| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E0466 |
Home vent non-invasive inter |
2,469 |
1,937 |
$724K |
| E1390 |
Oxygen concentrator |
15,197 |
11,597 |
$317K |
| B4035 |
Enteral feed supp pump per d |
940 |
795 |
$124K |
| E0431 |
Portable gaseous 02 |
10,064 |
7,720 |
$118K |
| E0601 |
Cont airway pressure device |
3,600 |
3,062 |
$68K |
| B4160 |
Ef ped caloric dense>/=0.7kc |
180 |
170 |
$46K |
| E0562 |
Humidifier heated used w pap |
3,067 |
2,761 |
$41K |
| B9998 |
Enteral supp not otherwise c |
423 |
399 |
$23K |
| B4161 |
Ef ped hydrolyzed/amino acid |
24 |
24 |
$20K |
| E0470 |
Rad w/o backup non-inv intfc |
316 |
266 |
$20K |
| E0570 |
Nebulizer with compression |
5,127 |
3,906 |
$20K |
| B9002 |
Enter nutr inf pump any type |
268 |
259 |
$16K |
| B4150 |
Ef complet w/intact nutrient |
239 |
196 |
$12K |
| A7031 |
Replacement facemask interfa |
1,131 |
907 |
$7K |
| A7030 |
Cpap full face mask |
1,051 |
828 |
$7K |
| B4034 |
Enter feed supkit syr by day |
111 |
82 |
$7K |
| A4604 |
Tubing with heating element |
1,522 |
1,158 |
$6K |
| E0465 |
Home vent invasive interface |
14 |
12 |
$3K |
| A7003 |
Nebulizer administration set |
2,328 |
1,645 |
$2K |
| B4088 |
Gastro/jejuno tube, low-pro |
66 |
63 |
$2K |
| E1392 |
Portable oxygen concentrator |
525 |
410 |
$2K |
| E0776 |
Iv pole |
174 |
171 |
$2K |
| B4152 |
Ef calorie dense>/=1.5kcal |
31 |
25 |
$2K |
| A7034 |
Nasal application device |
1,157 |
883 |
$2K |
| A7035 |
Pos airway press headgear |
1,457 |
1,116 |
$1K |
| A7038 |
Pos airway pressure filter |
3,357 |
2,591 |
$971.28 |
| K0001 |
Standard wheelchair |
170 |
154 |
$799.97 |
| A7046 |
Repl water chamber, pap dev |
1,020 |
792 |
$620.69 |
| A7033 |
Replacement nasal pillows |
178 |
133 |
$477.52 |
| A7037 |
Pos airway pressure tubing |
763 |
589 |
$447.20 |
| E0143 |
Walker folding wheeled w/o s |
30 |
24 |
$415.17 |
| A7032 |
Replacement nasal cushion |
169 |
143 |
$390.76 |
| A7000 |
Disposable canister for pump |
33 |
25 |
$177.38 |
| A7002 |
Tubing used w suction pump |
74 |
55 |
$87.69 |
| A7039 |
Filter, non disposable w pap |
16 |
12 |
$0.00 |