| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| B4035 |
Enteral feed supp pump per d |
138 |
124 |
$19K |
| E1390 |
Oxygen concentrator |
320 |
242 |
$15K |
| B4088 |
Gastro/jejuno tube, low-pro |
179 |
133 |
$12K |
| E0601 |
Cont airway pressure device |
214 |
184 |
$9K |
| B4160 |
Ef ped caloric dense>/=0.7kc |
29 |
24 |
$4K |
| E0562 |
Humidifier heated used w pap |
233 |
196 |
$4K |
| E0431 |
Portable gaseous 02 |
193 |
160 |
$3K |
| E0570 |
Nebulizer with compression |
147 |
139 |
$2K |
| A7035 |
Pos airway press headgear |
70 |
70 |
$878.88 |
| A7037 |
Pos airway pressure tubing |
45 |
45 |
$700.72 |
| A7034 |
Nasal application device |
12 |
12 |
$348.97 |
| K0001 |
Standard wheelchair |
17 |
13 |
$289.98 |
| A7038 |
Pos airway pressure filter |
93 |
93 |
$265.92 |