| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| B4150 |
Ef complet w/intact nutrient |
265 |
255 |
$254K |
| B4153 |
Ef hydrolyzed/amino acids |
140 |
129 |
$174K |
| B4160 |
Ef ped caloric dense>/=0.7kc |
369 |
329 |
$158K |
| E1390 |
Oxygen concentrator |
1,150 |
1,054 |
$108K |
| B4035 |
Enteral feed supp pump per d |
223 |
222 |
$41K |
| K0001 |
Standard wheelchair |
2,475 |
1,973 |
$38K |
| E0431 |
Portable gaseous 02 |
1,028 |
945 |
$19K |
| B4088 |
Gastro/jejuno tube, low-pro |
198 |
182 |
$17K |
| A9900 |
Supply/accessory/service |
149 |
144 |
$11K |
| E0260 |
Hosp bed semi-electr w/ matt |
206 |
133 |
$6K |
| E0570 |
Nebulizer with compression |
115 |
103 |
$5K |
| A4927 |
Non-sterile gloves |
366 |
354 |
$5K |
| K0195 |
Elevating whlchair leg rests |
484 |
425 |
$5K |
| E0603 |
Electric breast pump |
65 |
65 |
$5K |
| A4216 |
Sterile water/saline, 10 ml |
155 |
148 |
$4K |
| E0240 |
Bath/shower chair |
86 |
38 |
$4K |
| E0445 |
Oximeter non-invasive |
51 |
51 |
$3K |
| E0143 |
Walker folding wheeled w/o s |
55 |
49 |
$3K |
| B9002 |
Enter nutr inf pump any type |
50 |
49 |
$3K |
| E0600 |
Suction pump portab hom modl |
86 |
84 |
$2K |
| A4554 |
Disposable underpads |
40 |
39 |
$1K |
| E0601 |
Cont airway pressure device |
26 |
25 |
$1K |
| A6402 |
Sterile gauze <= 16 sq in |
115 |
102 |
$1K |
| A4450 |
Non-waterproof tape |
27 |
26 |
$1K |
| A7003 |
Nebulizer administration set |
64 |
57 |
$955.91 |
| B4082 |
Enteral ng tubing w/o stylet |
12 |
12 |
$743.12 |
| E0562 |
Humidifier heated used w pap |
77 |
77 |
$622.84 |
| A6446 |
Conform band s w>=3" <5"/yd |
72 |
69 |
$468.72 |
| A5120 |
Skin barrier, wipe or swab |
82 |
72 |
$392.72 |
| A6216 |
Non-sterile gauze<=16 sq in |
122 |
107 |
$132.38 |