| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| B4035 |
Enteral feed supp pump per d |
32,626 |
19,540 |
$4.97M |
| B4161 |
Ef ped hydrolyzed/amino acid |
11,681 |
9,456 |
$4.62M |
| B4160 |
Ef ped caloric dense>/=0.7kc |
18,492 |
14,638 |
$1.88M |
| B4149 |
Ef blenderized foods |
6,950 |
5,249 |
$1.85M |
| E1390 |
Oxygen concentrator |
20,396 |
14,757 |
$1.25M |
| S9494 |
Hit antibiotic total diem |
5,310 |
1,396 |
$1.13M |
| B4034 |
Enter feed supkit syr by day |
13,586 |
8,506 |
$1.02M |
| E0601 |
Cont airway pressure device |
22,988 |
16,408 |
$956K |
| B4153 |
Ef hydrolyzed/amino acids |
2,158 |
1,623 |
$883K |
| B4185 |
Pn soln nos 10 grams lipids |
5,500 |
1,183 |
$846K |
| B4155 |
Ef incomplete/modular |
6,894 |
5,850 |
$770K |
| T1030 |
Rn home care per diem |
4,386 |
1,393 |
$737K |
| B4088 |
Gastro/jejuno tube, low-pro |
6,111 |
5,623 |
$702K |
| B4224 |
Parenteral administration ki |
6,157 |
1,281 |
$644K |
| B4152 |
Ef calorie dense>/=1.5kcal |
6,146 |
4,226 |
$629K |
| B9002 |
Enter nutr inf pump any type |
686 |
634 |
$549K |
| A9999 |
Dme supply or accessory, nos |
4,643 |
2,731 |
$540K |
| A7030 |
Cpap full face mask |
7,709 |
5,322 |
$472K |
| B4189 |
Parenteral sol amino acid & |
602 |
131 |
$471K |
| B9998 |
Enteral supp not otherwise c |
25,662 |
18,971 |
$403K |
| E0562 |
Humidifier heated used w pap |
14,973 |
9,499 |
$325K |
| B4150 |
Ef complet w/intact nutrient |
2,777 |
2,161 |
$295K |
| B4100 |
Food thickener oral |
2,687 |
2,340 |
$288K |
| B4036 |
Enteral feed sup kit grav by |
2,709 |
1,878 |
$286K |
| B4103 |
Ef ped fluid and electrolyte |
3,562 |
2,800 |
$271K |
| A7034 |
Nasal application device |
7,362 |
5,036 |
$271K |
| E0570 |
Nebulizer with compression |
4,745 |
3,377 |
$262K |
| E0470 |
Rad w/o backup non-inv intfc |
3,154 |
2,105 |
$230K |
| B4154 |
Ef spec metabolic noninherit |
1,034 |
706 |
$216K |
| B4220 |
Parenteral supply kit premix |
6,145 |
1,280 |
$206K |
| A7035 |
Pos airway press headgear |
10,948 |
7,724 |
$146K |
| B4158 |
Ef ped complete intact nut |
1,760 |
1,358 |
$142K |
| A7031 |
Replacement facemask interfa |
6,603 |
4,498 |
$133K |
| A7037 |
Pos airway pressure tubing |
6,820 |
5,078 |
$132K |
| E1392 |
Portable oxygen concentrator |
5,769 |
4,205 |
$105K |
| K0738 |
Portable gas oxygen system |
5,627 |
4,131 |
$104K |
| A4627 |
Spacer bag/reservoir |
2,088 |
1,861 |
$71K |
| A4604 |
Tubing with heating element |
7,840 |
5,076 |
$63K |
| A7032 |
Replacement nasal cushion |
3,234 |
2,179 |
$44K |
| A4670 |
Automatic bp monitor, dial |
1,139 |
585 |
$36K |
| A7038 |
Pos airway pressure filter |
15,506 |
10,702 |
$36K |
| E0431 |
Portable gaseous 02 |
3,597 |
2,682 |
$36K |
| E0776 |
Iv pole |
378 |
354 |
$33K |
| A7033 |
Replacement nasal pillows |
2,899 |
1,968 |
$30K |
| B9004 |
Parenteral infus pump portab |
287 |
79 |
$24K |
| A7046 |
Repl water chamber, pap dev |
4,224 |
2,737 |
$10K |
| A7036 |
Pos airway press chinstrap |
780 |
550 |
$5K |
| A7039 |
Filter, non disposable w pap |
18 |
13 |
$69.77 |