| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| B4035 |
Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
525 |
471 |
$88K |
| E1390 |
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate |
2,289 |
2,237 |
$38K |
| T4534 |
Youth sized disposable incontinence product, protective underwear/pull-on, each |
217 |
216 |
$28K |
| B9998 |
Noc for enteral supplies |
113 |
77 |
$8K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
29 |
29 |
$650.89 |
| E1392 |
Portable oxygen concentrator, rental |
833 |
820 |
$649.22 |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
13 |
13 |
$217.87 |
| A7037 |
Tubing used with positive airway pressure device |
12 |
12 |
$0.00 |
| A7035 |
Headgear used with positive airway pressure device |
25 |
25 |
$0.00 |
| A7038 |
Filter, disposable, used with positive airway pressure device |
26 |
26 |
$0.00 |