| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| B4161 |
Ef ped hydrolyzed/amino acid |
1,669 |
1,489 |
$950K |
| B4149 |
Ef blenderized foods |
2,892 |
2,222 |
$906K |
| B4035 |
Enteral feed supp pump per d |
6,460 |
4,880 |
$792K |
| B4185 |
Pn soln nos 10 grams lipids |
2,216 |
560 |
$495K |
| A4222 |
Infusion supplies with pump |
1,901 |
536 |
$261K |
| B4224 |
Parenteral administration ki |
2,139 |
488 |
$242K |
| A4223 |
Infusion supplies w/o pump |
1,447 |
605 |
$241K |
| B4152 |
Ef calorie dense>/=1.5kcal |
2,006 |
1,687 |
$214K |
| B4150 |
Ef complet w/intact nutrient |
2,121 |
1,774 |
$193K |
| B4160 |
Ef ped caloric dense>/=0.7kc |
1,789 |
1,538 |
$190K |
| B4087 |
Gastro/jejuno tube, std |
1,503 |
1,335 |
$139K |
| B9002 |
Enter nutr inf pump any type |
1,870 |
1,751 |
$123K |
| B4189 |
Parenteral sol amino acid & |
96 |
24 |
$114K |
| B4034 |
Enter feed supkit syr by day |
1,748 |
1,465 |
$109K |
| A4221 |
Supp non-insulin inf cath/wk |
4,341 |
1,908 |
$85K |
| B4220 |
Parenteral supply kit premix |
1,986 |
475 |
$73K |
| E0781 |
External ambulatory infus pu |
333 |
296 |
$64K |
| B4088 |
Gastro/jejuno tube, low-pro |
992 |
943 |
$57K |
| S9460 |
Diabetic management program, |
367 |
185 |
$45K |
| 99601 |
|
316 |
128 |
$39K |
| B4100 |
Food thickener oral |
534 |
442 |
$17K |
| B4153 |
Ef hydrolyzed/amino acids |
19 |
12 |
$9K |
| B4155 |
Ef incomplete/modular |
160 |
150 |
$7K |
| B4154 |
Ef spec metabolic noninherit |
25 |
24 |
$5K |
| B9004 |
Parenteral infus pump portab |
15 |
12 |
$5K |