| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| B4035 |
Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
5,818 |
5,568 |
$207K |
| B4154 |
Enteral formula, nutritionally complete, for special metabolic needs, excludes inherited disease of metabolism, includes altered composition of proteins, fats, carbohydrates, vitamins and/or minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit |
2,080 |
2,009 |
$184K |
| B4150 |
Enteral formula, nutritionally complete with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit |
2,179 |
2,097 |
$93K |
| B4152 |
Enteral formula, nutritionally complete, calorically dense (equal to or greater than 1.5 kcal/ml) with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit |
1,357 |
1,305 |
$69K |
| B9002 |
Enteral nutrition infusion pump, any type |
3,622 |
3,599 |
$66K |
| E0372 |
Powered air overlay for mattress, standard mattress length and width |
296 |
236 |
$61K |
| E0776 |
Iv pole |
10,085 |
10,073 |
$31K |
| B4034 |
Enteral feeding supply kit; syringe fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
343 |
315 |
$11K |
| B4088 |
Gastrostomy/jejunostomy tube, low-profile, any material, any type, each |
44 |
44 |
$6K |
| E0277 |
Powered pressure-reducing air mattress |
14 |
13 |
$4K |
| B9998 |
Noc for enteral supplies |
14 |
14 |
$865.22 |