| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| B4035 |
Enteral feed supp pump per d |
8,208 |
4,166 |
$124K |
| E0570 |
Nebulizer with compression |
1,871 |
1,710 |
$122K |
| E1390 |
Oxygen concentrator |
2,037 |
1,658 |
$73K |
| B4152 |
Ef calorie dense>/=1.5kcal |
5,904 |
3,008 |
$43K |
| A7005 |
Nondisposable nebulizer set |
1,770 |
1,636 |
$33K |
| B4154 |
Ef spec metabolic noninherit |
2,161 |
1,057 |
$29K |
| E0431 |
Portable gaseous 02 |
962 |
807 |
$10K |
| E1392 |
Portable oxygen concentrator |
753 |
586 |
$7K |
| E0143 |
Walker folding wheeled w/o s |
150 |
122 |
$7K |
| E1140 |
Wheelchair standard detach a |
28 |
26 |
$4K |
| B4150 |
Ef complet w/intact nutrient |
420 |
245 |
$3K |
| E1150 |
Wheelchair standard w/ leg r |
24 |
24 |
$2K |
| B9002 |
Enter nutr inf pump any type |
772 |
523 |
$2K |
| B4034 |
Enter feed supkit syr by day |
512 |
246 |
$1K |
| E0776 |
Iv pole |
896 |
671 |
$1K |
| E0601 |
Cont airway pressure device |
62 |
58 |
$777.60 |
| A4357 |
Bedside drainage bag |
496 |
372 |
$388.12 |
| K0001 |
Standard wheelchair |
40 |
37 |
$286.54 |
| A7013 |
Disposable compressor filter |
88 |
82 |
$245.89 |
| B4087 |
Gastro/jejuno tube, std |
89 |
72 |
$143.81 |
| A4338 |
Indwelling catheter latex |
344 |
260 |
$137.74 |
| E0971 |
Wheelchair anti-tipping devi |
27 |
15 |
$130.34 |
| A7015 |
Aerosol mask used w nebulize |
91 |
85 |
$120.42 |
| A4310 |
Insert tray w/o bag/cath |
486 |
367 |
$67.84 |
| A7038 |
Pos airway pressure filter |
42 |
27 |
$39.17 |
| A5114 |
Foam/fabric leg strap |
91 |
75 |
$18.24 |
| A4334 |
Urinary cath leg strap |
82 |
55 |
$4.42 |