| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| B4035 |
Enteral feed supp pump per d |
1,932 |
1,575 |
$212K |
| B4160 |
Ef ped caloric dense>/=0.7kc |
1,009 |
792 |
$173K |
| A4606 |
Oxygen probe used w oximeter |
1,675 |
1,357 |
$121K |
| B9998 |
Enteral supp not otherwise c |
3,673 |
2,099 |
$120K |
| E1390 |
Oxygen concentrator |
2,462 |
2,105 |
$97K |
| A4217 |
Sterile water/saline, 500 ml |
1,297 |
929 |
$88K |
| A7526 |
Tracheostomy tube collar |
917 |
735 |
$50K |
| A7520 |
Trach/laryn tube non-cuffed |
619 |
472 |
$49K |
| E1399 |
Durable medical equipment mi |
4,786 |
1,788 |
$42K |
| S8189 |
Trach supply noc |
908 |
465 |
$41K |
| E0445 |
Oximeter non-invasive |
410 |
387 |
$35K |
| E0431 |
Portable gaseous 02 |
2,718 |
2,319 |
$27K |
| A6402 |
Sterile gauze <= 16 sq in |
1,964 |
1,637 |
$27K |
| A7000 |
Disposable canister for pump |
1,585 |
1,268 |
$21K |
| B4161 |
Ef ped hydrolyzed/amino acid |
45 |
38 |
$19K |
| A4452 |
Waterproof tape |
1,012 |
831 |
$16K |
| A4628 |
Oropharyngeal suction cath |
946 |
787 |
$15K |
| A7002 |
Tubing used w suction pump |
1,439 |
1,125 |
$15K |
| A4927 |
Non-sterile gloves |
1,106 |
941 |
$13K |
| A4216 |
Sterile water/saline, 10 ml |
411 |
337 |
$12K |
| B9002 |
Enter nutr inf pump any type |
226 |
207 |
$12K |
| A4618 |
Breathing circuits |
489 |
360 |
$9K |
| A4213 |
20+ cc syringe only |
1,467 |
1,264 |
$8K |
| A7507 |
Integrated filter & holder |
79 |
61 |
$7K |
| B4082 |
Enteral ng tubing w/o stylet |
146 |
107 |
$5K |
| A4624 |
Tracheal suction tube |
35 |
25 |
$4K |
| A4210 |
Nonneedle injection device |
928 |
754 |
$4K |
| E0443 |
Portable 02 contents, gas |
165 |
114 |
$3K |
| B4088 |
Gastro/jejuno tube, low-pro |
124 |
122 |
$3K |
| E0600 |
Suction pump portab hom modl |
61 |
51 |
$2K |
| E0776 |
Iv pole |
179 |
165 |
$2K |
| B4034 |
Enter feed supkit syr by day |
50 |
37 |
$2K |
| A7046 |
Repl water chamber, pap dev |
117 |
94 |
$2K |
| E1405 |
O2/water vapor enrich w/heat |
13 |
12 |
$372.00 |
| A7004 |
Disposable nebulizer sml vol |
152 |
100 |
$339.71 |
| A7003 |
Nebulizer administration set |
99 |
75 |
$299.31 |
| A4402 |
Lubricant per ounce |
32 |
29 |
$208.93 |
| A4245 |
Alcohol wipes per box |
63 |
49 |
$159.68 |
| A4450 |
Non-waterproof tape |
95 |
78 |
$93.05 |
| A4616 |
Tubing (oxygen) per foot |
47 |
37 |
$55.93 |
| A7525 |
Tracheostomy mask |
13 |
12 |
$42.73 |