| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| B4161 |
Ef ped hydrolyzed/amino acid |
2,590 |
2,018 |
$1.41M |
| B4160 |
Ef ped caloric dense>/=0.7kc |
7,638 |
6,509 |
$1.19M |
| B4035 |
Enteral feed supp pump per d |
9,222 |
7,098 |
$849K |
| E1390 |
Oxygen concentrator |
27,924 |
21,669 |
$722K |
| B4152 |
Ef calorie dense>/=1.5kcal |
4,546 |
3,376 |
$279K |
| B4149 |
Ef blenderized foods |
995 |
824 |
$253K |
| B4150 |
Ef complet w/intact nutrient |
3,442 |
2,679 |
$237K |
| E0466 |
Home vent non-invasive inter |
665 |
529 |
$210K |
| B9002 |
Enter nutr inf pump any type |
2,178 |
1,818 |
$188K |
| E0601 |
Cont airway pressure device |
3,443 |
2,695 |
$130K |
| B9998 |
Enteral supp not otherwise c |
4,729 |
3,198 |
$127K |
| A4604 |
Tubing with heating element |
5,081 |
4,504 |
$125K |
| E0431 |
Portable gaseous 02 |
17,968 |
14,086 |
$112K |
| A7030 |
Cpap full face mask |
2,377 |
2,069 |
$107K |
| B4103 |
Ef ped fluid and electrolyte |
695 |
595 |
$88K |
| B4034 |
Enter feed supkit syr by day |
2,276 |
1,687 |
$81K |
| B4154 |
Ef spec metabolic noninherit |
516 |
396 |
$67K |
| E0570 |
Nebulizer with compression |
5,140 |
3,974 |
$63K |
| A7031 |
Replacement facemask interfa |
3,037 |
2,615 |
$61K |
| B4158 |
Ef ped complete intact nut |
369 |
322 |
$56K |
| A7034 |
Nasal application device |
1,733 |
1,479 |
$49K |
| E0776 |
Iv pole |
2,476 |
2,111 |
$42K |
| E1392 |
Portable oxygen concentrator |
3,708 |
2,923 |
$40K |
| B4155 |
Ef incomplete/modular |
1,010 |
870 |
$38K |
| E0562 |
Humidifier heated used w pap |
3,987 |
3,103 |
$35K |
| A7035 |
Pos airway press headgear |
2,993 |
2,586 |
$33K |
| A7032 |
Replacement nasal cushion |
1,281 |
1,070 |
$26K |
| B4088 |
Gastro/jejuno tube, low-pro |
1,005 |
854 |
$22K |
| A7046 |
Repl water chamber, pap dev |
2,502 |
2,193 |
$18K |
| A7038 |
Pos airway pressure filter |
9,005 |
7,087 |
$16K |
| B4036 |
Enteral feed sup kit grav by |
112 |
85 |
$7K |
| A7033 |
Replacement nasal pillows |
343 |
309 |
$6K |
| A7037 |
Pos airway pressure tubing |
805 |
682 |
$5K |
| E0443 |
Portable 02 contents, gas |
528 |
370 |
$4K |
| A7005 |
Nondisposable nebulizer set |
597 |
492 |
$4K |
| A7003 |
Nebulizer administration set |
2,548 |
1,953 |
$2K |
| E0470 |
Rad w/o backup non-inv intfc |
31 |
26 |
$918.63 |
| A7000 |
Disposable canister for pump |
58 |
50 |
$732.48 |
| A7015 |
Aerosol mask used w nebulize |
579 |
513 |
$425.37 |
| A7002 |
Tubing used w suction pump |
82 |
64 |
$347.71 |
| G0249 |
Provide inr test mater/equip |
516 |
437 |
$213.76 |
| A7039 |
Filter, non disposable w pap |
42 |
37 |
$171.19 |
| A7013 |
Disposable compressor filter |
109 |
105 |
$54.67 |