| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| B4161 |
Ef ped hydrolyzed/amino acid |
15,135 |
3,155 |
$1.62M |
| A4222 |
Infusion supplies with pump |
22,179 |
5,484 |
$978K |
| B4035 |
Enteral feed supp pump per d |
29,007 |
6,066 |
$940K |
| B4160 |
Ef ped caloric dense>/=0.7kc |
18,059 |
3,730 |
$746K |
| S9342 |
Hit enteral pump diem |
44,497 |
2,070 |
$657K |
| J1561 |
Gamunex-c/gammaked |
2,418 |
179 |
$427K |
| B4152 |
Ef calorie dense>/=1.5kcal |
10,641 |
2,715 |
$342K |
| B4034 |
Enter feed supkit syr by day |
14,721 |
3,041 |
$285K |
| 99601 |
|
7,419 |
2,917 |
$215K |
| A4221 |
Supp non-insulin inf cath/wk |
22,558 |
7,190 |
$185K |
| B4150 |
Ef complet w/intact nutrient |
5,738 |
1,419 |
$169K |
| B4153 |
Ef hydrolyzed/amino acids |
1,050 |
387 |
$134K |
| S9500 |
Hit antibiotic q24h diem |
4,011 |
225 |
$108K |
| S9343 |
Hit enteral bolus nurs |
9,651 |
381 |
$78K |
| B4088 |
Gastro/jejuno tube, low-pro |
2,154 |
1,446 |
$66K |
| S9340 |
Hit enteral per diem |
2,976 |
306 |
$63K |
| 99602 |
Nursing care in home rn |
2,842 |
1,094 |
$56K |
| S9338 |
Hit immunotherapy diem |
1,636 |
537 |
$50K |
| B9002 |
Enter nutr inf pump any type |
851 |
625 |
$37K |
| B4154 |
Ef spec metabolic noninherit |
499 |
112 |
$35K |
| B4155 |
Ef incomplete/modular |
1,722 |
539 |
$27K |
| B4185 |
Pn soln nos 10 grams lipids |
368 |
36 |
$24K |
| E0781 |
External ambulatory infus pu |
235 |
118 |
$15K |
| B9998 |
Enteral supp not otherwise c |
297 |
193 |
$12K |
| B4149 |
Ef blenderized foods |
40 |
28 |
$8K |
| B4158 |
Ef ped complete intact nut |
113 |
27 |
$4K |
| S9359 |
Hit anti-tnf per diem |
124 |
78 |
$4K |
| E0776 |
Iv pole |
185 |
83 |
$583.23 |
| J3370 |
Vancomycin hcl injection |
914 |
12 |
$576.36 |
| S9123 |
Nursing care in home rn |
24 |
17 |
$90.00 |
| G0299 |
Hhs/hospice of rn ea 15 min |
16 |
12 |
$18.75 |
| A4223 |
Infusion supplies w/o pump |
98 |
37 |
$0.00 |