| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
34,313 |
21,036 |
$1.13M |
| B4160 |
Ef ped caloric dense>/=0.7kc |
6,241 |
5,187 |
$618K |
| B4035 |
Enteral feed supp pump per d |
5,215 |
2,794 |
$514K |
| B4152 |
Ef calorie dense>/=1.5kcal |
2,035 |
1,487 |
$220K |
| B4161 |
Ef ped hydrolyzed/amino acid |
377 |
337 |
$185K |
| E0466 |
Home vent non-invasive inter |
992 |
495 |
$181K |
| B4034 |
Enter feed supkit syr by day |
2,622 |
1,479 |
$141K |
| E0431 |
Portable gaseous 02 |
19,580 |
12,196 |
$112K |
| E0445 |
Oximeter non-invasive |
768 |
417 |
$74K |
| A7030 |
Cpap full face mask |
1,449 |
1,034 |
$54K |
| E1392 |
Portable oxygen concentrator |
5,051 |
3,176 |
$42K |
| B4155 |
Ef incomplete/modular |
310 |
266 |
$40K |
| E0601 |
Cont airway pressure device |
2,064 |
1,232 |
$39K |
| A7031 |
Replacement facemask interfa |
1,584 |
1,147 |
$37K |
| E0570 |
Nebulizer with compression |
3,695 |
2,500 |
$31K |
| B4150 |
Ef complet w/intact nutrient |
269 |
186 |
$31K |
| B4088 |
Gastro/jejuno tube, low-pro |
279 |
214 |
$20K |
| E0562 |
Humidifier heated used w pap |
2,121 |
1,406 |
$17K |
| A7037 |
Pos airway pressure tubing |
2,101 |
1,506 |
$16K |
| A7038 |
Pos airway pressure filter |
3,869 |
2,951 |
$11K |
| A7035 |
Pos airway press headgear |
1,206 |
882 |
$11K |
| E0465 |
Home vent invasive interface |
49 |
25 |
$10K |
| B9002 |
Enter nutr inf pump any type |
84 |
63 |
$6K |
| A7520 |
Trach/laryn tube non-cuffed |
40 |
24 |
$2K |
| A7034 |
Nasal application device |
84 |
58 |
$2K |
| A7003 |
Nebulizer administration set |
1,559 |
1,181 |
$1K |
| B4103 |
Ef ped fluid and electrolyte |
15 |
12 |
$1K |
| A7032 |
Replacement nasal cushion |
21 |
12 |
$810.27 |
| A7005 |
Nondisposable nebulizer set |
97 |
75 |
$542.52 |
| A7046 |
Repl water chamber, pap dev |
192 |
146 |
$485.77 |
| K0001 |
Standard wheelchair |
97 |
54 |
$388.50 |
| E0776 |
Iv pole |
15 |
12 |
$88.05 |
| A7002 |
Tubing used w suction pump |
15 |
12 |
$57.63 |
| A7013 |
Disposable compressor filter |
15 |
13 |
$6.17 |