| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| B4160 |
Ef ped caloric dense>/=0.7kc |
399 |
316 |
$99K |
| E1390 |
Oxygen concentrator |
2,213 |
1,863 |
$95K |
| E0601 |
Cont airway pressure device |
1,102 |
965 |
$46K |
| B4150 |
Ef complet w/intact nutrient |
743 |
463 |
$28K |
| B4035 |
Enteral feed supp pump per d |
445 |
297 |
$25K |
| B4152 |
Ef calorie dense>/=1.5kcal |
195 |
145 |
$15K |
| E0570 |
Nebulizer with compression |
583 |
512 |
$12K |
| A7030 |
Cpap full face mask |
151 |
137 |
$11K |
| A4604 |
Tubing with heating element |
342 |
303 |
$10K |
| E0562 |
Humidifier heated used w pap |
181 |
169 |
$10K |
| E0260 |
Hosp bed semi-electr w/ matt |
457 |
382 |
$9K |
| K0001 |
Standard wheelchair |
596 |
493 |
$6K |
| E1392 |
Portable oxygen concentrator |
378 |
328 |
$6K |
| B9002 |
Enter nutr inf pump any type |
237 |
187 |
$4K |
| K0003 |
Lightweight wheelchair |
122 |
110 |
$3K |
| A7035 |
Pos airway press headgear |
236 |
215 |
$3K |
| K0738 |
Portable gas oxygen system |
438 |
411 |
$3K |
| E0143 |
Walker folding wheeled w/o s |
66 |
59 |
$2K |
| B4034 |
Enter feed supkit syr by day |
37 |
27 |
$1K |
| E0431 |
Portable gaseous 02 |
127 |
103 |
$1K |
| A7031 |
Replacement facemask interfa |
28 |
26 |
$1K |
| A7038 |
Pos airway pressure filter |
451 |
384 |
$1K |
| K0195 |
Elevating whlchair leg rests |
168 |
148 |
$1K |
| A7034 |
Nasal application device |
14 |
13 |
$761.28 |
| E0630 |
Patient lift hydraulic |
31 |
26 |
$680.71 |
| B4088 |
Gastro/jejuno tube, low-pro |
15 |
13 |
$286.67 |
| A7003 |
Nebulizer administration set |
143 |
130 |
$259.36 |
| A7013 |
Disposable compressor filter |
106 |
95 |
$38.13 |