| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
15,910 |
12,696 |
$587K |
| B4035 |
Enteral feed supp pump per d |
4,413 |
3,289 |
$498K |
| B4161 |
Ef ped hydrolyzed/amino acid |
674 |
487 |
$266K |
| B4149 |
Ef blenderized foods |
1,419 |
1,046 |
$253K |
| B4160 |
Ef ped caloric dense>/=0.7kc |
1,181 |
971 |
$171K |
| E0466 |
Home vent non-invasive inter |
1,027 |
782 |
$141K |
| B9002 |
Enter nutr inf pump any type |
1,471 |
1,223 |
$111K |
| E0431 |
Portable gaseous 02 |
8,689 |
7,191 |
$100K |
| B4152 |
Ef calorie dense>/=1.5kcal |
1,444 |
1,117 |
$93K |
| B4153 |
Ef hydrolyzed/amino acids |
447 |
316 |
$90K |
| B4034 |
Enter feed supkit syr by day |
1,330 |
1,055 |
$76K |
| B4150 |
Ef complet w/intact nutrient |
911 |
735 |
$52K |
| B9998 |
Enteral supp not otherwise c |
1,782 |
1,127 |
$51K |
| E0601 |
Cont airway pressure device |
1,462 |
1,312 |
$47K |
| E1392 |
Portable oxygen concentrator |
6,822 |
5,250 |
$29K |
| A7031 |
Replacement facemask interfa |
1,493 |
1,327 |
$25K |
| A7030 |
Cpap full face mask |
764 |
649 |
$24K |
| B4155 |
Ef incomplete/modular |
363 |
265 |
$20K |
| E0570 |
Nebulizer with compression |
3,079 |
2,451 |
$17K |
| E0562 |
Humidifier heated used w pap |
1,838 |
1,679 |
$15K |
| A4604 |
Tubing with heating element |
939 |
817 |
$14K |
| E0776 |
Iv pole |
1,347 |
1,090 |
$9K |
| B4088 |
Gastro/jejuno tube, low-pro |
742 |
591 |
$9K |
| A7035 |
Pos airway press headgear |
792 |
658 |
$5K |
| A7038 |
Pos airway pressure filter |
2,582 |
2,249 |
$5K |
| A7034 |
Nasal application device |
235 |
181 |
$3K |
| A7032 |
Replacement nasal cushion |
91 |
75 |
$2K |
| A7046 |
Repl water chamber, pap dev |
423 |
345 |
$1K |
| A7003 |
Nebulizer administration set |
1,003 |
888 |
$624.95 |
| A7037 |
Pos airway pressure tubing |
142 |
120 |
$494.72 |
| A7005 |
Nondisposable nebulizer set |
133 |
123 |
$368.54 |
| A7033 |
Replacement nasal pillows |
12 |
12 |
$115.71 |
| E0443 |
Portable 02 contents, gas |
61 |
52 |
$45.34 |
| A7013 |
Disposable compressor filter |
72 |
61 |
$34.49 |