| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| B4161 |
Ef ped hydrolyzed/amino acid |
18,835 |
11,898 |
$7.03M |
| B4035 |
Enteral feed supp pump per d |
27,758 |
22,017 |
$5.20M |
| E0465 |
Home vent invasive interface |
2,389 |
2,118 |
$1.71M |
| B4160 |
Ef ped caloric dense>/=0.7kc |
8,392 |
5,611 |
$1.13M |
| B4149 |
Ef blenderized foods |
4,933 |
2,799 |
$903K |
| E1390 |
Oxygen concentrator |
13,618 |
12,273 |
$891K |
| E0618 |
Apnea monitor |
2,122 |
1,965 |
$411K |
| B9002 |
Enter nutr inf pump any type |
5,291 |
4,881 |
$363K |
| E0445 |
Oximeter non-invasive |
4,121 |
3,588 |
$271K |
| B4034 |
Enter feed supkit syr by day |
2,445 |
2,000 |
$243K |
| E0431 |
Portable gaseous 02 |
13,770 |
12,391 |
$212K |
| B4153 |
Ef hydrolyzed/amino acids |
477 |
296 |
$156K |
| A7526 |
Tracheostomy tube collar |
3,487 |
2,791 |
$152K |
| B4088 |
Gastro/jejuno tube, low-pro |
5,959 |
5,288 |
$152K |
| A4624 |
Tracheal suction tube |
2,206 |
1,800 |
$146K |
| A4629 |
Tracheostomy care kit |
2,117 |
1,690 |
$138K |
| E0570 |
Nebulizer with compression |
1,563 |
1,437 |
$124K |
| B4155 |
Ef incomplete/modular |
4,671 |
3,191 |
$117K |
| B4150 |
Ef complet w/intact nutrient |
891 |
516 |
$91K |
| A4605 |
Trach suction cath close sys |
822 |
659 |
$85K |
| E0601 |
Cont airway pressure device |
2,310 |
2,115 |
$70K |
| E1150 |
Wheelchair standard w/ leg r |
1,039 |
952 |
$62K |
| B4158 |
Ef ped complete intact nut |
547 |
305 |
$61K |
| A7000 |
Disposable canister for pump |
6,495 |
5,592 |
$56K |
| E0619 |
Apnea monitor w recorder |
257 |
250 |
$52K |
| E0600 |
Suction pump portab hom modl |
1,202 |
1,116 |
$45K |
| A7031 |
Replacement facemask interfa |
1,671 |
1,393 |
$42K |
| A7030 |
Cpap full face mask |
617 |
499 |
$38K |
| A4628 |
Oropharyngeal suction cath |
6,592 |
5,487 |
$33K |
| E0776 |
Iv pole |
2,584 |
2,388 |
$27K |
| E0562 |
Humidifier heated used w pap |
2,744 |
2,517 |
$26K |
| A7520 |
Trach/laryn tube non-cuffed |
1,469 |
1,162 |
$26K |
| A7002 |
Tubing used w suction pump |
6,005 |
5,131 |
$25K |
| A4604 |
Tubing with heating element |
943 |
748 |
$24K |
| A4216 |
Sterile water/saline, 10 ml |
1,568 |
1,096 |
$24K |
| A7521 |
Trach/laryn tube cuffed |
1,141 |
858 |
$22K |
| A7005 |
Nondisposable nebulizer set |
2,237 |
2,008 |
$21K |
| A4481 |
Tracheostoma filter |
2,553 |
2,075 |
$20K |
| A4217 |
Sterile water/saline, 500 ml |
280 |
242 |
$15K |
| A4927 |
Non-sterile gloves |
1,834 |
1,456 |
$14K |
| S8189 |
Trach supply noc |
1,110 |
528 |
$10K |
| A7038 |
Pos airway pressure filter |
3,164 |
2,581 |
$9K |
| A6402 |
Sterile gauze <= 16 sq in |
2,339 |
1,814 |
$9K |
| A7046 |
Repl water chamber, pap dev |
1,085 |
855 |
$6K |
| A7035 |
Pos airway press headgear |
412 |
321 |
$5K |
| A4402 |
Lubricant per ounce |
2,342 |
1,917 |
$5K |
| A4606 |
Oxygen probe used w oximeter |
1,521 |
1,085 |
$4K |
| A7013 |
Disposable compressor filter |
4,917 |
4,161 |
$3K |
| A4657 |
Syringe w/wo needle |
1,859 |
1,534 |
$2K |
| A4483 |
Moisture exchanger |
241 |
130 |
$2K |
| A7015 |
Aerosol mask used w nebulize |
1,436 |
1,330 |
$2K |
| A7003 |
Nebulizer administration set |
766 |
573 |
$1K |
| A7032 |
Replacement nasal cushion |
15 |
14 |
$488.28 |
| A9900 |
Supply/accessory/service |
731 |
399 |
$356.59 |
| A7012 |
Nebulizer water collec devic |
138 |
129 |
$353.43 |
| A4557 |
Lead wires, pair |
47 |
42 |
$269.15 |
| A6257 |
Transparent film <= 16 sq in |
15 |
14 |
$157.16 |
| A4615 |
Cannula nasal |
409 |
340 |
$23.77 |
| A4616 |
Tubing (oxygen) per foot |
783 |
581 |
$19.98 |
| E1353 |
Oxygen supplies regulator |
132 |
126 |
$3.88 |
| A9270 |
Non-covered item or service |
95 |
60 |
$0.00 |
| 84035 |
|
39 |
38 |
$0.00 |