| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| B4035 |
Enteral feed supp pump per d |
7,566 |
6,891 |
$1.05M |
| E1390 |
Oxygen concentrator |
19,813 |
19,625 |
$951K |
| B4160 |
Ef ped caloric dense>/=0.7kc |
5,202 |
4,887 |
$826K |
| B4161 |
Ef ped hydrolyzed/amino acid |
1,353 |
1,233 |
$524K |
| B4152 |
Ef calorie dense>/=1.5kcal |
2,730 |
2,497 |
$307K |
| B4150 |
Ef complet w/intact nutrient |
2,964 |
2,774 |
$287K |
| E0601 |
Cont airway pressure device |
6,624 |
6,555 |
$243K |
| B4153 |
Ef hydrolyzed/amino acids |
582 |
534 |
$199K |
| B9998 |
Enteral supp not otherwise c |
3,549 |
3,187 |
$173K |
| B4154 |
Ef spec metabolic noninherit |
847 |
780 |
$164K |
| E0431 |
Portable gaseous 02 |
11,614 |
11,531 |
$133K |
| B9002 |
Enter nutr inf pump any type |
2,074 |
2,039 |
$112K |
| A7030 |
Cpap full face mask |
2,659 |
2,617 |
$103K |
| B4088 |
Gastro/jejuno tube, low-pro |
1,163 |
1,155 |
$80K |
| E0470 |
Rad w/o backup non-inv intfc |
971 |
970 |
$72K |
| A7031 |
Replacement facemask interfa |
2,454 |
2,423 |
$60K |
| E0562 |
Humidifier heated used w pap |
6,623 |
6,552 |
$56K |
| B4034 |
Enter feed supkit syr by day |
1,096 |
1,005 |
$51K |
| B4087 |
Gastro/jejuno tube, std |
985 |
758 |
$50K |
| A7034 |
Nasal application device |
1,970 |
1,952 |
$47K |
| E0570 |
Nebulizer with compression |
6,837 |
6,785 |
$47K |
| B4036 |
Enteral feed sup kit grav by |
356 |
331 |
$38K |
| A7035 |
Pos airway press headgear |
3,175 |
3,138 |
$34K |
| A7038 |
Pos airway pressure filter |
7,006 |
6,882 |
$33K |
| A7037 |
Pos airway pressure tubing |
2,996 |
2,963 |
$30K |
| E1392 |
Portable oxygen concentrator |
3,677 |
3,628 |
$24K |
| A7032 |
Replacement nasal cushion |
893 |
878 |
$18K |
| Q0513 |
Disp fee inhal drugs/30 days |
1,993 |
1,825 |
$18K |
| E0466 |
Home vent non-invasive inter |
39 |
39 |
$18K |
| A4604 |
Tubing with heating element |
1,539 |
1,526 |
$16K |
| J7626 |
Budesonide non-comp unit |
447 |
419 |
$14K |
| A7046 |
Repl water chamber, pap dev |
3,167 |
3,149 |
$14K |
| B4155 |
Ef incomplete/modular |
388 |
365 |
$11K |
| E0776 |
Iv pole |
1,332 |
1,325 |
$11K |
| A7033 |
Replacement nasal pillows |
618 |
603 |
$11K |
| A7005 |
Nondisposable nebulizer set |
1,195 |
1,187 |
$7K |
| J7613 |
Albuterol non-comp unit |
1,321 |
1,202 |
$4K |
| J7606 |
Formoterol fumarate, inh |
14 |
12 |
$3K |
| A7003 |
Nebulizer administration set |
3,310 |
3,121 |
$3K |
| J7620 |
Albuterol ipratrop non-comp |
494 |
457 |
$2K |
| K0738 |
Portable gas oxygen system |
45 |
45 |
$1K |
| A7036 |
Pos airway press chinstrap |
137 |
137 |
$683.31 |
| K0001 |
Standard wheelchair |
12 |
12 |
$355.13 |
| E0443 |
Portable 02 contents, gas |
18 |
18 |
$317.35 |
| A7039 |
Filter, non disposable w pap |
186 |
182 |
$266.04 |
| A7013 |
Disposable compressor filter |
13 |
13 |
$2.60 |