| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| B4161 |
Ef ped hydrolyzed/amino acid |
906 |
835 |
$865K |
| B4035 |
Enteral feed supp pump per d |
4,074 |
3,390 |
$639K |
| B4160 |
Ef ped caloric dense>/=0.7kc |
1,720 |
1,516 |
$354K |
| E1390 |
Oxygen concentrator |
6,226 |
4,832 |
$189K |
| E0445 |
Oximeter non-invasive |
1,344 |
1,312 |
$126K |
| B9998 |
Enteral supp not otherwise c |
2,157 |
2,046 |
$116K |
| E0466 |
Home vent non-invasive inter |
265 |
214 |
$78K |
| E0431 |
Portable gaseous 02 |
3,543 |
2,888 |
$61K |
| B4152 |
Ef calorie dense>/=1.5kcal |
684 |
486 |
$41K |
| B4088 |
Gastro/jejuno tube, low-pro |
517 |
481 |
$27K |
| E0600 |
Suction pump portab hom modl |
766 |
678 |
$11K |
| E0570 |
Nebulizer with compression |
2,676 |
1,909 |
$8K |
| B9002 |
Enter nutr inf pump any type |
120 |
114 |
$7K |
| E0601 |
Cont airway pressure device |
272 |
262 |
$5K |
| B4155 |
Ef incomplete/modular |
64 |
61 |
$2K |
| A7003 |
Nebulizer administration set |
1,029 |
713 |
$2K |
| B4034 |
Enter feed supkit syr by day |
12 |
12 |
$2K |
| E1392 |
Portable oxygen concentrator |
327 |
256 |
$1K |
| E0562 |
Humidifier heated used w pap |
313 |
285 |
$1K |
| E0776 |
Iv pole |
75 |
61 |
$469.76 |
| A7002 |
Tubing used w suction pump |
277 |
214 |
$384.77 |
| A7031 |
Replacement facemask interfa |
85 |
77 |
$289.56 |
| A7000 |
Disposable canister for pump |
14 |
12 |
$104.46 |
| A7038 |
Pos airway pressure filter |
226 |
196 |
$7.56 |
| A7035 |
Pos airway press headgear |
27 |
24 |
$0.00 |
| A7030 |
Cpap full face mask |
41 |
38 |
$0.00 |
| A7037 |
Pos airway pressure tubing |
14 |
13 |
$0.00 |