| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| B4161 |
Ef ped hydrolyzed/amino acid |
4,951 |
3,262 |
$1.61M |
| B4160 |
Ef ped caloric dense>/=0.7kc |
6,795 |
4,238 |
$830K |
| B4035 |
Enteral feed supp pump per d |
14,177 |
8,985 |
$820K |
| B4150 |
Ef complet w/intact nutrient |
4,244 |
2,710 |
$451K |
| B4152 |
Ef calorie dense>/=1.5kcal |
3,084 |
1,872 |
$368K |
| B4100 |
Food thickener oral |
3,685 |
2,635 |
$302K |
| B4149 |
Ef blenderized foods |
1,935 |
845 |
$289K |
| B4153 |
Ef hydrolyzed/amino acids |
609 |
322 |
$203K |
| B9998 |
Enteral supp not otherwise c |
6,529 |
4,462 |
$157K |
| B4155 |
Ef incomplete/modular |
3,974 |
2,544 |
$105K |
| A4213 |
20+ cc syringe only |
882 |
649 |
$77K |
| B4154 |
Ef spec metabolic noninherit |
319 |
171 |
$71K |
| B9002 |
Enter nutr inf pump any type |
926 |
640 |
$19K |
| B4162 |
Ef ped specmetabolic inherit |
81 |
51 |
$15K |
| A4322 |
Irrigation syringe |
731 |
576 |
$5K |
| B4034 |
Enter feed supkit syr by day |
616 |
356 |
$2K |
| A4221 |
Supp non-insulin inf cath/wk |
166 |
58 |
$2K |
| E0776 |
Iv pole |
40 |
38 |
$243.47 |