| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| B4035 |
Enteral feed supp pump per d |
3,112 |
2,584 |
$726K |
| B9998 |
Enteral supp not otherwise c |
4,040 |
2,783 |
$465K |
| E1390 |
Oxygen concentrator |
8,937 |
7,778 |
$404K |
| B4161 |
Ef ped hydrolyzed/amino acid |
457 |
280 |
$265K |
| A9999 |
Dme supply or accessory, nos |
3,966 |
2,914 |
$200K |
| E0445 |
Oximeter non-invasive |
1,695 |
873 |
$167K |
| B4160 |
Ef ped caloric dense>/=0.7kc |
561 |
404 |
$139K |
| E0601 |
Cont airway pressure device |
3,812 |
3,384 |
$134K |
| E0570 |
Nebulizer with compression |
1,308 |
1,259 |
$125K |
| A4628 |
Oropharyngeal suction cath |
1,892 |
1,665 |
$118K |
| A4606 |
Oxygen probe used w oximeter |
7,870 |
1,964 |
$107K |
| B9002 |
Enter nutr inf pump any type |
609 |
521 |
$88K |
| K0738 |
Portable gas oxygen system |
3,093 |
2,679 |
$74K |
| A7031 |
Replacement facemask interfa |
3,072 |
2,667 |
$74K |
| A4624 |
Tracheal suction tube |
401 |
333 |
$57K |
| E0260 |
Hosp bed semi-electr w/ matt |
1,110 |
886 |
$52K |
| E0431 |
Portable gaseous 02 |
4,636 |
4,046 |
$51K |
| K0823 |
Pwc gp 2 std cap chair |
634 |
575 |
$50K |
| E0562 |
Humidifier heated used w pap |
1,312 |
1,151 |
$48K |
| A7526 |
Tracheostomy tube collar |
759 |
638 |
$46K |
| A7030 |
Cpap full face mask |
1,080 |
914 |
$46K |
| A7037 |
Pos airway pressure tubing |
4,281 |
3,905 |
$37K |
| A7034 |
Nasal application device |
923 |
797 |
$31K |
| A7000 |
Disposable canister for pump |
2,396 |
2,126 |
$31K |
| A7508 |
Housing & integrated adhesiv |
152 |
136 |
$20K |
| A4629 |
Tracheostomy care kit |
195 |
172 |
$19K |
| A7035 |
Pos airway press headgear |
1,656 |
1,433 |
$18K |
| K0001 |
Standard wheelchair |
1,397 |
1,167 |
$18K |
| A7038 |
Pos airway pressure filter |
4,904 |
4,222 |
$14K |
| A7005 |
Nondisposable nebulizer set |
1,291 |
1,202 |
$13K |
| A7002 |
Tubing used w suction pump |
2,409 |
2,138 |
$12K |
| A6402 |
Sterile gauze <= 16 sq in |
865 |
751 |
$11K |
| A7033 |
Replacement nasal pillows |
641 |
573 |
$9K |
| B4149 |
Ef blenderized foods |
40 |
26 |
$8K |
| E1399 |
Durable medical equipment mi |
16 |
12 |
$8K |
| B4034 |
Enter feed supkit syr by day |
55 |
49 |
$7K |
| A4452 |
Waterproof tape |
874 |
749 |
$6K |
| A7032 |
Replacement nasal cushion |
164 |
145 |
$5K |
| A4213 |
20+ cc syringe only |
843 |
745 |
$4K |
| K0195 |
Elevating whlchair leg rests |
314 |
276 |
$3K |
| A7039 |
Filter, non disposable w pap |
590 |
521 |
$2K |
| E0776 |
Iv pole |
124 |
104 |
$2K |
| A7015 |
Aerosol mask used w nebulize |
1,495 |
1,433 |
$2K |
| K0739 |
Repair/svc dme non-oxygen eq |
27 |
25 |
$1K |
| A7013 |
Disposable compressor filter |
1,137 |
1,095 |
$1K |
| A7046 |
Repl water chamber, pap dev |
122 |
102 |
$811.64 |
| L3908 |
Who cock-up nonmolde pre ots |
13 |
12 |
$540.56 |
| A4604 |
Tubing with heating element |
15 |
13 |
$321.42 |
| A7525 |
Tracheostomy mask |
137 |
124 |
$179.36 |
| A7012 |
Nebulizer water collec devic |
43 |
36 |
$170.85 |
| A7003 |
Nebulizer administration set |
75 |
71 |
$124.03 |
| A7007 |
Lg vol nebulizer disposable |
15 |
12 |
$55.04 |