#498 of 11K

B4152

Enteral formula, calorically dense, per 100 calories

Enteral formula, calorically dense, per 100 calories is the #498 most-billed Medicaid procedure code, with $183.9M in payments across 2.1M claims from 2018–2024. The national median cost per claim is $92.20.

Total Paid

$183.9M

0.02% of all spending

Total Claims

2.1M

Providers

929

Avg Cost/Claim

$87

National Cost Distribution

How much do providers bill per claim for B4152? Based on 921 providers billing this code nationally.

Median

$92.20

Average

$102.58

Std Dev

$89.12

Max

$1,883.36

Percentile Distribution (Cost per Claim)

p10

$25.44

p25

$52.80

Median

$92.20

p75

$132.60

p90

$178.23

p95

$214.84

p99

$345.23

50% of providers bill between $52.80 and $132.60 per claim for this code.

90% bill between $25.44 and $178.23.

Top 1% bill above $345.23.

About This Procedure

HCPCS code B4152 (Enteral formula, calorically dense, per 100 calories) was billed by 929 providers across 2.1M claims, totaling $183.9M in Medicaid payments from 2018–2024. This code was used for 1.5M unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$92.20

Providers Billing

921

National Spending

$183.9M

Avg/Median Ratio

1.11×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for B4152

#	Provider	Total Paid	Cost/Claim	vs Median	Tier
1	Option 1 Nutrition Solutions Llc Denver, CO · Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition	$3.9M	$137.91	1.5× median	Above 75th
2	Medco Respiratory Instruments, Inc. Houston, TX · Durable Medical Equipment & Medical Supplies	$3.4M	$187.34	2.0× median	Top 10%
3	1033231832	$2.5M	$119.75	1.3× median	Above Median
4	1346248341	$2.5M	$80.77	0.9× median	Below Median
5	1871509489	$2.4M	$85.88	0.9× median	Below Median
6	Continuum, Llc Philadelphia, PA · Durable Medical Equipment & Medical Supplies	$2.1M	$126.16	1.4× median	Above Median
7	Indiana University Health, Inc Indianapolis, IN · Durable Medical Equipment & Medical Supplies	$2.0M	$119.73	1.3× median	Above Median
8	1922046085	$2.0M	$1,883.36	20.4× median	Top 1%
9	1124132154	$2.0M	$160.83	1.7× median	Above 75th
10	1184653388	$2.0M	$117.67	1.3× median	Above Median
11	Home Care Delivered, Inc. Richmond, VA · Durable Medical Equipment & Medical Supplies	$1.8M	$81.33	0.9× median	Below Median
12	1902863434	$1.8M	$127.60	1.4× median	Above Median
13	Rgh Enterprises, Llc Twinsburg, OH · Prosthetic/Orthotic Supplier	$1.7M	$67.44	0.7× median	Below Median
14	1467467050	$1.6M	$136.31	1.5× median	Above 75th
15	Shield California Health Care Center Inc Valencia, CA · Durable Medical Equipment & Medical Supplies	$1.5M	$145.49	1.6× median	Above 75th
16	1265526396	$1.4M	$117.41	1.3× median	Above Median
17	1336736115	$1.4M	$89.40	1.0× median	Below Median
18	1326096629	$1.4M	$131.36	1.4× median	Above Median
19	1346270527	$1.4M	$112.14	1.2× median	Above Median
20	1619970845	$1.3M	$55.81	0.6× median	Below Median

Showing top 20 of 929 providers billing this code

Related Procedures

B4161Enteral formula, semisolid, 100 calories = 1 unit$1.05B B4160Enteral formula, per 100 calories$628.3M B4149Enteral formula, manufactured blenderized, per 100 calories$259.1M B4150Enteral formula, nutritionally complete with fiber, per 100 calories$254.4M B4154$148.5M

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