| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
34,920 |
32,543 |
$1.57M |
| B4160 |
Ef ped caloric dense>/=0.7kc |
3,119 |
2,267 |
$614K |
| E0466 |
Home vent non-invasive inter |
901 |
823 |
$348K |
| B4035 |
Enteral feed supp pump per d |
2,824 |
2,476 |
$264K |
| B4152 |
Ef calorie dense>/=1.5kcal |
2,517 |
2,092 |
$242K |
| B4161 |
Ef ped hydrolyzed/amino acid |
917 |
640 |
$232K |
| E0431 |
Portable gaseous 02 |
14,640 |
13,697 |
$194K |
| E0601 |
Cont airway pressure device |
5,146 |
4,838 |
$192K |
| B4150 |
Ef complet w/intact nutrient |
2,247 |
1,808 |
$156K |
| B4154 |
Ef spec metabolic noninherit |
1,416 |
1,164 |
$133K |
| A7030 |
Cpap full face mask |
2,072 |
1,894 |
$83K |
| E1392 |
Portable oxygen concentrator |
4,115 |
3,803 |
$69K |
| A7031 |
Replacement facemask interfa |
2,595 |
2,374 |
$65K |
| E0562 |
Humidifier heated used w pap |
2,428 |
2,257 |
$59K |
| A7034 |
Nasal application device |
2,190 |
1,961 |
$46K |
| E0570 |
Nebulizer with compression |
3,473 |
3,128 |
$38K |
| B4034 |
Enter feed supkit syr by day |
877 |
792 |
$37K |
| A7032 |
Replacement nasal cushion |
1,800 |
1,645 |
$34K |
| A7035 |
Pos airway press headgear |
2,797 |
2,540 |
$33K |
| B9998 |
Enteral supp not otherwise c |
457 |
388 |
$29K |
| A7037 |
Pos airway pressure tubing |
3,399 |
3,123 |
$28K |
| A7038 |
Pos airway pressure filter |
9,311 |
8,566 |
$23K |
| B9002 |
Enter nutr inf pump any type |
456 |
425 |
$19K |
| A7033 |
Replacement nasal pillows |
662 |
608 |
$13K |
| A4604 |
Tubing with heating element |
573 |
536 |
$12K |
| A7005 |
Nondisposable nebulizer set |
721 |
658 |
$6K |
| E0470 |
Rad w/o backup non-inv intfc |
81 |
75 |
$6K |
| A7046 |
Repl water chamber, pap dev |
1,304 |
1,171 |
$4K |
| E0260 |
Hosp bed semi-electr w/ matt |
130 |
95 |
$4K |
| B4158 |
Ef ped complete intact nut |
77 |
43 |
$3K |
| K0001 |
Standard wheelchair |
82 |
74 |
$2K |
| A7039 |
Filter, non disposable w pap |
348 |
321 |
$1K |
| E0776 |
Iv pole |
154 |
150 |
$577.66 |
| A7003 |
Nebulizer administration set |
437 |
373 |
$437.49 |
| B4103 |
Ef ped fluid and electrolyte |
12 |
12 |
$239.99 |