B4160
Enteral formula, per 100 calories
Enteral formula, per 100 calories is the #232 most-billed Medicaid procedure code, with $628.3M in payments across 4.1M claims from 2018–2024. The national median cost per claim is $157.30.
Total Paid
$628.3M
0.06% of all spending
Total Claims
4.1M
Providers
780
Avg Cost/Claim
$152
National Cost Distribution
How much do providers bill per claim for B4160? Based on 750 providers billing this code nationally.
Median
$157.30
Average
$174.21
Std Dev
$94.89
Max
$1,069.02
Percentile Distribution (Cost per Claim)
50% of providers bill between $118.74 and $215.62 per claim for this code.
90% bill between $84.01 and $292.79.
Top 1% bill above $446.95.
About This Procedure
HCPCS code B4160 (Enteral formula, per 100 calories) was billed by 780 providers across 4.1M claims, totaling $628.3M in Medicaid payments from 2018–2024. This code was used for 3.2M unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$157.30
Providers Billing
750
National Spending
$628.3M
Avg/Median Ratio
1.11×
Normal distribution
Top Providers Billing This Code
Ranked by total Medicaid payments for B4160
| # | Provider | Total Paid |
|---|---|---|
| 1 | Hhsc Wic Program Austin, TX · Pharmacy | $76.8M |
| 2 | Option 1 Nutrition Solutions Llc Denver, CO · Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition | $36.1M |
| 3 | Medco Respiratory Instruments, Inc. Houston, TX · Durable Medical Equipment & Medical Supplies | $22.5M |
| 4 | Indiana University Health, Inc Indianapolis, IN · Durable Medical Equipment & Medical Supplies | $22.3M |
| 5 | 1871509489 | $16.4M |
| 6 | Pediatric Home Respiratory Services Llc Roseville, MN · Home Health | $11.0M |
| 7 | 1619988284 | $8.9M |
| 8 | Continuum, Llc Philadelphia, PA · Durable Medical Equipment & Medical Supplies | $8.5M |
| 9 | 1902863434 | $8.0M |
| 10 | Shield California Health Care Center Inc Valencia, CA · Durable Medical Equipment & Medical Supplies | $6.6M |
| 11 | 1407159817 | $6.5M |
| 12 | Apple Homecare Medical Supply Llc Richardson, TX · Durable Medical Equipment & Medical Supplies, Customized Equipment | $6.4M |
| 13 | 1043512114 | $6.4M |
| 14 | 1306961792 | $5.6M |
| 15 | 1194859629 | $5.4M |
| 16 | 1710918164 | $4.9M |
| 17 | Shield Denver Health Care Center Inc Aurora, CO · Durable Medical Equipment & Medical Supplies | $4.7M |
| 18 | 1801866173 | $4.4M |
| 19 | 1124132154 | $4.3M |
| 20 | 1659319325 | $4.2M |
Showing top 20 of 780 providers billing this code