| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| B4161 |
Ef ped hydrolyzed/amino acid |
3,210 |
2,599 |
$2.32M |
| A4223 |
Infusion supplies w/o pump |
20,849 |
3,743 |
$2.08M |
| B4160 |
Ef ped caloric dense>/=0.7kc |
5,141 |
4,133 |
$1.86M |
| B4035 |
Enteral feed supp pump per d |
11,040 |
8,402 |
$1.57M |
| B4149 |
Ef blenderized foods |
2,942 |
2,405 |
$1.02M |
| B4034 |
Enter feed supkit syr by day |
5,435 |
4,344 |
$381K |
| B4088 |
Gastro/jejuno tube, low-pro |
4,101 |
3,610 |
$337K |
| B4152 |
Ef calorie dense>/=1.5kcal |
3,168 |
2,320 |
$321K |
| B4150 |
Ef complet w/intact nutrient |
2,677 |
1,955 |
$238K |
| B9002 |
Enter nutr inf pump any type |
2,778 |
2,553 |
$128K |
| A4221 |
Supp non-insulin inf cath/wk |
13,763 |
3,983 |
$89K |
| B4153 |
Ef hydrolyzed/amino acids |
179 |
131 |
$83K |
| B4158 |
Ef ped complete intact nut |
571 |
424 |
$80K |
| E0776 |
Iv pole |
1,142 |
670 |
$47K |
| 99601 |
|
550 |
206 |
$40K |
| S9500 |
Hit antibiotic q24h diem |
701 |
87 |
$14K |
| B4155 |
Ef incomplete/modular |
234 |
183 |
$6K |
| B4154 |
Ef spec metabolic noninherit |
74 |
49 |
$5K |
| B9998 |
Enteral supp not otherwise c |
400 |
333 |
$3K |
| A4222 |
Infusion supplies with pump |
18 |
13 |
$52.33 |
| J0878 |
Daptomycin injection |
40 |
14 |
$2.73 |
| B4185 |
Pn soln nos 10 grams lipids |
28 |
12 |
$0.00 |