| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| B4161 |
Ef ped hydrolyzed/amino acid |
6,062 |
3,646 |
$1.67M |
| B4035 |
Enteral feed supp pump per d |
26,449 |
4,449 |
$803K |
| B4160 |
Ef ped caloric dense>/=0.7kc |
5,123 |
3,370 |
$448K |
| S9379 |
Hit noc per diem |
4,504 |
301 |
$166K |
| B4152 |
Ef calorie dense>/=1.5kcal |
2,803 |
1,705 |
$120K |
| B4150 |
Ef complet w/intact nutrient |
2,470 |
1,615 |
$116K |
| B4149 |
Ef blenderized foods |
497 |
338 |
$97K |
| B4034 |
Enter feed supkit syr by day |
5,949 |
1,042 |
$54K |
| S9340 |
Hit enteral per diem |
849 |
50 |
$53K |
| B9002 |
Enter nutr inf pump any type |
1,195 |
1,074 |
$44K |
| B4153 |
Ef hydrolyzed/amino acids |
190 |
100 |
$38K |
| B4155 |
Ef incomplete/modular |
414 |
310 |
$10K |
| B4088 |
Gastro/jejuno tube, low-pro |
248 |
217 |
$8K |
| A4221 |
Supp non-insulin inf cath/wk |
2,216 |
701 |
$4K |
| A4222 |
Infusion supplies with pump |
143 |
36 |
$3K |
| A4305 |
Drug delivery system >=50 ml |
531 |
50 |
$1K |