| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
27,416 |
25,623 |
$1.01M |
| B4152 |
Ef calorie dense>/=1.5kcal |
7,211 |
5,887 |
$613K |
| B4150 |
Ef complet w/intact nutrient |
6,573 |
5,731 |
$472K |
| B4154 |
Ef spec metabolic noninherit |
5,612 |
5,036 |
$458K |
| B4035 |
Enteral feed supp pump per d |
4,773 |
4,181 |
$426K |
| B4160 |
Ef ped caloric dense>/=0.7kc |
1,785 |
1,429 |
$345K |
| B4034 |
Enter feed supkit syr by day |
3,146 |
2,745 |
$276K |
| E0431 |
Portable gaseous 02 |
14,130 |
13,458 |
$225K |
| E0601 |
Cont airway pressure device |
2,099 |
1,991 |
$79K |
| B9998 |
Enteral supp not otherwise c |
923 |
756 |
$49K |
| B9002 |
Enter nutr inf pump any type |
1,327 |
1,271 |
$47K |
| B4153 |
Ef hydrolyzed/amino acids |
189 |
149 |
$46K |
| E0470 |
Rad w/o backup non-inv intfc |
456 |
437 |
$35K |
| B4161 |
Ef ped hydrolyzed/amino acid |
43 |
36 |
$29K |
| A7030 |
Cpap full face mask |
844 |
797 |
$28K |
| A7034 |
Nasal application device |
1,076 |
1,021 |
$27K |
| A7031 |
Replacement facemask interfa |
1,233 |
1,153 |
$21K |
| E0570 |
Nebulizer with compression |
2,110 |
1,881 |
$19K |
| A7035 |
Pos airway press headgear |
1,529 |
1,457 |
$19K |
| A7033 |
Replacement nasal pillows |
950 |
915 |
$17K |
| E1392 |
Portable oxygen concentrator |
1,193 |
1,088 |
$14K |
| A7038 |
Pos airway pressure filter |
6,574 |
6,266 |
$14K |
| B4155 |
Ef incomplete/modular |
634 |
583 |
$12K |
| E0776 |
Iv pole |
1,822 |
1,736 |
$12K |
| A4604 |
Tubing with heating element |
1,023 |
981 |
$11K |
| A7037 |
Pos airway pressure tubing |
914 |
861 |
$11K |
| B4088 |
Gastro/jejuno tube, low-pro |
238 |
222 |
$10K |
| E0562 |
Humidifier heated used w pap |
295 |
265 |
$9K |
| A7032 |
Replacement nasal cushion |
431 |
405 |
$7K |
| A7005 |
Nondisposable nebulizer set |
380 |
349 |
$2K |
| A7046 |
Repl water chamber, pap dev |
409 |
390 |
$1K |
| E0260 |
Hosp bed semi-electr w/ matt |
43 |
38 |
$998.41 |
| A7003 |
Nebulizer administration set |
987 |
889 |
$932.46 |
| A7039 |
Filter, non disposable w pap |
34 |
33 |
$229.34 |