| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| S9500 |
Hit antibiotic q24h diem |
934 |
259 |
$98K |
| S9338 |
Hit immunotherapy diem |
730 |
248 |
$21K |
| E1390 |
Oxygen concentrator |
4,479 |
4,472 |
$20K |
| B4035 |
Enteral feed supp pump per d |
563 |
352 |
$16K |
| A4213 |
20+ cc syringe only |
376 |
271 |
$9K |
| S9351 |
Hit cont antiemetic diem |
52 |
14 |
$6K |
| E0431 |
Portable gaseous 02 |
2,695 |
2,688 |
$3K |
| B4034 |
Enter feed supkit syr by day |
299 |
187 |
$3K |
| S9373 |
Hit hydra total diem |
28 |
13 |
$3K |
| B4152 |
Ef calorie dense>/=1.5kcal |
180 |
153 |
$1K |
| A7030 |
Cpap full face mask |
81 |
80 |
$997.09 |
| A7031 |
Replacement facemask interfa |
97 |
97 |
$559.40 |
| E0570 |
Nebulizer with compression |
334 |
334 |
$347.54 |
| E0601 |
Cont airway pressure device |
45 |
45 |
$288.84 |
| A4604 |
Tubing with heating element |
29 |
29 |
$154.62 |
| A7038 |
Pos airway pressure filter |
307 |
305 |
$135.94 |
| B9998 |
Enteral supp not otherwise c |
80 |
48 |
$60.00 |
| A7037 |
Pos airway pressure tubing |
54 |
54 |
$55.50 |
| E0143 |
Walker folding wheeled w/o s |
26 |
26 |
$47.57 |
| E1392 |
Portable oxygen concentrator |
196 |
196 |
$39.40 |
| K0001 |
Standard wheelchair |
14 |
14 |
$23.03 |
| E0562 |
Humidifier heated used w pap |
12 |
12 |
$18.04 |
| A7035 |
Pos airway press headgear |
25 |
25 |
$16.50 |
| E0156 |
Walker seat attachment |
12 |
12 |
$0.00 |
| A7003 |
Nebulizer administration set |
15 |
13 |
$0.00 |
| A7046 |
Repl water chamber, pap dev |
12 |
12 |
$0.00 |