| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| B4161 |
Ef ped hydrolyzed/amino acid |
4,864 |
2,497 |
$1.75M |
| B4160 |
Ef ped caloric dense>/=0.7kc |
11,724 |
5,346 |
$923K |
| B4035 |
Enteral feed supp pump per d |
8,008 |
5,419 |
$837K |
| B4152 |
Ef calorie dense>/=1.5kcal |
9,362 |
5,397 |
$648K |
| B4149 |
Ef blenderized foods |
2,349 |
1,069 |
$578K |
| B4150 |
Ef complet w/intact nutrient |
6,335 |
3,598 |
$532K |
| S9342 |
Hit enteral pump diem |
3,065 |
1,116 |
$396K |
| B4154 |
Ef spec metabolic noninherit |
3,894 |
2,204 |
$330K |
| B4034 |
Enter feed supkit syr by day |
4,321 |
2,860 |
$294K |
| B4153 |
Ef hydrolyzed/amino acids |
1,101 |
668 |
$254K |
| B4162 |
Ef ped specmetabolic inherit |
740 |
446 |
$177K |
| 99601 |
|
2,168 |
724 |
$129K |
| B4155 |
Ef incomplete/modular |
2,109 |
1,242 |
$118K |
| 99602 |
Nursing care in home rn |
1,447 |
512 |
$105K |
| B4036 |
Enteral feed sup kit grav by |
1,117 |
686 |
$101K |
| B9998 |
Enteral supp not otherwise c |
1,619 |
1,032 |
$62K |
| S9343 |
Hit enteral bolus nurs |
1,165 |
479 |
$59K |
| S9338 |
Hit immunotherapy diem |
1,366 |
442 |
$52K |
| B9002 |
Enter nutr inf pump any type |
992 |
785 |
$42K |
| B4088 |
Gastro/jejuno tube, low-pro |
1,940 |
1,390 |
$31K |
| A4221 |
Supp non-insulin inf cath/wk |
2,635 |
720 |
$24K |
| A4213 |
20+ cc syringe only |
270 |
230 |
$7K |
| A9999 |
Dme supply or accessory, nos |
336 |
207 |
$6K |
| E0776 |
Iv pole |
893 |
660 |
$3K |
| A4222 |
Infusion supplies with pump |
30 |
12 |
$1K |
| B4087 |
Gastro/jejuno tube, std |
43 |
25 |
$248.43 |