| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E0466 |
Home vent non-invasive inter |
5,514 |
5,323 |
$2.49M |
| E1390 |
Oxygen concentrator |
32,229 |
31,237 |
$1.92M |
| B4161 |
Ef ped hydrolyzed/amino acid |
734 |
593 |
$470K |
| E0601 |
Cont airway pressure device |
9,296 |
8,888 |
$326K |
| B4035 |
Enteral feed supp pump per d |
2,738 |
1,848 |
$283K |
| B4160 |
Ef ped caloric dense>/=0.7kc |
704 |
599 |
$256K |
| E0431 |
Portable gaseous 02 |
15,621 |
15,060 |
$195K |
| A7030 |
Cpap full face mask |
2,032 |
1,941 |
$123K |
| K0738 |
Portable gas oxygen system |
8,225 |
8,025 |
$117K |
| A7034 |
Nasal application device |
2,548 |
2,475 |
$100K |
| B4152 |
Ef calorie dense>/=1.5kcal |
590 |
505 |
$92K |
| E0562 |
Humidifier heated used w pap |
1,058 |
1,014 |
$91K |
| E0470 |
Rad w/o backup non-inv intfc |
938 |
909 |
$67K |
| B4150 |
Ef complet w/intact nutrient |
490 |
426 |
$64K |
| A4604 |
Tubing with heating element |
2,165 |
2,101 |
$58K |
| B4088 |
Gastro/jejuno tube, low-pro |
523 |
498 |
$52K |
| A7035 |
Pos airway press headgear |
3,254 |
3,133 |
$45K |
| B9998 |
Enteral supp not otherwise c |
641 |
445 |
$42K |
| A7031 |
Replacement facemask interfa |
1,798 |
1,709 |
$39K |
| A7032 |
Replacement nasal cushion |
1,466 |
1,425 |
$36K |
| E0570 |
Nebulizer with compression |
1,349 |
1,320 |
$33K |
| A7037 |
Pos airway pressure tubing |
2,423 |
2,334 |
$33K |
| A7038 |
Pos airway pressure filter |
4,939 |
4,779 |
$27K |
| B9002 |
Enter nutr inf pump any type |
535 |
534 |
$27K |
| E1392 |
Portable oxygen concentrator |
1,327 |
1,304 |
$21K |
| A7046 |
Repl water chamber, pap dev |
1,852 |
1,796 |
$15K |
| A7033 |
Replacement nasal pillows |
487 |
464 |
$11K |
| B4155 |
Ef incomplete/modular |
207 |
184 |
$9K |
| B4034 |
Enter feed supkit syr by day |
118 |
90 |
$5K |
| A7005 |
Nondisposable nebulizer set |
355 |
327 |
$4K |
| E0260 |
Hosp bed semi-electr w/ matt |
128 |
128 |
$4K |
| A7039 |
Filter, non disposable w pap |
507 |
489 |
$3K |
| A7036 |
Pos airway press chinstrap |
267 |
258 |
$2K |
| A7003 |
Nebulizer administration set |
101 |
100 |
$119.65 |
| A7013 |
Disposable compressor filter |
240 |
235 |
$111.42 |