| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| B4035 |
Enteral feed supp pump per d |
15,006 |
8,732 |
$2.10M |
| B4161 |
Ef ped hydrolyzed/amino acid |
4,502 |
3,626 |
$2.01M |
| B4160 |
Ef ped caloric dense>/=0.7kc |
13,575 |
11,087 |
$1.42M |
| E1390 |
Oxygen concentrator |
23,917 |
14,292 |
$786K |
| B4152 |
Ef calorie dense>/=1.5kcal |
5,089 |
3,727 |
$692K |
| B4149 |
Ef blenderized foods |
1,964 |
1,442 |
$691K |
| B4150 |
Ef complet w/intact nutrient |
3,526 |
2,708 |
$402K |
| B4155 |
Ef incomplete/modular |
3,005 |
2,384 |
$372K |
| B4034 |
Enter feed supkit syr by day |
5,314 |
3,252 |
$371K |
| B4153 |
Ef hydrolyzed/amino acids |
543 |
387 |
$236K |
| B9002 |
Enter nutr inf pump any type |
1,879 |
1,501 |
$218K |
| B4088 |
Gastro/jejuno tube, low-pro |
2,993 |
2,453 |
$211K |
| B9998 |
Enteral supp not otherwise c |
3,248 |
1,413 |
$177K |
| B4103 |
Ef ped fluid and electrolyte |
899 |
737 |
$132K |
| E0445 |
Oximeter non-invasive |
1,015 |
571 |
$98K |
| E0431 |
Portable gaseous 02 |
14,035 |
8,603 |
$90K |
| E0466 |
Home vent non-invasive inter |
308 |
168 |
$80K |
| E0601 |
Cont airway pressure device |
3,526 |
2,260 |
$77K |
| A7030 |
Cpap full face mask |
1,626 |
1,198 |
$68K |
| B4036 |
Enteral feed sup kit grav by |
609 |
355 |
$53K |
| A7031 |
Replacement facemask interfa |
2,209 |
1,595 |
$48K |
| E0776 |
Iv pole |
1,905 |
1,486 |
$33K |
| A7034 |
Nasal application device |
1,351 |
942 |
$30K |
| E0562 |
Humidifier heated used w pap |
3,438 |
2,307 |
$25K |
| A7037 |
Pos airway pressure tubing |
2,163 |
1,578 |
$18K |
| E1392 |
Portable oxygen concentrator |
2,397 |
1,387 |
$17K |
| A7035 |
Pos airway press headgear |
2,021 |
1,474 |
$17K |
| A7038 |
Pos airway pressure filter |
5,054 |
3,783 |
$15K |
| B4154 |
Ef spec metabolic noninherit |
71 |
50 |
$14K |
| E0570 |
Nebulizer with compression |
4,284 |
2,840 |
$14K |
| A7032 |
Replacement nasal cushion |
621 |
444 |
$14K |
| B4100 |
Food thickener oral |
28 |
25 |
$5K |
| A4604 |
Tubing with heating element |
447 |
321 |
$5K |
| A7520 |
Trach/laryn tube non-cuffed |
101 |
37 |
$2K |
| A4629 |
Tracheostomy care kit |
33 |
24 |
$2K |
| A4624 |
Tracheal suction tube |
19 |
15 |
$2K |
| A7033 |
Replacement nasal pillows |
83 |
62 |
$2K |
| A7046 |
Repl water chamber, pap dev |
495 |
367 |
$1K |
| Q0513 |
Disp fee inhal drugs/30 days |
175 |
99 |
$1K |
| A7526 |
Tracheostomy tube collar |
56 |
40 |
$1K |
| A7003 |
Nebulizer administration set |
1,376 |
1,141 |
$938.75 |
| J7626 |
Budesonide non-comp unit |
16 |
14 |
$619.20 |
| A4217 |
Sterile water/saline, 500 ml |
16 |
14 |
$570.48 |
| A7000 |
Disposable canister for pump |
50 |
40 |
$550.54 |
| E0443 |
Portable 02 contents, gas |
150 |
92 |
$309.71 |
| A7002 |
Tubing used w suction pump |
71 |
55 |
$259.40 |
| J7613 |
Albuterol non-comp unit |
41 |
30 |
$121.67 |
| J7620 |
Albuterol ipratrop non-comp |
16 |
14 |
$88.07 |
| A7005 |
Nondisposable nebulizer set |
41 |
28 |
$56.19 |