| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| B4161 |
Ef ped hydrolyzed/amino acid |
3,529 |
2,828 |
$2.59M |
| E1390 |
Oxygen concentrator |
43,938 |
40,384 |
$1.76M |
| B4160 |
Ef ped caloric dense>/=0.7kc |
7,215 |
5,823 |
$1.33M |
| B4035 |
Enteral feed supp pump per d |
9,883 |
8,695 |
$1.16M |
| E0466 |
Home vent non-invasive inter |
2,645 |
2,454 |
$1.05M |
| B4152 |
Ef calorie dense>/=1.5kcal |
7,851 |
6,534 |
$780K |
| B4154 |
Ef spec metabolic noninherit |
5,991 |
5,316 |
$565K |
| B4150 |
Ef complet w/intact nutrient |
6,168 |
5,338 |
$465K |
| B4153 |
Ef hydrolyzed/amino acids |
967 |
811 |
$417K |
| E0445 |
Oximeter non-invasive |
2,965 |
2,772 |
$379K |
| E0431 |
Portable gaseous 02 |
19,798 |
18,364 |
$308K |
| B9998 |
Enteral supp not otherwise c |
3,911 |
3,263 |
$225K |
| B9002 |
Enter nutr inf pump any type |
3,089 |
2,995 |
$168K |
| B4034 |
Enter feed supkit syr by day |
2,515 |
2,279 |
$154K |
| E0619 |
Apnea monitor w recorder |
863 |
788 |
$149K |
| E0601 |
Cont airway pressure device |
4,809 |
4,525 |
$146K |
| A7030 |
Cpap full face mask |
3,721 |
3,510 |
$128K |
| B4088 |
Gastro/jejuno tube, low-pro |
1,620 |
1,516 |
$113K |
| B4158 |
Ef ped complete intact nut |
948 |
654 |
$113K |
| A7031 |
Replacement facemask interfa |
4,737 |
4,472 |
$87K |
| B4149 |
Ef blenderized foods |
390 |
332 |
$84K |
| E0470 |
Rad w/o backup non-inv intfc |
1,283 |
1,230 |
$82K |
| B4155 |
Ef incomplete/modular |
1,703 |
1,541 |
$59K |
| A7034 |
Nasal application device |
2,998 |
2,826 |
$58K |
| E0562 |
Humidifier heated used w pap |
3,590 |
3,286 |
$54K |
| A7035 |
Pos airway press headgear |
4,364 |
4,112 |
$45K |
| A7033 |
Replacement nasal pillows |
2,195 |
2,056 |
$41K |
| A7037 |
Pos airway pressure tubing |
5,619 |
5,290 |
$40K |
| E1392 |
Portable oxygen concentrator |
3,839 |
3,531 |
$40K |
| E0570 |
Nebulizer with compression |
3,336 |
3,026 |
$38K |
| E0776 |
Iv pole |
1,773 |
1,687 |
$38K |
| E0465 |
Home vent invasive interface |
67 |
62 |
$37K |
| A7032 |
Replacement nasal cushion |
1,940 |
1,823 |
$36K |
| A7038 |
Pos airway pressure filter |
15,871 |
14,959 |
$33K |
| E0260 |
Hosp bed semi-electr w/ matt |
949 |
871 |
$32K |
| A7526 |
Tracheostomy tube collar |
1,138 |
904 |
$26K |
| K0001 |
Standard wheelchair |
1,209 |
1,117 |
$25K |
| A7000 |
Disposable canister for pump |
1,490 |
1,253 |
$16K |
| B4100 |
Food thickener oral |
212 |
196 |
$16K |
| A4624 |
Tracheal suction tube |
625 |
511 |
$15K |
| A4604 |
Tubing with heating element |
1,058 |
1,011 |
$14K |
| E0439 |
Stationary liquid 02 |
163 |
152 |
$11K |
| A4483 |
Moisture exchanger |
42 |
37 |
$8K |
| A7046 |
Repl water chamber, pap dev |
2,407 |
2,271 |
$6K |
| A7002 |
Tubing used w suction pump |
1,180 |
1,004 |
$6K |
| A6402 |
Sterile gauze <= 16 sq in |
761 |
596 |
$5K |
| A7039 |
Filter, non disposable w pap |
932 |
885 |
$4K |
| A7003 |
Nebulizer administration set |
3,319 |
2,840 |
$4K |
| E0443 |
Portable 02 contents, gas |
265 |
231 |
$3K |
| A4629 |
Tracheostomy care kit |
101 |
91 |
$2K |
| B4102 |
Ef adult fluids and electro |
113 |
101 |
$2K |
| A4623 |
Tracheostomy inner cannula |
28 |
24 |
$2K |
| A4628 |
Oropharyngeal suction cath |
287 |
234 |
$2K |
| E0600 |
Suction pump portab hom modl |
30 |
25 |
$2K |
| A7005 |
Nondisposable nebulizer set |
214 |
191 |
$1K |
| A4927 |
Non-sterile gloves |
121 |
99 |
$1K |
| A4217 |
Sterile water/saline, 500 ml |
29 |
25 |
$927.04 |
| A7520 |
Trach/laryn tube non-cuffed |
31 |
27 |
$853.06 |
| A7015 |
Aerosol mask used w nebulize |
432 |
370 |
$282.56 |
| E0143 |
Walker folding wheeled w/o s |
12 |
12 |
$254.70 |
| A7525 |
Tracheostomy mask |
144 |
107 |
$108.90 |
| A7007 |
Lg vol nebulizer disposable |
27 |
25 |
$83.76 |
| A7036 |
Pos airway press chinstrap |
13 |
12 |
$58.34 |
| A4450 |
Non-waterproof tape |
30 |
24 |
$13.31 |