| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| B4152 |
Ef calorie dense>/=1.5kcal |
12,666 |
9,421 |
$841K |
| B4160 |
Ef ped caloric dense>/=0.7kc |
4,405 |
3,401 |
$834K |
| E1390 |
Oxygen concentrator |
20,718 |
19,167 |
$750K |
| B4035 |
Enteral feed supp pump per d |
5,975 |
5,011 |
$483K |
| B4150 |
Ef complet w/intact nutrient |
6,517 |
5,129 |
$433K |
| B4153 |
Ef hydrolyzed/amino acids |
1,799 |
1,494 |
$424K |
| E0466 |
Home vent non-invasive inter |
884 |
835 |
$266K |
| B4161 |
Ef ped hydrolyzed/amino acid |
945 |
658 |
$263K |
| B4154 |
Ef spec metabolic noninherit |
2,740 |
2,080 |
$257K |
| B4034 |
Enter feed supkit syr by day |
2,471 |
2,080 |
$93K |
| E0431 |
Portable gaseous 02 |
6,738 |
6,246 |
$90K |
| B9002 |
Enter nutr inf pump any type |
1,454 |
1,377 |
$69K |
| B4158 |
Ef ped complete intact nut |
941 |
556 |
$65K |
| B9998 |
Enteral supp not otherwise c |
1,094 |
980 |
$61K |
| B4036 |
Enteral feed sup kit grav by |
1,031 |
901 |
$58K |
| E0601 |
Cont airway pressure device |
1,003 |
962 |
$38K |
| E1392 |
Portable oxygen concentrator |
4,023 |
3,736 |
$37K |
| B4088 |
Gastro/jejuno tube, low-pro |
614 |
562 |
$33K |
| B4149 |
Ef blenderized foods |
128 |
101 |
$27K |
| E0570 |
Nebulizer with compression |
2,084 |
1,849 |
$22K |
| B4155 |
Ef incomplete/modular |
432 |
338 |
$11K |
| E0776 |
Iv pole |
1,561 |
1,469 |
$10K |
| A7038 |
Pos airway pressure filter |
2,353 |
2,230 |
$5K |
| A7037 |
Pos airway pressure tubing |
542 |
511 |
$5K |
| E0562 |
Humidifier heated used w pap |
170 |
164 |
$4K |
| A7031 |
Replacement facemask interfa |
202 |
191 |
$3K |
| A7030 |
Cpap full face mask |
66 |
63 |
$3K |
| A7035 |
Pos airway press headgear |
215 |
199 |
$3K |
| E0260 |
Hosp bed semi-electr w/ matt |
111 |
97 |
$2K |
| A7034 |
Nasal application device |
67 |
64 |
$2K |
| B4102 |
Ef adult fluids and electro |
50 |
40 |
$2K |
| A7032 |
Replacement nasal cushion |
108 |
102 |
$1K |
| A7003 |
Nebulizer administration set |
208 |
183 |
$119.94 |
| A7005 |
Nondisposable nebulizer set |
20 |
18 |
$109.45 |
| A7046 |
Repl water chamber, pap dev |
18 |
17 |
$59.98 |
| A7015 |
Aerosol mask used w nebulize |
15 |
13 |
$7.73 |