B4161
Enteral formula, semisolid, 100 calories = 1 unit
Enteral formula, semisolid, 100 calories = 1 unit is the #166 most-billed Medicaid procedure code, with $1.05B in payments across 2.7M claims from 2018–2024. The national median cost per claim is $465.86.
Total Paid
$1.05B
0.10% of all spending
Total Claims
2.7M
Providers
543
Avg Cost/Claim
$389
National Cost Distribution
How much do providers bill per claim for B4161? Based on 531 providers billing this code nationally.
Median
$465.86
Average
$500.99
Std Dev
$251.45
Max
$1,800.89
Percentile Distribution (Cost per Claim)
50% of providers bill between $351.45 and $634.87 per claim for this code.
90% bill between $211.06 and $812.71.
Top 1% bill above $1,240.08.
About This Procedure
HCPCS code B4161 (Enteral formula, semisolid, 100 calories = 1 unit) was billed by 543 providers across 2.7M claims, totaling $1.05B in Medicaid payments from 2018–2024. This code was used for 1.9M unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$465.86
Providers Billing
531
National Spending
$1.05B
Avg/Median Ratio
1.08×
Normal distribution
Top Providers Billing This Code
Ranked by total Medicaid payments for B4161
| # | Provider | Total Paid |
|---|---|---|
| 1 | Hhsc Wic Program Austin, TX · Pharmacy | $146.8M |
| 2 | Indiana University Health, Inc Indianapolis, IN · Durable Medical Equipment & Medical Supplies | $65.1M |
| 3 | Medco Respiratory Instruments, Inc. Houston, TX · Durable Medical Equipment & Medical Supplies | $31.8M |
| 4 | Option 1 Nutrition Solutions Llc Denver, CO · Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition | $31.8M |
| 5 | 1871509489 | $20.3M |
| 6 | 1902863434 | $17.6M |
| 7 | Pediatric Home Respiratory Services Llc Roseville, MN · Home Health | $16.9M |
| 8 | Apple Homecare Medical Supply Llc Richardson, TX · Durable Medical Equipment & Medical Supplies, Customized Equipment | $15.3M |
| 9 | 1801866173 | $11.9M |
| 10 | 1710225271 | $11.9M |
| 11 | 1407159817 | $11.6M |
| 12 | 1194859629 | $9.7M |
| 13 | 1043512114 | $9.5M |
| 14 | 1154418218 | $9.1M |
| 15 | 1346270527 | $9.1M |
| 16 | 1902897259 | $8.8M |
| 17 | 1184653388 | $8.8M |
| 18 | 1003862020 | $8.5M |
| 19 | 1306961792 | $8.4M |
| 20 | 1871738153 | $7.7M |
Showing top 20 of 543 providers billing this code