| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
10,893 |
10,820 |
$552K |
| B4035 |
Enteral feed supp pump per d |
768 |
696 |
$138K |
| E0466 |
Home vent non-invasive inter |
351 |
347 |
$104K |
| B4160 |
Ef ped caloric dense>/=0.7kc |
489 |
440 |
$80K |
| E0431 |
Portable gaseous 02 |
6,141 |
6,066 |
$68K |
| E0601 |
Cont airway pressure device |
1,871 |
1,844 |
$61K |
| B9998 |
Enteral supp not otherwise c |
552 |
508 |
$50K |
| B4152 |
Ef calorie dense>/=1.5kcal |
284 |
254 |
$39K |
| A7030 |
Cpap full face mask |
1,215 |
1,201 |
$39K |
| A7031 |
Replacement facemask interfa |
1,358 |
1,340 |
$29K |
| B4161 |
Ef ped hydrolyzed/amino acid |
61 |
52 |
$26K |
| B9002 |
Enter nutr inf pump any type |
394 |
390 |
$21K |
| E0562 |
Humidifier heated used w pap |
2,515 |
2,491 |
$18K |
| E0570 |
Nebulizer with compression |
2,834 |
2,817 |
$13K |
| A7035 |
Pos airway press headgear |
1,177 |
1,163 |
$10K |
| A7037 |
Pos airway pressure tubing |
1,274 |
1,258 |
$10K |
| A7038 |
Pos airway pressure filter |
2,717 |
2,679 |
$9K |
| E0470 |
Rad w/o backup non-inv intfc |
127 |
124 |
$7K |
| A7034 |
Nasal application device |
236 |
231 |
$5K |
| E1392 |
Portable oxygen concentrator |
513 |
502 |
$3K |
| A7046 |
Repl water chamber, pap dev |
1,006 |
999 |
$3K |
| E0776 |
Iv pole |
276 |
275 |
$2K |
| A7032 |
Replacement nasal cushion |
80 |
80 |
$2K |
| A7003 |
Nebulizer administration set |
1,678 |
1,575 |
$2K |
| A4604 |
Tubing with heating element |
142 |
138 |
$1K |
| B4034 |
Enter feed supkit syr by day |
12 |
12 |
$903.85 |
| Q0513 |
Disp fee inhal drugs/30 days |
46 |
40 |
$356.71 |
| J7626 |
Budesonide non-comp unit |
13 |
12 |
$310.56 |
| A7005 |
Nondisposable nebulizer set |
38 |
38 |
$292.15 |
| J7620 |
Albuterol ipratrop non-comp |
16 |
13 |
$41.20 |
| J7613 |
Albuterol non-comp unit |
13 |
12 |
$27.08 |