| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| B4161 |
Ef ped hydrolyzed/amino acid |
5,673 |
4,604 |
$2.30M |
| B4035 |
Enteral feed supp pump per d |
16,205 |
7,896 |
$1.73M |
| S9494 |
Hit antibiotic total diem |
5,621 |
861 |
$559K |
| B4160 |
Ef ped caloric dense>/=0.7kc |
4,696 |
3,875 |
$515K |
| B4149 |
Ef blenderized foods |
1,574 |
1,254 |
$507K |
| B4153 |
Ef hydrolyzed/amino acids |
850 |
617 |
$483K |
| B4152 |
Ef calorie dense>/=1.5kcal |
2,960 |
2,133 |
$401K |
| T1030 |
Rn home care per diem |
4,501 |
905 |
$326K |
| B4150 |
Ef complet w/intact nutrient |
1,804 |
1,422 |
$296K |
| B4088 |
Gastro/jejuno tube, low-pro |
2,314 |
2,058 |
$230K |
| B9002 |
Enter nutr inf pump any type |
4,947 |
2,548 |
$203K |
| B4155 |
Ef incomplete/modular |
1,467 |
1,159 |
$187K |
| B4034 |
Enter feed supkit syr by day |
2,890 |
1,561 |
$128K |
| B4154 |
Ef spec metabolic noninherit |
239 |
180 |
$81K |
| B9998 |
Enteral supp not otherwise c |
3,044 |
2,482 |
$51K |
| B4224 |
Parenteral administration ki |
446 |
98 |
$36K |
| E0781 |
External ambulatory infus pu |
277 |
162 |
$28K |
| B4185 |
Pn soln nos 10 grams lipids |
193 |
49 |
$25K |
| S9500 |
Hit antibiotic q24h diem |
134 |
14 |
$18K |
| 99601 |
|
112 |
42 |
$12K |
| S9338 |
Hit immunotherapy diem |
690 |
189 |
$10K |
| B4220 |
Parenteral supply kit premix |
362 |
86 |
$10K |
| B4103 |
Ef ped fluid and electrolyte |
103 |
89 |
$8K |
| B4158 |
Ef ped complete intact nut |
42 |
38 |
$6K |
| A4221 |
Supp non-insulin inf cath/wk |
128 |
40 |
$762.30 |
| A4927 |
Non-sterile gloves |
217 |
132 |
$0.00 |
| K0552 |
Sup/ext non-ins inf pump syr |
219 |
108 |
$0.00 |