| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
26,780 |
23,553 |
$611K |
| B4035 |
Enteral feed supp pump per d |
2,829 |
1,767 |
$158K |
| E0431 |
Portable gaseous 02 |
12,954 |
11,384 |
$69K |
| B4152 |
Ef calorie dense>/=1.5kcal |
1,172 |
800 |
$50K |
| B4034 |
Enter feed supkit syr by day |
1,400 |
973 |
$45K |
| A7031 |
Replacement facemask interfa |
2,312 |
2,194 |
$39K |
| B4150 |
Ef complet w/intact nutrient |
825 |
597 |
$34K |
| A7030 |
Cpap full face mask |
1,288 |
1,209 |
$32K |
| B4160 |
Ef ped caloric dense>/=0.7kc |
186 |
180 |
$16K |
| E0601 |
Cont airway pressure device |
943 |
867 |
$14K |
| E1392 |
Portable oxygen concentrator |
2,250 |
1,956 |
$13K |
| E0466 |
Home vent non-invasive inter |
77 |
62 |
$10K |
| A7038 |
Pos airway pressure filter |
4,523 |
4,242 |
$8K |
| A7037 |
Pos airway pressure tubing |
1,956 |
1,834 |
$8K |
| A7034 |
Nasal application device |
756 |
700 |
$8K |
| A7035 |
Pos airway press headgear |
1,302 |
1,225 |
$8K |
| A7032 |
Replacement nasal cushion |
407 |
380 |
$6K |
| E0570 |
Nebulizer with compression |
3,119 |
2,789 |
$6K |
| E0562 |
Humidifier heated used w pap |
979 |
877 |
$5K |
| A7033 |
Replacement nasal pillows |
311 |
295 |
$4K |
| A7046 |
Repl water chamber, pap dev |
988 |
937 |
$4K |
| B9002 |
Enter nutr inf pump any type |
84 |
78 |
$2K |
| K0001 |
Standard wheelchair |
274 |
246 |
$2K |
| A7003 |
Nebulizer administration set |
2,063 |
1,853 |
$1K |
| A4604 |
Tubing with heating element |
45 |
42 |
$317.72 |
| E0776 |
Iv pole |
55 |
50 |
$279.73 |
| E0443 |
Portable 02 contents, gas |
121 |
113 |
$231.60 |
| B4088 |
Gastro/jejuno tube, low-pro |
15 |
12 |
$202.19 |
| B9998 |
Enteral supp not otherwise c |
15 |
13 |
$177.41 |