| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| B4035 |
Enteral feed supp pump per d |
4,743 |
3,306 |
$376K |
| B4161 |
Ef ped hydrolyzed/amino acid |
1,437 |
889 |
$370K |
| B4160 |
Ef ped caloric dense>/=0.7kc |
3,732 |
2,283 |
$364K |
| E1390 |
Oxygen concentrator |
10,851 |
10,193 |
$345K |
| B9998 |
Enteral supp not otherwise c |
2,641 |
1,801 |
$101K |
| A7030 |
Cpap full face mask |
2,242 |
2,132 |
$93K |
| E0466 |
Home vent non-invasive inter |
376 |
343 |
$91K |
| A7031 |
Replacement facemask interfa |
3,350 |
3,183 |
$82K |
| E0601 |
Cont airway pressure device |
2,762 |
2,568 |
$70K |
| B4152 |
Ef calorie dense>/=1.5kcal |
1,424 |
1,014 |
$58K |
| B9002 |
Enter nutr inf pump any type |
856 |
754 |
$53K |
| B4034 |
Enter feed supkit syr by day |
1,576 |
1,074 |
$46K |
| B4150 |
Ef complet w/intact nutrient |
1,012 |
593 |
$45K |
| E0431 |
Portable gaseous 02 |
6,696 |
6,240 |
$39K |
| E0562 |
Humidifier heated used w pap |
3,303 |
3,097 |
$28K |
| A7037 |
Pos airway pressure tubing |
2,770 |
2,649 |
$19K |
| A7035 |
Pos airway press headgear |
1,750 |
1,665 |
$16K |
| A7038 |
Pos airway pressure filter |
5,141 |
4,872 |
$15K |
| E0570 |
Nebulizer with compression |
3,863 |
3,705 |
$14K |
| B4088 |
Gastro/jejuno tube, low-pro |
536 |
455 |
$10K |
| E0776 |
Iv pole |
790 |
728 |
$8K |
| A7034 |
Nasal application device |
302 |
283 |
$8K |
| A7032 |
Replacement nasal cushion |
270 |
262 |
$7K |
| E1392 |
Portable oxygen concentrator |
762 |
684 |
$5K |
| A7046 |
Repl water chamber, pap dev |
952 |
914 |
$4K |
| B4153 |
Ef hydrolyzed/amino acids |
13 |
12 |
$3K |
| E0470 |
Rad w/o backup non-inv intfc |
69 |
67 |
$2K |
| A7003 |
Nebulizer administration set |
1,471 |
1,369 |
$1K |
| E0443 |
Portable 02 contents, gas |
138 |
135 |
$629.50 |
| A7033 |
Replacement nasal pillows |
12 |
12 |
$249.33 |
| A7005 |
Nondisposable nebulizer set |
14 |
12 |
$83.87 |
| A7039 |
Filter, non disposable w pap |
16 |
15 |
$65.55 |
| A7015 |
Aerosol mask used w nebulize |
57 |
54 |
$31.13 |
| A7014 |
Compressor nondispos filter |
14 |
14 |
$13.97 |
| A4604 |
Tubing with heating element |
56 |
54 |
$0.00 |