| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
35,792 |
31,038 |
$1.34M |
| E0466 |
Home vent non-invasive inter |
2,256 |
1,816 |
$592K |
| B4035 |
Enteral feed supp pump per d |
4,045 |
3,037 |
$541K |
| B4152 |
Ef calorie dense>/=1.5kcal |
3,668 |
3,021 |
$322K |
| B4160 |
Ef ped caloric dense>/=0.7kc |
3,035 |
1,651 |
$303K |
| B4149 |
Ef blenderized foods |
1,198 |
727 |
$297K |
| B4034 |
Enter feed supkit syr by day |
1,442 |
1,129 |
$248K |
| B4161 |
Ef ped hydrolyzed/amino acid |
504 |
323 |
$226K |
| E0601 |
Cont airway pressure device |
4,771 |
3,890 |
$146K |
| B4150 |
Ef complet w/intact nutrient |
1,397 |
1,182 |
$132K |
| A7031 |
Replacement facemask interfa |
4,837 |
4,399 |
$126K |
| E0431 |
Portable gaseous 02 |
14,345 |
12,160 |
$104K |
| A7030 |
Cpap full face mask |
1,787 |
1,562 |
$63K |
| B4154 |
Ef spec metabolic noninherit |
354 |
309 |
$57K |
| A7037 |
Pos airway pressure tubing |
4,962 |
4,572 |
$56K |
| B9998 |
Enteral supp not otherwise c |
2,923 |
1,685 |
$46K |
| E0562 |
Humidifier heated used w pap |
5,451 |
4,489 |
$43K |
| B9002 |
Enter nutr inf pump any type |
788 |
720 |
$41K |
| E0570 |
Nebulizer with compression |
3,461 |
2,751 |
$31K |
| E1392 |
Portable oxygen concentrator |
2,950 |
2,511 |
$27K |
| A7035 |
Pos airway press headgear |
2,062 |
1,857 |
$24K |
| A7034 |
Nasal application device |
669 |
606 |
$24K |
| A7038 |
Pos airway pressure filter |
7,103 |
6,472 |
$23K |
| A7032 |
Replacement nasal cushion |
761 |
709 |
$21K |
| K0003 |
Lightweight wheelchair |
659 |
571 |
$18K |
| A7046 |
Repl water chamber, pap dev |
1,440 |
1,296 |
$11K |
| E0260 |
Hosp bed semi-electr w/ matt |
391 |
312 |
$10K |
| B4088 |
Gastro/jejuno tube, low-pro |
204 |
145 |
$7K |
| A7033 |
Replacement nasal pillows |
371 |
364 |
$6K |
| E0776 |
Iv pole |
610 |
550 |
$5K |
| E0443 |
Portable 02 contents, gas |
667 |
600 |
$4K |
| B4153 |
Ef hydrolyzed/amino acids |
14 |
12 |
$4K |
| B4036 |
Enteral feed sup kit grav by |
25 |
24 |
$3K |
| A7005 |
Nondisposable nebulizer set |
310 |
271 |
$1K |
| K0195 |
Elevating whlchair leg rests |
217 |
188 |
$1K |
| A7003 |
Nebulizer administration set |
2,102 |
1,724 |
$1K |
| K0001 |
Standard wheelchair |
145 |
118 |
$1K |
| A7039 |
Filter, non disposable w pap |
209 |
190 |
$792.14 |
| A4604 |
Tubing with heating element |
17 |
15 |
$491.26 |
| Q0513 |
Disp fee inhal drugs/30 days |
105 |
89 |
$466.58 |
| J7620 |
Albuterol ipratrop non-comp |
12 |
12 |
$21.45 |