| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| B4035 |
Enteral feed supp pump per d |
3,553 |
3,035 |
$487K |
| E1390 |
Oxygen concentrator |
9,525 |
6,948 |
$329K |
| E0466 |
Home vent non-invasive inter |
1,022 |
953 |
$184K |
| A7030 |
Cpap full face mask |
3,257 |
2,900 |
$182K |
| E0601 |
Cont airway pressure device |
6,616 |
4,203 |
$120K |
| B4160 |
Ef ped caloric dense>/=0.7kc |
790 |
661 |
$118K |
| E0603 |
Electric breast pump |
1,329 |
887 |
$115K |
| A7031 |
Replacement facemask interfa |
4,204 |
3,778 |
$97K |
| A7034 |
Nasal application device |
1,947 |
1,731 |
$72K |
| E0431 |
Portable gaseous 02 |
5,851 |
4,248 |
$60K |
| B4149 |
Ef blenderized foods |
217 |
168 |
$59K |
| A7037 |
Pos airway pressure tubing |
5,044 |
4,430 |
$58K |
| A7035 |
Pos airway press headgear |
3,640 |
3,253 |
$49K |
| E0562 |
Humidifier heated used w pap |
7,692 |
4,823 |
$47K |
| B4088 |
Gastro/jejuno tube, low-pro |
659 |
568 |
$39K |
| A7046 |
Repl water chamber, pap dev |
3,961 |
3,618 |
$33K |
| A7038 |
Pos airway pressure filter |
8,990 |
7,931 |
$30K |
| A7033 |
Replacement nasal pillows |
1,595 |
1,464 |
$25K |
| E0570 |
Nebulizer with compression |
3,239 |
1,899 |
$24K |
| B4036 |
Enteral feed sup kit grav by |
206 |
181 |
$14K |
| A4213 |
20+ cc syringe only |
1,198 |
1,064 |
$14K |
| K0001 |
Standard wheelchair |
1,458 |
940 |
$13K |
| A7039 |
Filter, non disposable w pap |
1,840 |
1,623 |
$7K |
| B4150 |
Ef complet w/intact nutrient |
58 |
53 |
$6K |
| E1392 |
Portable oxygen concentrator |
313 |
233 |
$6K |
| B9002 |
Enter nutr inf pump any type |
220 |
161 |
$5K |
| A7032 |
Replacement nasal cushion |
291 |
270 |
$4K |
| B4152 |
Ef calorie dense>/=1.5kcal |
32 |
25 |
$2K |
| E0143 |
Walker folding wheeled w/o s |
60 |
51 |
$2K |
| E0776 |
Iv pole |
460 |
339 |
$2K |
| A4322 |
Irrigation syringe |
54 |
53 |
$2K |
| A7005 |
Nondisposable nebulizer set |
103 |
79 |
$871.05 |
| E0600 |
Suction pump portab hom modl |
29 |
24 |
$258.86 |
| A6402 |
Sterile gauze <= 16 sq in |
350 |
302 |
$225.09 |
| A7036 |
Pos airway press chinstrap |
14 |
14 |
$87.22 |
| A7003 |
Nebulizer administration set |
119 |
92 |
$48.60 |