| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
58,752 |
45,771 |
$2.44M |
| B4161 |
Ef ped hydrolyzed/amino acid |
4,203 |
3,250 |
$2.18M |
| B4160 |
Ef ped caloric dense>/=0.7kc |
6,951 |
5,634 |
$1.27M |
| E0466 |
Home vent non-invasive inter |
3,542 |
2,494 |
$1.23M |
| B4035 |
Enteral feed supp pump per d |
5,564 |
4,139 |
$804K |
| A7030 |
Cpap full face mask |
12,890 |
10,019 |
$793K |
| A7031 |
Replacement facemask interfa |
22,648 |
18,632 |
$727K |
| E0601 |
Cont airway pressure device |
19,374 |
15,455 |
$706K |
| A4604 |
Tubing with heating element |
16,454 |
13,105 |
$433K |
| E0431 |
Portable gaseous 02 |
40,719 |
31,635 |
$360K |
| E0562 |
Humidifier heated used w pap |
23,244 |
18,814 |
$276K |
| A7034 |
Nasal application device |
6,096 |
4,944 |
$227K |
| E0470 |
Rad w/o backup non-inv intfc |
2,853 |
2,063 |
$203K |
| B4150 |
Ef complet w/intact nutrient |
2,148 |
1,564 |
$193K |
| E0570 |
Nebulizer with compression |
15,144 |
11,096 |
$191K |
| A7032 |
Replacement nasal cushion |
5,582 |
4,663 |
$186K |
| B4152 |
Ef calorie dense>/=1.5kcal |
1,748 |
1,274 |
$167K |
| B4034 |
Enter feed supkit syr by day |
2,797 |
1,934 |
$154K |
| A7035 |
Pos airway press headgear |
11,149 |
8,813 |
$143K |
| B9002 |
Enter nutr inf pump any type |
2,539 |
2,089 |
$136K |
| A7038 |
Pos airway pressure filter |
34,432 |
28,591 |
$136K |
| E0143 |
Walker folding wheeled w/o s |
4,169 |
3,368 |
$134K |
| A7033 |
Replacement nasal pillows |
4,660 |
4,028 |
$128K |
| E0114 |
Crutch underarm pair no wood |
2,515 |
2,284 |
$95K |
| E1130 |
Whlchr stand fxd arm ft rest |
2,285 |
1,976 |
$74K |
| E1392 |
Portable oxygen concentrator |
5,617 |
4,280 |
$71K |
| A7046 |
Repl water chamber, pap dev |
8,911 |
7,075 |
$67K |
| E0619 |
Apnea monitor w recorder |
395 |
340 |
$60K |
| E0445 |
Oximeter non-invasive |
424 |
396 |
$52K |
| B4149 |
Ef blenderized foods |
128 |
102 |
$44K |
| E0260 |
Hosp bed semi-electr w/ matt |
2,477 |
1,680 |
$39K |
| E0600 |
Suction pump portab hom modl |
1,482 |
1,166 |
$32K |
| A7037 |
Pos airway pressure tubing |
3,048 |
2,355 |
$31K |
| B4154 |
Ef spec metabolic noninherit |
222 |
156 |
$26K |
| B4088 |
Gastro/jejuno tube, low-pro |
1,399 |
1,149 |
$24K |
| E1150 |
Wheelchair standard w/ leg r |
290 |
249 |
$19K |
| E0776 |
Iv pole |
2,330 |
1,849 |
$17K |
| E0149 |
Heavy duty wheeled walker |
1,412 |
1,022 |
$17K |
| B4158 |
Ef ped complete intact nut |
83 |
65 |
$14K |
| B4155 |
Ef incomplete/modular |
250 |
206 |
$10K |
| E0156 |
Walker seat attachment |
859 |
676 |
$8K |
| A4623 |
Tracheostomy inner cannula |
37 |
26 |
$7K |
| A7003 |
Nebulizer administration set |
4,703 |
3,664 |
$5K |
| K0001 |
Standard wheelchair |
3,542 |
2,940 |
$4K |
| A7005 |
Nondisposable nebulizer set |
257 |
203 |
$3K |
| E1160 |
Wheelchair fixed arms |
53 |
38 |
$3K |
| B9998 |
Enteral supp not otherwise c |
316 |
261 |
$3K |
| E0443 |
Portable 02 contents, gas |
966 |
682 |
$3K |
| E0971 |
Wheelchair anti-tipping devi |
1,294 |
984 |
$2K |
| A4629 |
Tracheostomy care kit |
34 |
25 |
$2K |
| A7000 |
Disposable canister for pump |
98 |
78 |
$1K |
| A7015 |
Aerosol mask used w nebulize |
1,970 |
1,532 |
$1K |
| A7039 |
Filter, non disposable w pap |
310 |
234 |
$1K |
| E0990 |
Wheelchair elevating leg res |
214 |
156 |
$969.98 |
| E2601 |
Gen w/c cushion wdth < 22 in |
25 |
15 |
$620.27 |
| A7013 |
Disposable compressor filter |
1,659 |
1,244 |
$603.12 |
| E0565 |
Compressor air power source |
30 |
26 |
$547.23 |
| E0135 |
Walker folding adjust/fixed |
13 |
12 |
$437.02 |
| K0195 |
Elevating whlchair leg rests |
449 |
369 |
$279.99 |
| A7036 |
Pos airway press chinstrap |
28 |
25 |
$277.86 |
| A7002 |
Tubing used w suction pump |
13 |
12 |
$68.08 |
| A7525 |
Tracheostomy mask |
21 |
12 |
$2.37 |