| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| B4035 |
Enteral feed supp pump per d |
2,127 |
1,830 |
$507K |
| B4161 |
Ef ped hydrolyzed/amino acid |
631 |
506 |
$282K |
| B4088 |
Gastro/jejuno tube, low-pro |
1,429 |
1,222 |
$152K |
| B4160 |
Ef ped caloric dense>/=0.7kc |
807 |
683 |
$136K |
| E1390 |
Oxygen concentrator |
1,710 |
1,624 |
$130K |
| B4149 |
Ef blenderized foods |
440 |
328 |
$128K |
| B9002 |
Enter nutr inf pump any type |
1,017 |
870 |
$82K |
| E0601 |
Cont airway pressure device |
1,467 |
1,313 |
$54K |
| A4606 |
Oxygen probe used w oximeter |
152 |
92 |
$30K |
| E0562 |
Humidifier heated used w pap |
1,721 |
1,529 |
$22K |
| A4627 |
Spacer bag/reservoir |
1,165 |
1,047 |
$20K |
| E0431 |
Portable gaseous 02 |
1,286 |
1,221 |
$18K |
| E0570 |
Nebulizer with compression |
158 |
145 |
$15K |
| A4604 |
Tubing with heating element |
528 |
489 |
$13K |
| T4534 |
Youth size pull-on |
124 |
108 |
$12K |
| A7031 |
Replacement facemask interfa |
250 |
234 |
$12K |
| A4335 |
Incontinence supply |
646 |
578 |
$11K |
| A7030 |
Cpap full face mask |
142 |
130 |
$10K |
| E0445 |
Oximeter non-invasive |
57 |
48 |
$10K |
| E0776 |
Iv pole |
857 |
720 |
$9K |
| E0600 |
Suction pump portab hom modl |
241 |
212 |
$8K |
| A7035 |
Pos airway press headgear |
453 |
421 |
$7K |
| B9998 |
Enteral supp not otherwise c |
61 |
50 |
$6K |
| A7038 |
Pos airway pressure filter |
562 |
509 |
$5K |
| A7003 |
Nebulizer administration set |
697 |
619 |
$4K |
| K0001 |
Standard wheelchair |
253 |
223 |
$4K |
| E0471 |
Rad w/backup non inv intrfc |
13 |
12 |
$3K |
| B4036 |
Enteral feed sup kit grav by |
63 |
50 |
$3K |
| T4541 |
Large disposable underpad |
46 |
38 |
$2K |
| A4927 |
Non-sterile gloves |
146 |
117 |
$2K |
| A7000 |
Disposable canister for pump |
77 |
71 |
$2K |
| T4527 |
Adult size pull-on lg |
17 |
14 |
$1K |
| E0470 |
Rad w/o backup non-inv intfc |
14 |
12 |
$1K |
| A7002 |
Tubing used w suction pump |
122 |
109 |
$957.21 |
| A7015 |
Aerosol mask used w nebulize |
390 |
339 |
$697.43 |
| B4100 |
Food thickener oral |
16 |
12 |
$673.29 |
| E0114 |
Crutch underarm pair no wood |
22 |
14 |
$624.62 |
| A4216 |
Sterile water/saline, 10 ml |
87 |
29 |
$551.71 |
| T4542 |
Small disposable underpad |
20 |
17 |
$530.31 |
| A7034 |
Nasal application device |
12 |
12 |
$485.28 |
| A7046 |
Repl water chamber, pap dev |
62 |
60 |
$386.77 |
| S9445 |
Pt education noc individ |
14 |
13 |
$207.00 |