| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| B4161 |
Ef ped hydrolyzed/amino acid |
3,476 |
3,002 |
$2.27M |
| B4035 |
Enteral feed supp pump per d |
11,885 |
7,242 |
$1.41M |
| B4149 |
Ef blenderized foods |
1,860 |
1,618 |
$927K |
| B4160 |
Ef ped caloric dense>/=0.7kc |
3,426 |
2,802 |
$679K |
| B9002 |
Enter nutr inf pump any type |
2,767 |
2,614 |
$263K |
| B9998 |
Enteral supp not otherwise c |
2,441 |
1,802 |
$218K |
| B4034 |
Enter feed supkit syr by day |
3,909 |
2,461 |
$215K |
| B4088 |
Gastro/jejuno tube, low-pro |
1,410 |
1,315 |
$214K |
| A4222 |
Infusion supplies with pump |
724 |
294 |
$129K |
| B4152 |
Ef calorie dense>/=1.5kcal |
671 |
574 |
$86K |
| B4155 |
Ef incomplete/modular |
397 |
342 |
$56K |
| B4153 |
Ef hydrolyzed/amino acids |
39 |
36 |
$31K |
| A4221 |
Supp non-insulin inf cath/wk |
1,335 |
683 |
$23K |
| A5200 |
Percutaneous catheter anchor |
508 |
296 |
$15K |
| A4216 |
Sterile water/saline, 10 ml |
726 |
385 |
$6K |
| B4150 |
Ef complet w/intact nutrient |
21 |
12 |
$2K |
| E0776 |
Iv pole |
281 |
259 |
$2K |
| J1642 |
Inj heparin sodium per 10 u |
336 |
166 |
$1K |