| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
2,341 |
2,163 |
$136K |
| B4160 |
Ef ped caloric dense>/=0.7kc |
328 |
261 |
$109K |
| B4150 |
Ef complet w/intact nutrient |
991 |
829 |
$75K |
| B4035 |
Enteral feed supp pump per d |
965 |
776 |
$74K |
| B4152 |
Ef calorie dense>/=1.5kcal |
764 |
648 |
$48K |
| E0441 |
Stationary o2 contents, gas |
793 |
643 |
$26K |
| E0439 |
Stationary liquid 02 |
395 |
374 |
$25K |
| B4149 |
Ef blenderized foods |
73 |
63 |
$18K |
| E0431 |
Portable gaseous 02 |
1,218 |
1,116 |
$16K |
| B4034 |
Enter feed supkit syr by day |
231 |
199 |
$8K |
| E0442 |
Stationary o2 contents, liq |
329 |
222 |
$7K |
| A7037 |
Pos airway pressure tubing |
285 |
269 |
$5K |
| B4154 |
Ef spec metabolic noninherit |
31 |
25 |
$5K |
| E0434 |
Portable liquid 02 |
290 |
263 |
$5K |
| A7046 |
Repl water chamber, pap dev |
170 |
120 |
$3K |
| B4036 |
Enteral feed sup kit grav by |
31 |
29 |
$3K |
| E0601 |
Cont airway pressure device |
42 |
42 |
$1K |
| A7038 |
Pos airway pressure filter |
317 |
293 |
$838.99 |
| A7030 |
Cpap full face mask |
14 |
12 |
$565.27 |
| A7035 |
Pos airway press headgear |
28 |
24 |
$447.19 |
| B9002 |
Enter nutr inf pump any type |
28 |
27 |
$402.93 |
| E0776 |
Iv pole |
247 |
246 |
$384.12 |
| A7031 |
Replacement facemask interfa |
14 |
12 |
$343.74 |