| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| B4035 |
Enteral feed supp pump per d |
5,899 |
5,166 |
$1.06M |
| B4161 |
Ef ped hydrolyzed/amino acid |
1,322 |
1,146 |
$1.00M |
| E1390 |
Oxygen concentrator |
12,956 |
12,035 |
$741K |
| B4160 |
Ef ped caloric dense>/=0.7kc |
1,463 |
1,272 |
$500K |
| B4152 |
Ef calorie dense>/=1.5kcal |
2,783 |
2,428 |
$317K |
| B4149 |
Ef blenderized foods |
730 |
625 |
$263K |
| B4150 |
Ef complet w/intact nutrient |
2,377 |
2,180 |
$230K |
| B4034 |
Enter feed supkit syr by day |
2,451 |
2,166 |
$158K |
| B4088 |
Gastro/jejuno tube, low-pro |
1,354 |
1,210 |
$126K |
| B4036 |
Enteral feed sup kit grav by |
1,006 |
920 |
$121K |
| E0601 |
Cont airway pressure device |
3,248 |
3,086 |
$100K |
| B4154 |
Ef spec metabolic noninherit |
696 |
651 |
$88K |
| B9002 |
Enter nutr inf pump any type |
1,133 |
1,031 |
$71K |
| A7030 |
Cpap full face mask |
1,692 |
1,645 |
$70K |
| E1392 |
Portable oxygen concentrator |
4,682 |
4,238 |
$66K |
| E0431 |
Portable gaseous 02 |
4,668 |
4,456 |
$53K |
| A7034 |
Nasal application device |
1,584 |
1,533 |
$43K |
| A4604 |
Tubing with heating element |
2,227 |
2,148 |
$41K |
| A7032 |
Replacement nasal cushion |
1,031 |
991 |
$39K |
| A7031 |
Replacement facemask interfa |
1,621 |
1,571 |
$38K |
| E0562 |
Humidifier heated used w pap |
1,953 |
1,862 |
$35K |
| B4153 |
Ef hydrolyzed/amino acids |
117 |
106 |
$25K |
| B9998 |
Enteral supp not otherwise c |
624 |
552 |
$23K |
| A7035 |
Pos airway press headgear |
2,125 |
2,060 |
$22K |
| A7038 |
Pos airway pressure filter |
5,234 |
4,987 |
$20K |
| A7033 |
Replacement nasal pillows |
691 |
658 |
$18K |
| E0570 |
Nebulizer with compression |
3,626 |
3,593 |
$17K |
| A7046 |
Repl water chamber, pap dev |
1,793 |
1,725 |
$11K |
| B4155 |
Ef incomplete/modular |
302 |
255 |
$9K |
| E0776 |
Iv pole |
1,997 |
1,901 |
$9K |
| A7037 |
Pos airway pressure tubing |
1,238 |
1,197 |
$8K |
| A7003 |
Nebulizer administration set |
1,623 |
1,517 |
$2K |
| E0470 |
Rad w/o backup non-inv intfc |
12 |
12 |
$364.91 |
| A7005 |
Nondisposable nebulizer set |
41 |
41 |
$249.16 |
| A7039 |
Filter, non disposable w pap |
77 |
76 |
$130.62 |
| A7013 |
Disposable compressor filter |
15 |
15 |
$2.80 |