| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| B4161 |
Ef ped hydrolyzed/amino acid |
20,314 |
4,592 |
$2.22M |
| B4035 |
Enteral feed supp pump per d |
69,598 |
10,650 |
$1.90M |
| A4222 |
Infusion supplies with pump |
36,228 |
6,767 |
$1.75M |
| B4160 |
Ef ped caloric dense>/=0.7kc |
36,737 |
6,677 |
$1.29M |
| S9342 |
Hit enteral pump diem |
68,722 |
3,281 |
$1.11M |
| B4153 |
Ef hydrolyzed/amino acids |
8,326 |
1,343 |
$911K |
| B4152 |
Ef calorie dense>/=1.5kcal |
16,927 |
4,423 |
$593K |
| B4189 |
Parenteral sol amino acid & |
2,007 |
172 |
$503K |
| B4185 |
Pn soln nos 10 grams lipids |
5,254 |
646 |
$455K |
| B4224 |
Parenteral administration ki |
13,270 |
887 |
$408K |
| B4034 |
Enter feed supkit syr by day |
14,526 |
3,896 |
$356K |
| A4221 |
Supp non-insulin inf cath/wk |
29,897 |
8,709 |
$346K |
| B4149 |
Ef blenderized foods |
7,340 |
1,047 |
$340K |
| B4154 |
Ef spec metabolic noninherit |
3,224 |
897 |
$234K |
| B4150 |
Ef complet w/intact nutrient |
6,065 |
1,736 |
$207K |
| S9340 |
Hit enteral per diem |
14,608 |
917 |
$173K |
| B4220 |
Parenteral supply kit premix |
12,138 |
845 |
$162K |
| 99601 |
|
5,684 |
2,261 |
$157K |
| B4088 |
Gastro/jejuno tube, low-pro |
3,666 |
2,504 |
$130K |
| B4155 |
Ef incomplete/modular |
4,570 |
1,801 |
$114K |
| S9343 |
Hit enteral bolus nurs |
1,052 |
409 |
$79K |
| B9002 |
Enter nutr inf pump any type |
1,040 |
816 |
$58K |
| B9998 |
Enteral supp not otherwise c |
1,249 |
869 |
$47K |
| B4158 |
Ef ped complete intact nut |
1,496 |
236 |
$34K |
| 99602 |
Nursing care in home rn |
1,072 |
510 |
$25K |
| E0781 |
External ambulatory infus pu |
402 |
239 |
$23K |
| J1561 |
Gamunex-c/gammaked |
127 |
12 |
$20K |
| B4103 |
Ef ped fluid and electrolyte |
722 |
187 |
$16K |
| J1250 |
Inj dobutamine hcl/250 mg |
3,906 |
52 |
$7K |
| S9338 |
Hit immunotherapy diem |
418 |
61 |
$7K |
| S9500 |
Hit antibiotic q24h diem |
32 |
13 |
$6K |
| J3370 |
Vancomycin hcl injection |
1,497 |
27 |
$6K |
| J1642 |
Inj heparin sodium per 10 u |
62 |
30 |
$3K |
| B9004 |
Parenteral infus pump portab |
23 |
13 |
$3K |
| S9379 |
Hit noc per diem |
19 |
12 |
$1K |
| J0696 |
Ceftriaxone sodium injection |
35 |
14 |
$925.44 |
| S9123 |
Nursing care in home rn |
84 |
52 |
$540.00 |
| E0776 |
Iv pole |
77 |
41 |
$343.66 |
| G0299 |
Hhs/hospice of rn ea 15 min |
76 |
43 |
$165.00 |
| A4223 |
Infusion supplies w/o pump |
88 |
38 |
$0.00 |