amino acid |
2,191 |
1,009 |
$657K |
| B4160 |
Ef ped caloric dense>/=0.7kc |
2,058 |
1,193 |
$373K |
| A4222 |
Infusion supplies with pump |
1,742 |
654 |
$289K |
| B4152 |
Ef calorie dense>/=1.5kcal |
1,261 |
852 |
$137K |
| A4221 |
Supp non-insulin inf cath/wk |
4,614 |
1,908 |
$97K |
| B4149 |
Ef blenderized foods |
542 |
275 |
$80K |
| B9002 |
Enter nutr inf pump any type |
1,391 |
1,249 |
$78K |
| B4224 |
Parenteral administration ki |
775 |
195 |
$68K |
| B4158 |
Ef ped complete intact nut |
242 |
132 |
$32K |
| B4100 |
Food thickener oral |
314 |
178 |
$21K |
| B4220 |
Parenteral supply kit premix |
776 |
196 |
$21K |
| B4088 |
Gastro/jejuno tube, low-pro |
319 |
167 |
$16K |
| B4154 |
Ef spec metabolic noninherit |
125 |
57 |
$13K |
| A4305 |
Drug delivery system >=50 ml |
245 |
93 |
$13K |
| B4150 |
Ef complet w/intact nutrient |
255 |
137 |
$10K |
| B9998 |
Enteral supp not otherwise c |
132 |
116 |
$10K |
| A4216 |
Sterile water/saline, 10 ml |
1,229 |
603 |
$8K |
| B4155 |
Ef incomplete/modular |
19 |
12 |
$954.96 |