| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| B4035 |
Enteral feed supp pump per d |
165 |
103 |
$17K |
| E1390 |
Oxygen concentrator |
179 |
160 |
$11K |
| B9998 |
Enteral supp not otherwise c |
182 |
89 |
$7K |
| A7000 |
Disposable canister for pump |
260 |
241 |
$5K |
| A4606 |
Oxygen probe used w oximeter |
55 |
36 |
$5K |
| B9002 |
Enter nutr inf pump any type |
43 |
26 |
$3K |
| A7002 |
Tubing used w suction pump |
302 |
285 |
$2K |
| E0431 |
Portable gaseous 02 |
79 |
61 |
$901.23 |
| A4628 |
Oropharyngeal suction cath |
325 |
302 |
$614.14 |
| A4322 |
Irrigation syringe |
96 |
69 |
$525.30 |
| A4554 |
Disposable underpads |
35 |
25 |
$502.43 |
| A7526 |
Tracheostomy tube collar |
28 |
26 |
$502.20 |
| A4629 |
Tracheostomy care kit |
13 |
12 |
$390.60 |
| A6402 |
Sterile gauze <= 16 sq in |
98 |
67 |
$345.20 |
| A4216 |
Sterile water/saline, 10 ml |
26 |
24 |
$180.00 |
| T1999 |
Noc retail items andsupplies |
99 |
34 |
$143.16 |
| A4335 |
Incontinence supply |
38 |
27 |
$89.46 |