| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| B4161 |
Ef ped hydrolyzed/amino acid |
12,393 |
5,328 |
$3.49M |
| B4035 |
Enteral feed supp pump per d |
22,873 |
10,611 |
$2.58M |
| B4160 |
Ef ped caloric dense>/=0.7kc |
15,106 |
6,641 |
$1.32M |
| B4034 |
Enter feed supkit syr by day |
10,280 |
4,927 |
$620K |
| B4155 |
Ef incomplete/modular |
4,049 |
2,201 |
$545K |
| B4153 |
Ef hydrolyzed/amino acids |
4,195 |
1,405 |
$515K |
| B4150 |
Ef complet w/intact nutrient |
13,550 |
4,427 |
$494K |
| B4152 |
Ef calorie dense>/=1.5kcal |
10,482 |
3,463 |
$471K |
| B4149 |
Ef blenderized foods |
2,488 |
841 |
$270K |
| S9342 |
Hit enteral pump diem |
3,593 |
1,633 |
$262K |
| B4162 |
Ef ped specmetabolic inherit |
1,210 |
668 |
$260K |
| S9379 |
Hit noc per diem |
5,389 |
772 |
$211K |
| S9500 |
Hit antibiotic q24h diem |
3,493 |
747 |
$187K |
| S9340 |
Hit enteral per diem |
865 |
498 |
$128K |
| S9343 |
Hit enteral bolus nurs |
2,925 |
957 |
$122K |
| B4088 |
Gastro/jejuno tube, low-pro |
3,335 |
2,936 |
$78K |
| B4100 |
Food thickener oral |
2,385 |
978 |
$71K |
| S9338 |
Hit immunotherapy diem |
725 |
236 |
$27K |
| 99601 |
|
511 |
259 |
$25K |
| B9002 |
Enter nutr inf pump any type |
441 |
374 |
$25K |
| B4154 |
Ef spec metabolic noninherit |
744 |
174 |
$22K |
| S9501 |
Hit antibiotic q12h diem |
133 |
25 |
$9K |
| S9502 |
Hit antibiotic q8h diem |
83 |
14 |
$5K |
| B4103 |
Ef ped fluid and electrolyte |
186 |
49 |
$4K |
| A4221 |
Supp non-insulin inf cath/wk |
89 |
25 |
$173.06 |
| S5502 |
Hit interim cath care |
61 |
12 |
$163.44 |