| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| B4035 |
Enteral feed supp pump per d |
2,001 |
1,838 |
$389K |
| B4160 |
Ef ped caloric dense>/=0.7kc |
2,439 |
2,310 |
$381K |
| E1390 |
Oxygen concentrator |
8,322 |
7,441 |
$320K |
| B4161 |
Ef ped hydrolyzed/amino acid |
421 |
372 |
$218K |
| B4149 |
Ef blenderized foods |
1,050 |
691 |
$204K |
| B4152 |
Ef calorie dense>/=1.5kcal |
1,207 |
1,036 |
$147K |
| B4150 |
Ef complet w/intact nutrient |
1,225 |
1,069 |
$113K |
| E0466 |
Home vent non-invasive inter |
375 |
279 |
$73K |
| B9002 |
Enter nutr inf pump any type |
918 |
903 |
$68K |
| B4034 |
Enter feed supkit syr by day |
523 |
483 |
$49K |
| A7031 |
Replacement facemask interfa |
1,061 |
995 |
$35K |
| A7030 |
Cpap full face mask |
387 |
350 |
$29K |
| B4088 |
Gastro/jejuno tube, low-pro |
624 |
472 |
$27K |
| E0431 |
Portable gaseous 02 |
3,359 |
3,058 |
$25K |
| E1392 |
Portable oxygen concentrator |
2,305 |
1,998 |
$25K |
| A4604 |
Tubing with heating element |
626 |
564 |
$15K |
| E0601 |
Cont airway pressure device |
267 |
264 |
$10K |
| E0562 |
Humidifier heated used w pap |
565 |
554 |
$8K |
| E0776 |
Iv pole |
599 |
589 |
$8K |
| A7038 |
Pos airway pressure filter |
2,002 |
1,853 |
$7K |
| B4154 |
Ef spec metabolic noninherit |
48 |
38 |
$6K |
| E0443 |
Portable 02 contents, gas |
159 |
151 |
$5K |
| E0570 |
Nebulizer with compression |
743 |
659 |
$4K |
| A7035 |
Pos airway press headgear |
254 |
233 |
$4K |
| B4036 |
Enteral feed sup kit grav by |
12 |
12 |
$1K |
| A7032 |
Replacement nasal cushion |
29 |
27 |
$1K |
| A7046 |
Repl water chamber, pap dev |
99 |
96 |
$986.28 |
| A7003 |
Nebulizer administration set |
41 |
37 |
$57.14 |