| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| B4161 |
Ef ped hydrolyzed/amino acid |
2,230 |
1,758 |
$1.06M |
| E1390 |
Oxygen concentrator |
38,418 |
33,274 |
$971K |
| B4035 |
Enteral feed supp pump per d |
7,665 |
4,857 |
$772K |
| B4160 |
Ef ped caloric dense>/=0.7kc |
2,635 |
2,211 |
$414K |
| E0466 |
Home vent non-invasive inter |
1,790 |
1,477 |
$182K |
| B4152 |
Ef calorie dense>/=1.5kcal |
3,276 |
2,392 |
$154K |
| B4034 |
Enter feed supkit syr by day |
3,278 |
2,156 |
$121K |
| B9002 |
Enter nutr inf pump any type |
3,065 |
2,710 |
$110K |
| E0431 |
Portable gaseous 02 |
17,849 |
15,561 |
$106K |
| E0570 |
Nebulizer with compression |
10,287 |
9,316 |
$37K |
| B4158 |
Ef ped complete intact nut |
137 |
108 |
$35K |
| B4088 |
Gastro/jejuno tube, low-pro |
1,165 |
945 |
$28K |
| E0776 |
Iv pole |
3,231 |
2,733 |
$21K |
| E1392 |
Portable oxygen concentrator |
2,473 |
2,246 |
$20K |
| A7031 |
Replacement facemask interfa |
911 |
853 |
$17K |
| K0001 |
Standard wheelchair |
1,758 |
1,504 |
$13K |
| A7030 |
Cpap full face mask |
322 |
307 |
$11K |
| E0260 |
Hosp bed semi-electr w/ matt |
988 |
886 |
$10K |
| B4100 |
Food thickener oral |
138 |
88 |
$10K |
| A7005 |
Nondisposable nebulizer set |
1,822 |
1,642 |
$7K |
| A7032 |
Replacement nasal cushion |
325 |
302 |
$6K |
| Q0513 |
Disp fee inhal drugs/30 days |
714 |
639 |
$6K |
| B4149 |
Ef blenderized foods |
16 |
12 |
$5K |
| A7038 |
Pos airway pressure filter |
2,549 |
2,349 |
$5K |
| E0483 |
Hi freq chest wall oscil sys |
58 |
41 |
$4K |
| B9998 |
Enteral supp not otherwise c |
556 |
344 |
$4K |
| E0601 |
Cont airway pressure device |
314 |
276 |
$4K |
| A7034 |
Nasal application device |
259 |
236 |
$3K |
| B4150 |
Ef complet w/intact nutrient |
38 |
26 |
$3K |
| A7035 |
Pos airway press headgear |
494 |
446 |
$3K |
| A7037 |
Pos airway pressure tubing |
689 |
646 |
$3K |
| E0562 |
Humidifier heated used w pap |
628 |
528 |
$2K |
| A7003 |
Nebulizer administration set |
4,819 |
4,159 |
$2K |
| A7046 |
Repl water chamber, pap dev |
310 |
287 |
$1K |
| B4154 |
Ef spec metabolic noninherit |
18 |
12 |
$1K |
| A4604 |
Tubing with heating element |
39 |
37 |
$666.66 |
| E0443 |
Portable 02 contents, gas |
218 |
210 |
$534.03 |
| A7015 |
Aerosol mask used w nebulize |
879 |
783 |
$411.03 |
| E0630 |
Patient lift hydraulic |
74 |
49 |
$374.88 |
| A7013 |
Disposable compressor filter |
785 |
712 |
$210.23 |
| J7613 |
Albuterol non-comp unit |
161 |
149 |
$208.67 |