| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| B4160 |
Ef ped caloric dense>/=0.7kc |
2,651 |
852 |
$384K |
| B4035 |
Enteral feed supp pump per d |
3,549 |
1,653 |
$381K |
| B4220 |
Parenteral supply kit premix |
8,514 |
2,690 |
$239K |
| B4161 |
Ef ped hydrolyzed/amino acid |
546 |
300 |
$228K |
| A4211 |
Supp for self-adm injections |
1,474 |
503 |
$216K |
| B4224 |
Parenteral administration ki |
2,129 |
569 |
$158K |
| B4152 |
Ef calorie dense>/=1.5kcal |
2,097 |
951 |
$145K |
| B4088 |
Gastro/jejuno tube, low-pro |
1,042 |
811 |
$122K |
| A4222 |
Infusion supplies with pump |
604 |
277 |
$80K |
| B9998 |
Enteral supp not otherwise c |
1,499 |
1,107 |
$78K |
| B4150 |
Ef complet w/intact nutrient |
2,078 |
611 |
$56K |
| 99601 |
|
111 |
39 |
$15K |
| B4155 |
Ef incomplete/modular |
351 |
97 |
$11K |
| A4305 |
Drug delivery system >=50 ml |
117 |
41 |
$7K |
| A9901 |
Delivery/set up/dispensing |
289 |
210 |
$5K |
| E0781 |
External ambulatory infus pu |
29 |
24 |
$5K |
| B4034 |
Enter feed supkit syr by day |
215 |
37 |
$3K |