| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| B4035 |
Enteral feed supp pump per d |
15,645 |
13,199 |
$1.94M |
| E1390 |
Oxygen concentrator |
36,413 |
33,219 |
$1.25M |
| B4161 |
Ef ped hydrolyzed/amino acid |
2,221 |
1,832 |
$1.06M |
| B4152 |
Ef calorie dense>/=1.5kcal |
8,460 |
7,227 |
$565K |
| E0431 |
Portable gaseous 02 |
18,371 |
16,798 |
$530K |
| B4149 |
Ef blenderized foods |
1,968 |
1,648 |
$493K |
| B4150 |
Ef complet w/intact nutrient |
5,742 |
4,950 |
$455K |
| B4160 |
Ef ped caloric dense>/=0.7kc |
3,083 |
2,671 |
$378K |
| B9002 |
Enter nutr inf pump any type |
7,063 |
6,208 |
$344K |
| B4034 |
Enter feed supkit syr by day |
7,002 |
6,208 |
$253K |
| E0601 |
Cont airway pressure device |
8,811 |
7,854 |
$176K |
| B4088 |
Gastro/jejuno tube, low-pro |
3,575 |
3,206 |
$155K |
| B4153 |
Ef hydrolyzed/amino acids |
604 |
501 |
$150K |
| A7030 |
Cpap full face mask |
2,827 |
2,549 |
$110K |
| K0738 |
Portable gas oxygen system |
2,399 |
2,202 |
$89K |
| E0470 |
Rad w/o backup non-inv intfc |
1,621 |
1,434 |
$84K |
| E0562 |
Humidifier heated used w pap |
4,874 |
4,337 |
$79K |
| A7031 |
Replacement facemask interfa |
3,554 |
3,176 |
$71K |
| E0466 |
Home vent non-invasive inter |
281 |
231 |
$66K |
| E0260 |
Hosp bed semi-electr w/ matt |
2,527 |
2,315 |
$62K |
| A7034 |
Nasal application device |
2,331 |
2,144 |
$59K |
| B4155 |
Ef incomplete/modular |
461 |
384 |
$41K |
| A7038 |
Pos airway pressure filter |
10,283 |
9,365 |
$40K |
| A7035 |
Pos airway press headgear |
3,747 |
3,420 |
$38K |
| A7037 |
Pos airway pressure tubing |
4,107 |
3,760 |
$37K |
| E0776 |
Iv pole |
4,799 |
4,419 |
$36K |
| E0570 |
Nebulizer with compression |
7,857 |
7,177 |
$35K |
| K0001 |
Standard wheelchair |
3,591 |
2,875 |
$26K |
| A7032 |
Replacement nasal cushion |
1,301 |
1,193 |
$25K |
| A7046 |
Repl water chamber, pap dev |
2,809 |
2,561 |
$16K |
| E1392 |
Portable oxygen concentrator |
2,389 |
2,233 |
$16K |
| A7033 |
Replacement nasal pillows |
947 |
871 |
$15K |
| B9998 |
Enteral supp not otherwise c |
1,141 |
1,010 |
$12K |
| B4154 |
Ef spec metabolic noninherit |
74 |
57 |
$12K |
| A4604 |
Tubing with heating element |
1,344 |
1,245 |
$10K |
| E0630 |
Patient lift hydraulic |
474 |
430 |
$10K |
| B4100 |
Food thickener oral |
94 |
79 |
$8K |
| A7039 |
Filter, non disposable w pap |
1,792 |
1,672 |
$7K |
| K0195 |
Elevating whlchair leg rests |
1,210 |
883 |
$4K |
| B4036 |
Enteral feed sup kit grav by |
91 |
65 |
$4K |
| A7003 |
Nebulizer administration set |
2,017 |
1,796 |
$2K |
| Q0513 |
Disp fee inhal drugs/30 days |
146 |
130 |
$1K |
| A4213 |
20+ cc syringe only |
260 |
158 |
$315.38 |
| E0443 |
Portable 02 contents, gas |
26 |
26 |
$257.07 |
| A7005 |
Nondisposable nebulizer set |
12 |
12 |
$81.31 |
| A7013 |
Disposable compressor filter |
104 |
92 |
$35.21 |
| J7613 |
Albuterol non-comp unit |
20 |
16 |
$17.80 |