| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| B4189 |
Parenteral sol amino acid & |
7,999 |
1,049 |
$3.55M |
| B4185 |
Pn soln nos 10 grams lipids |
6,430 |
1,280 |
$2.49M |
| B4105 |
Enzyme cartridge enteral nut |
564 |
510 |
$2.28M |
| B4224 |
Parenteral administration ki |
20,306 |
1,338 |
$703K |
| B4035 |
Enteral feed supp pump per d |
22,378 |
1,930 |
$344K |
| A4222 |
Infusion supplies with pump |
5,806 |
1,357 |
$259K |
| B4220 |
Parenteral supply kit premix |
19,924 |
1,336 |
$228K |
| B4152 |
Ef calorie dense>/=1.5kcal |
671 |
560 |
$75K |
| B4161 |
Ef ped hydrolyzed/amino acid |
388 |
251 |
$74K |
| B4160 |
Ef ped caloric dense>/=0.7kc |
429 |
231 |
$44K |
| B4034 |
Enter feed supkit syr by day |
4,222 |
444 |
$33K |
| A4221 |
Supp non-insulin inf cath/wk |
2,580 |
1,064 |
$18K |
| A4223 |
Infusion supplies w/o pump |
736 |
162 |
$12K |
| S9379 |
Hit noc per diem |
212 |
52 |
$8K |
| A4305 |
Drug delivery system >=50 ml |
17 |
12 |
$5K |
| B4155 |
Ef incomplete/modular |
18 |
14 |
$3K |
| S9342 |
Hit enteral pump diem |
75 |
12 |
$3K |
| B4150 |
Ef complet w/intact nutrient |
17 |
13 |
$2K |
| B9998 |
Enteral supp not otherwise c |
15 |
15 |
$728.82 |
| A4245 |
Alcohol wipes per box |
162 |
96 |
$339.81 |
| A5200 |
Percutaneous catheter anchor |
23 |
12 |
$202.21 |