| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| B4161 |
Ef ped hydrolyzed/amino acid |
2,381 |
1,777 |
$1.20M |
| B4035 |
Enteral feed supp pump per d |
4,166 |
3,754 |
$958K |
| B4160 |
Ef ped caloric dense>/=0.7kc |
2,398 |
1,856 |
$350K |
| B4149 |
Ef blenderized foods |
1,167 |
927 |
$291K |
| B4153 |
Ef hydrolyzed/amino acids |
281 |
214 |
$104K |
| B4034 |
Enter feed supkit syr by day |
813 |
722 |
$91K |
| B9002 |
Enter nutr inf pump any type |
1,067 |
1,001 |
$68K |
| B4152 |
Ef calorie dense>/=1.5kcal |
489 |
352 |
$58K |
| B4150 |
Ef complet w/intact nutrient |
353 |
282 |
$41K |
| B4158 |
Ef ped complete intact nut |
193 |
129 |
$37K |
| B4088 |
Gastro/jejuno tube, low-pro |
1,391 |
1,311 |
$35K |
| B4103 |
Ef ped fluid and electrolyte |
504 |
397 |
$33K |
| B4155 |
Ef incomplete/modular |
1,195 |
931 |
$29K |
| E0776 |
Iv pole |
666 |
643 |
$7K |
| A6258 |
Transparent film >16<=48 in |
73 |
72 |
$1K |
| A4927 |
Non-sterile gloves |
292 |
269 |
$1K |