| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| B4161 |
Ef ped hydrolyzed/amino acid |
3,866 |
3,333 |
$3.59M |
| B4035 |
Enteral feed supp pump per d |
15,675 |
13,083 |
$2.83M |
| B4160 |
Ef ped caloric dense>/=0.7kc |
5,088 |
4,476 |
$1.59M |
| B4149 |
Ef blenderized foods |
2,729 |
2,307 |
$1.13M |
| B4153 |
Ef hydrolyzed/amino acids |
1,995 |
1,667 |
$926K |
| B4154 |
Ef spec metabolic noninherit |
2,774 |
2,311 |
$701K |
| B4152 |
Ef calorie dense>/=1.5kcal |
4,835 |
4,138 |
$538K |
| B4150 |
Ef complet w/intact nutrient |
3,168 |
2,618 |
$425K |
| B4088 |
Gastro/jejuno tube, low-pro |
3,777 |
3,586 |
$363K |
| B4034 |
Enter feed supkit syr by day |
4,386 |
3,576 |
$273K |
| B9002 |
Enter nutr inf pump any type |
4,560 |
4,322 |
$224K |
| B4036 |
Enteral feed sup kit grav by |
1,936 |
1,710 |
$118K |
| B4155 |
Ef incomplete/modular |
2,256 |
1,959 |
$108K |
| A4223 |
Infusion supplies w/o pump |
3,016 |
1,163 |
$105K |
| A4221 |
Supp non-insulin inf cath/wk |
5,759 |
2,334 |
$80K |
| B4224 |
Parenteral administration ki |
1,596 |
334 |
$65K |
| S9500 |
Hit antibiotic q24h diem |
958 |
106 |
$58K |
| B9998 |
Enteral supp not otherwise c |
486 |
415 |
$43K |
| B4158 |
Ef ped complete intact nut |
296 |
213 |
$37K |
| A4222 |
Infusion supplies with pump |
416 |
146 |
$36K |
| E0781 |
External ambulatory infus pu |
1,991 |
98 |
$11K |
| A4213 |
20+ cc syringe only |
390 |
159 |
$4K |
| E0776 |
Iv pole |
43 |
25 |
$2K |
| B4220 |
Parenteral supply kit premix |
54 |
12 |
$467.50 |