| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| B4161 |
Ef ped hydrolyzed/amino acid |
1,046 |
878 |
$1.69M |
| B4160 |
Ef ped caloric dense>/=0.7kc |
2,458 |
2,071 |
$744K |
| B4035 |
Enteral feed supp pump per d |
2,215 |
1,806 |
$424K |
| B4088 |
Gastro/jejuno tube, low-pro |
797 |
698 |
$288K |
| B4149 |
Ef blenderized foods |
410 |
334 |
$145K |
| B4100 |
Food thickener oral |
253 |
215 |
$120K |
| B9002 |
Enter nutr inf pump any type |
950 |
811 |
$75K |
| B4150 |
Ef complet w/intact nutrient |
500 |
393 |
$53K |
| B4152 |
Ef calorie dense>/=1.5kcal |
374 |
297 |
$49K |
| B4034 |
Enter feed supkit syr by day |
353 |
279 |
$35K |
| B4155 |
Ef incomplete/modular |
306 |
250 |
$18K |
| B4158 |
Ef ped complete intact nut |
16 |
12 |
$12K |
| E0776 |
Iv pole |
397 |
342 |
$9K |
| B4154 |
Ef spec metabolic noninherit |
38 |
36 |
$5K |