| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| B4160 |
Ef ped caloric dense>/=0.7kc |
26,691 |
21,816 |
$2.29M |
| B4161 |
Ef ped hydrolyzed/amino acid |
3,771 |
2,688 |
$1.39M |
| B4035 |
Enteral feed supp pump per d |
9,990 |
5,290 |
$1.13M |
| E1390 |
Oxygen concentrator |
31,737 |
18,465 |
$1.12M |
| E0466 |
Home vent non-invasive inter |
3,018 |
1,573 |
$757K |
| B4152 |
Ef calorie dense>/=1.5kcal |
5,679 |
4,237 |
$609K |
| B4150 |
Ef complet w/intact nutrient |
4,211 |
3,382 |
$411K |
| B4103 |
Ef ped fluid and electrolyte |
3,333 |
2,694 |
$241K |
| E0601 |
Cont airway pressure device |
7,185 |
4,387 |
$166K |
| A7030 |
Cpap full face mask |
3,361 |
2,117 |
$144K |
| B4154 |
Ef spec metabolic noninherit |
565 |
422 |
$108K |
| B4088 |
Gastro/jejuno tube, low-pro |
1,314 |
959 |
$95K |
| A7031 |
Replacement facemask interfa |
4,215 |
2,698 |
$93K |
| E0431 |
Portable gaseous 02 |
14,691 |
8,673 |
$91K |
| B9002 |
Enter nutr inf pump any type |
1,044 |
703 |
$74K |
| E0562 |
Humidifier heated used w pap |
8,429 |
5,204 |
$57K |
| E1392 |
Portable oxygen concentrator |
5,701 |
3,276 |
$51K |
| A7037 |
Pos airway pressure tubing |
4,366 |
2,853 |
$36K |
| A7034 |
Nasal application device |
1,432 |
933 |
$34K |
| A7035 |
Pos airway press headgear |
3,234 |
2,160 |
$31K |
| B4034 |
Enter feed supkit syr by day |
434 |
284 |
$25K |
| B4036 |
Enteral feed sup kit grav by |
472 |
269 |
$25K |
| B4155 |
Ef incomplete/modular |
109 |
94 |
$24K |
| A7038 |
Pos airway pressure filter |
8,191 |
5,631 |
$24K |
| E0570 |
Nebulizer with compression |
4,277 |
2,801 |
$16K |
| E0776 |
Iv pole |
1,723 |
1,291 |
$14K |
| B4153 |
Ef hydrolyzed/amino acids |
55 |
36 |
$13K |
| B9998 |
Enteral supp not otherwise c |
308 |
138 |
$10K |
| A7033 |
Replacement nasal pillows |
548 |
349 |
$9K |
| A7032 |
Replacement nasal cushion |
256 |
185 |
$6K |
| A4604 |
Tubing with heating element |
327 |
213 |
$5K |
| A7046 |
Repl water chamber, pap dev |
1,385 |
857 |
$3K |
| B4158 |
Ef ped complete intact nut |
16 |
12 |
$2K |
| A7003 |
Nebulizer administration set |
949 |
627 |
$363.35 |
| A7005 |
Nondisposable nebulizer set |
60 |
40 |
$334.46 |