| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A4223 |
Infusion supplies w/o pump |
1,943 |
835 |
$448K |
| B4035 |
Enteral feed supp pump per d |
1,376 |
1,123 |
$171K |
| B4160 |
Ef ped caloric dense>/=0.7kc |
415 |
329 |
$61K |
| A4221 |
Supp non-insulin inf cath/wk |
2,605 |
1,420 |
$48K |
| A4222 |
Infusion supplies with pump |
478 |
300 |
$25K |
| B4034 |
Enter feed supkit syr by day |
246 |
209 |
$17K |
| B9002 |
Enter nutr inf pump any type |
116 |
115 |
$7K |
| B4150 |
Ef complet w/intact nutrient |
35 |
25 |
$2K |
| B4152 |
Ef calorie dense>/=1.5kcal |
29 |
24 |
$2K |
| B4088 |
Gastro/jejuno tube, low-pro |
12 |
12 |
$380.86 |