| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| B4105 |
Enzyme cartridge enteral nut |
1,079 |
603 |
$3.79M |
| S9494 |
Hit antibiotic total diem |
3,013 |
863 |
$670K |
| B4035 |
Enteral feed supp pump per d |
5,995 |
2,632 |
$550K |
| T1030 |
Rn home care per diem |
2,921 |
937 |
$467K |
| B4161 |
Ef ped hydrolyzed/amino acid |
10,321 |
579 |
$223K |
| B4152 |
Ef calorie dense>/=1.5kcal |
2,081 |
930 |
$128K |
| B4034 |
Enter feed supkit syr by day |
1,646 |
695 |
$66K |
| B4185 |
Pn soln nos 10 grams lipids |
320 |
24 |
$29K |
| S9342 |
Hit enteral pump diem |
802 |
36 |
$13K |
| B4224 |
Parenteral administration ki |
307 |
24 |
$11K |
| 99601 |
|
57 |
24 |
$7K |
| B4160 |
Ef ped caloric dense>/=0.7kc |
746 |
26 |
$4K |
| B4220 |
Parenteral supply kit premix |
318 |
24 |
$3K |
| B9002 |
Enter nutr inf pump any type |
75 |
44 |
$2K |
| B4088 |
Gastro/jejuno tube, low-pro |
18 |
12 |
$1K |
| S9379 |
Hit noc per diem |
62 |
12 |
$0.00 |
| A4213 |
20+ cc syringe only |
36 |
15 |
$0.00 |
| A4215 |
Sterile needle |
52 |
14 |
$0.00 |