| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| B4161 |
Ef ped hydrolyzed/amino acid |
3,349 |
2,461 |
$2.66M |
| B4035 |
Enteral feed supp pump per d |
13,762 |
7,438 |
$1.37M |
| B4160 |
Ef ped caloric dense>/=0.7kc |
4,320 |
3,411 |
$1.13M |
| B9998 |
Enteral supp not otherwise c |
7,478 |
6,000 |
$666K |
| B4149 |
Ef blenderized foods |
2,083 |
1,533 |
$645K |
| A4223 |
Infusion supplies w/o pump |
7,934 |
2,176 |
$617K |
| B4153 |
Ef hydrolyzed/amino acids |
1,750 |
1,163 |
$587K |
| B4154 |
Ef spec metabolic noninherit |
1,222 |
791 |
$512K |
| S9342 |
Hit enteral pump diem |
2,017 |
1,104 |
$474K |
| B4150 |
Ef complet w/intact nutrient |
4,826 |
3,589 |
$449K |
| B4152 |
Ef calorie dense>/=1.5kcal |
4,356 |
2,963 |
$344K |
| B4034 |
Enter feed supkit syr by day |
5,479 |
3,376 |
$237K |
| B9002 |
Enter nutr inf pump any type |
2,116 |
1,615 |
$120K |
| A4221 |
Supp non-insulin inf cath/wk |
10,611 |
3,357 |
$93K |
| B4185 |
Pn soln nos 10 grams lipids |
1,376 |
225 |
$78K |
| A4222 |
Infusion supplies with pump |
1,146 |
257 |
$63K |
| B4224 |
Parenteral administration ki |
1,368 |
202 |
$49K |
| B4155 |
Ef incomplete/modular |
1,334 |
994 |
$36K |
| B4088 |
Gastro/jejuno tube, low-pro |
628 |
559 |
$30K |
| A4305 |
Drug delivery system >=50 ml |
322 |
77 |
$27K |
| B4220 |
Parenteral supply kit premix |
1,410 |
212 |
$23K |
| 99601 |
|
176 |
65 |
$20K |
| S9343 |
Hit enteral bolus nurs |
64 |
24 |
$18K |
| E0776 |
Iv pole |
324 |
218 |
$18K |
| B4158 |
Ef ped complete intact nut |
121 |
75 |
$14K |
| S9500 |
Hit antibiotic q24h diem |
73 |
24 |
$7K |
| E0781 |
External ambulatory infus pu |
15 |
12 |
$1K |
| K0552 |
Sup/ext non-ins inf pump syr |
218 |
129 |
$910.42 |
| A4211 |
Supp for self-adm injections |
465 |
123 |
$328.64 |
| J7050 |
Normal saline solution infus |
33 |
12 |
$82.60 |