| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
4,834 |
4,809 |
$388K |
| B4035 |
Enteral feed supp pump per d |
5,172 |
1,149 |
$184K |
| E0603 |
Electric breast pump |
842 |
828 |
$103K |
| E0431 |
Portable gaseous 02 |
4,368 |
4,342 |
$70K |
| H2015 |
Comp comm supp svc, 15 min |
1,328 |
641 |
$57K |
| E0570 |
Nebulizer with compression |
1,330 |
1,325 |
$55K |
| E0114 |
Crutch underarm pair no wood |
1,828 |
1,818 |
$52K |
| E0143 |
Walker folding wheeled w/o s |
832 |
832 |
$46K |
| H0043 |
Supported housing, per diem |
432 |
227 |
$23K |
| M0245 |
Bamlan and etesev infusion |
59 |
59 |
$21K |
| S9500 |
Hit antibiotic q24h diem |
170 |
52 |
$18K |
| H0032 |
Mh svc plan dev by non-md |
1,024 |
515 |
$16K |
| E0601 |
Cont airway pressure device |
270 |
264 |
$12K |
| B4152 |
Ef calorie dense>/=1.5kcal |
100 |
86 |
$9K |
| K0001 |
Standard wheelchair |
383 |
383 |
$9K |
| L3260 |
Ambulatory surgical boot eac |
105 |
104 |
$4K |
| B9002 |
Enter nutr inf pump any type |
44 |
39 |
$3K |
| E0562 |
Humidifier heated used w pap |
152 |
149 |
$2K |
| L4386 |
Non-pneum walk boot pre cst |
16 |
15 |
$1K |
| L4350 |
Ankle control ortho pre ots |
15 |
15 |
$986.72 |
| A7038 |
Pos airway pressure filter |
315 |
313 |
$900.97 |
| A7003 |
Nebulizer administration set |
306 |
304 |
$608.32 |
| A7035 |
Pos airway press headgear |
24 |
24 |
$410.94 |
| K0195 |
Elevating whlchair leg rests |
13 |
13 |
$102.28 |
| E0776 |
Iv pole |
12 |
12 |
$86.01 |
| A7015 |
Aerosol mask used w nebulize |
16 |
16 |
$16.68 |
| A4565 |
Slings |
12 |
12 |
$0.00 |