| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| B4035 |
Enteral feed supp pump per d |
13,424 |
11,393 |
$2.15M |
| E1390 |
Oxygen concentrator |
41,056 |
37,734 |
$1.37M |
| B4161 |
Ef ped hydrolyzed/amino acid |
2,362 |
2,166 |
$1.19M |
| B4160 |
Ef ped caloric dense>/=0.7kc |
5,265 |
4,809 |
$880K |
| B9002 |
Enter nutr inf pump any type |
6,115 |
5,331 |
$617K |
| B4149 |
Ef blenderized foods |
1,631 |
1,362 |
$510K |
| E0431 |
Portable gaseous 02 |
14,204 |
13,101 |
$397K |
| B4152 |
Ef calorie dense>/=1.5kcal |
4,404 |
3,764 |
$393K |
| K0738 |
Portable gas oxygen system |
9,909 |
9,179 |
$340K |
| E0466 |
Home vent non-invasive inter |
1,938 |
1,771 |
$337K |
| B4150 |
Ef complet w/intact nutrient |
3,173 |
2,746 |
$309K |
| E0601 |
Cont airway pressure device |
10,736 |
9,730 |
$218K |
| B4034 |
Enter feed supkit syr by day |
3,682 |
2,848 |
$170K |
| A7030 |
Cpap full face mask |
3,501 |
3,333 |
$156K |
| B4088 |
Gastro/jejuno tube, low-pro |
2,510 |
2,235 |
$156K |
| E0562 |
Humidifier heated used w pap |
6,683 |
6,290 |
$120K |
| A7031 |
Replacement facemask interfa |
4,056 |
3,816 |
$96K |
| E0470 |
Rad w/o backup non-inv intfc |
1,710 |
1,499 |
$79K |
| A7034 |
Nasal application device |
2,513 |
2,371 |
$64K |
| B4153 |
Ef hydrolyzed/amino acids |
207 |
170 |
$63K |
| B4158 |
Ef ped complete intact nut |
126 |
120 |
$61K |
| E0260 |
Hosp bed semi-electr w/ matt |
2,440 |
2,265 |
$50K |
| E0471 |
Rad w/backup non inv intrfc |
496 |
458 |
$48K |
| A7035 |
Pos airway press headgear |
4,379 |
4,153 |
$44K |
| A7038 |
Pos airway pressure filter |
10,780 |
10,093 |
$43K |
| E0776 |
Iv pole |
3,384 |
3,260 |
$38K |
| E0570 |
Nebulizer with compression |
8,842 |
8,358 |
$36K |
| A7032 |
Replacement nasal cushion |
1,478 |
1,391 |
$32K |
| A7037 |
Pos airway pressure tubing |
2,603 |
2,502 |
$32K |
| A4604 |
Tubing with heating element |
3,527 |
3,284 |
$31K |
| B4036 |
Enteral feed sup kit grav by |
740 |
565 |
$28K |
| E0143 |
Walker folding wheeled w/o s |
1,040 |
963 |
$26K |
| B4154 |
Ef spec metabolic noninherit |
179 |
152 |
$24K |
| E0445 |
Oximeter non-invasive |
231 |
220 |
$24K |
| A7033 |
Replacement nasal pillows |
1,383 |
1,293 |
$23K |
| K0001 |
Standard wheelchair |
2,770 |
2,552 |
$21K |
| A7046 |
Repl water chamber, pap dev |
2,835 |
2,688 |
$17K |
| E1392 |
Portable oxygen concentrator |
1,885 |
1,777 |
$14K |
| E0600 |
Suction pump portab hom modl |
367 |
340 |
$14K |
| A4624 |
Tracheal suction tube |
97 |
66 |
$13K |
| T4522 |
Adult size brief/diaper med |
196 |
156 |
$13K |
| B4100 |
Food thickener oral |
95 |
91 |
$12K |
| E0630 |
Patient lift hydraulic |
832 |
793 |
$12K |
| E0465 |
Home vent invasive interface |
22 |
12 |
$11K |
| A7039 |
Filter, non disposable w pap |
2,251 |
2,162 |
$9K |
| K0003 |
Lightweight wheelchair |
1,013 |
888 |
$8K |
| K0195 |
Elevating whlchair leg rests |
1,628 |
1,454 |
$8K |
| A7526 |
Tracheostomy tube collar |
174 |
143 |
$6K |
| B9998 |
Enteral supp not otherwise c |
238 |
187 |
$6K |
| E0565 |
Compressor air power source |
296 |
255 |
$5K |
| E0149 |
Heavy duty wheeled walker |
397 |
387 |
$4K |
| Q0513 |
Disp fee inhal drugs/30 days |
319 |
263 |
$3K |
| A7507 |
Integrated filter & holder |
33 |
24 |
$2K |
| E0443 |
Portable 02 contents, gas |
195 |
191 |
$2K |
| A7005 |
Nondisposable nebulizer set |
515 |
498 |
$2K |
| A7003 |
Nebulizer administration set |
1,837 |
1,678 |
$2K |
| E0181 |
Press pad alternating w/ pum |
238 |
229 |
$2K |
| A7520 |
Trach/laryn tube non-cuffed |
32 |
25 |
$1K |
| A7000 |
Disposable canister for pump |
379 |
237 |
$1K |
| B4155 |
Ef incomplete/modular |
29 |
24 |
$901.35 |
| K0007 |
Extra heavy duty wheelchair |
42 |
39 |
$880.49 |
| A4606 |
Oxygen probe used w oximeter |
72 |
41 |
$741.84 |
| K0002 |
Stnd hemi (low seat) whlchr |
91 |
89 |
$636.76 |
| A7002 |
Tubing used w suction pump |
482 |
340 |
$554.32 |
| E0971 |
Wheelchair anti-tipping devi |
615 |
561 |
$520.03 |
| J7613 |
Albuterol non-comp unit |
181 |
152 |
$479.96 |
| J7620 |
Albuterol ipratrop non-comp |
127 |
105 |
$421.94 |
| Z0020 |
|
53 |
52 |
$201.60 |
| A4628 |
Oropharyngeal suction cath |
67 |
54 |
$139.81 |
| A7013 |
Disposable compressor filter |
391 |
371 |
$90.70 |
| E0621 |
Patient lift sling or seat |
99 |
97 |
$83.34 |
| E0156 |
Walker seat attachment |
14 |
12 |
$66.54 |
| E0310 |
Rails bed side full length |
137 |
132 |
$56.75 |
| E0305 |
Rails bed side half length |
154 |
150 |
$38.54 |
| A4213 |
20+ cc syringe only |
47 |
12 |
$22.96 |