| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| B4035 |
Enteral feed supp pump per d |
12,436 |
6,541 |
$1.59M |
| B4161 |
Ef ped hydrolyzed/amino acid |
4,377 |
2,818 |
$1.44M |
| E1390 |
Oxygen concentrator |
20,096 |
14,295 |
$1.04M |
| B4152 |
Ef calorie dense>/=1.5kcal |
3,914 |
2,376 |
$415K |
| B4149 |
Ef blenderized foods |
1,199 |
744 |
$311K |
| A7030 |
Cpap full face mask |
3,521 |
2,671 |
$280K |
| E0143 |
Walker folding wheeled w/o s |
4,792 |
3,925 |
$224K |
| E0601 |
Cont airway pressure device |
6,457 |
5,072 |
$196K |
| B4034 |
Enter feed supkit syr by day |
4,184 |
2,366 |
$191K |
| B4088 |
Gastro/jejuno tube, low-pro |
2,145 |
1,576 |
$166K |
| B9002 |
Enter nutr inf pump any type |
2,245 |
1,495 |
$152K |
| B4160 |
Ef ped caloric dense>/=0.7kc |
1,921 |
1,244 |
$150K |
| E0260 |
Hosp bed semi-electr w/ matt |
4,371 |
3,308 |
$130K |
| E0431 |
Portable gaseous 02 |
13,469 |
10,028 |
$121K |
| E0163 |
Commode chair with fixed arm |
1,943 |
1,569 |
$96K |
| K0001 |
Standard wheelchair |
7,087 |
5,716 |
$96K |
| K0003 |
Lightweight wheelchair |
3,306 |
2,511 |
$85K |
| A7031 |
Replacement facemask interfa |
2,828 |
1,967 |
$77K |
| E0445 |
Oximeter non-invasive |
773 |
657 |
$76K |
| B4150 |
Ef complet w/intact nutrient |
683 |
451 |
$72K |
| A4629 |
Tracheostomy care kit |
1,174 |
724 |
$71K |
| A7037 |
Pos airway pressure tubing |
3,916 |
2,993 |
$66K |
| E0562 |
Humidifier heated used w pap |
3,388 |
2,535 |
$64K |
| A7034 |
Nasal application device |
1,133 |
860 |
$61K |
| E0570 |
Nebulizer with compression |
5,942 |
4,451 |
$60K |
| A4624 |
Tracheal suction tube |
789 |
488 |
$57K |
| E0600 |
Suction pump portab hom modl |
2,279 |
1,660 |
$52K |
| A7035 |
Pos airway press headgear |
2,078 |
1,572 |
$36K |
| K0195 |
Elevating whlchair leg rests |
4,230 |
3,233 |
$33K |
| E0630 |
Patient lift hydraulic |
864 |
695 |
$28K |
| A7038 |
Pos airway pressure filter |
6,485 |
4,807 |
$28K |
| E0470 |
Rad w/o backup non-inv intfc |
561 |
443 |
$28K |
| A7526 |
Tracheostomy tube collar |
1,283 |
837 |
$24K |
| E0240 |
Bath/shower chair |
448 |
354 |
$21K |
| B9998 |
Enteral supp not otherwise c |
2,928 |
1,327 |
$21K |
| A7000 |
Disposable canister for pump |
1,846 |
1,316 |
$20K |
| K0007 |
Extra heavy duty wheelchair |
358 |
263 |
$17K |
| E1392 |
Portable oxygen concentrator |
1,479 |
1,114 |
$16K |
| E0247 |
Trans bench w/wo comm open |
208 |
164 |
$14K |
| E0114 |
Crutch underarm pair no wood |
495 |
446 |
$13K |
| K0006 |
Heavy duty wheelchair |
394 |
292 |
$13K |
| B4155 |
Ef incomplete/modular |
180 |
131 |
$13K |
| A7520 |
Trach/laryn tube non-cuffed |
436 |
225 |
$12K |
| E0156 |
Walker seat attachment |
1,108 |
907 |
$10K |
| A4604 |
Tubing with heating element |
476 |
386 |
$10K |
| A4628 |
Oropharyngeal suction cath |
1,629 |
1,188 |
$9K |
| A7032 |
Replacement nasal cushion |
232 |
176 |
$8K |
| E0471 |
Rad w/backup non inv intrfc |
73 |
50 |
$8K |
| A7002 |
Tubing used w suction pump |
2,076 |
1,409 |
$8K |
| B4154 |
Ef spec metabolic noninherit |
76 |
39 |
$7K |
| E0165 |
Commode chair with detacharm |
110 |
92 |
$4K |
| A7046 |
Repl water chamber, pap dev |
575 |
463 |
$4K |
| A4217 |
Sterile water/saline, 500 ml |
34 |
26 |
$3K |
| E2601 |
Gen w/c cushion wdth < 22 in |
125 |
105 |
$3K |
| A7033 |
Replacement nasal pillows |
112 |
93 |
$3K |
| E0265 |
Hosp bed total electr w/ mat |
56 |
42 |
$2K |
| A4222 |
Infusion supplies with pump |
111 |
55 |
$2K |
| E0971 |
Wheelchair anti-tipping devi |
27 |
25 |
$1K |
| A7003 |
Nebulizer administration set |
700 |
542 |
$1K |
| A6402 |
Sterile gauze <= 16 sq in |
366 |
225 |
$597.84 |
| E1038 |
Transport chair pt wt<=300lb |
64 |
50 |
$199.60 |
| E0100 |
Cane adjust/fixed with tip |
15 |
13 |
$126.94 |
| A4221 |
Supp non-insulin inf cath/wk |
60 |
40 |
$122.15 |
| A7525 |
Tracheostomy mask |
65 |
49 |
$114.77 |
| A7007 |
Lg vol nebulizer disposable |
16 |
12 |
$99.60 |
| A4452 |
Waterproof tape |
86 |
45 |
$29.63 |
| A4450 |
Non-waterproof tape |
44 |
27 |
$1.20 |
| J9190 |
Fluorouracil injection |
51 |
27 |
$0.00 |
| E0781 |
External ambulatory infus pu |
12 |
12 |
$0.00 |
| W4211 |
|
32 |
16 |
$0.00 |