| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| B4035 |
Enteral feed supp pump per d |
6,499 |
4,118 |
$528K |
| E1390 |
Oxygen concentrator |
12,103 |
10,259 |
$310K |
| B4161 |
Ef ped hydrolyzed/amino acid |
677 |
513 |
$286K |
| B4160 |
Ef ped caloric dense>/=0.7kc |
1,999 |
1,444 |
$229K |
| B4152 |
Ef calorie dense>/=1.5kcal |
2,753 |
1,975 |
$148K |
| B4034 |
Enter feed supkit syr by day |
3,210 |
2,017 |
$144K |
| B4149 |
Ef blenderized foods |
436 |
327 |
$109K |
| B4150 |
Ef complet w/intact nutrient |
1,639 |
1,213 |
$75K |
| E0431 |
Portable gaseous 02 |
6,765 |
5,840 |
$39K |
| B9002 |
Enter nutr inf pump any type |
1,394 |
1,210 |
$39K |
| A7031 |
Replacement facemask interfa |
1,122 |
1,044 |
$20K |
| B4088 |
Gastro/jejuno tube, low-pro |
760 |
590 |
$16K |
| E1392 |
Portable oxygen concentrator |
1,078 |
1,012 |
$12K |
| E0776 |
Iv pole |
1,488 |
1,318 |
$6K |
| A7030 |
Cpap full face mask |
180 |
169 |
$6K |
| A7038 |
Pos airway pressure filter |
2,621 |
2,374 |
$5K |
| A7037 |
Pos airway pressure tubing |
1,027 |
948 |
$4K |
| E0570 |
Nebulizer with compression |
1,307 |
1,139 |
$3K |
| A7035 |
Pos airway press headgear |
352 |
323 |
$2K |
| A7034 |
Nasal application device |
97 |
88 |
$1K |
| B9998 |
Enteral supp not otherwise c |
85 |
68 |
$889.61 |
| E0600 |
Suction pump portab hom modl |
40 |
36 |
$842.03 |
| A7046 |
Repl water chamber, pap dev |
181 |
170 |
$754.00 |
| B4154 |
Ef spec metabolic noninherit |
27 |
24 |
$638.50 |
| E0601 |
Cont airway pressure device |
68 |
64 |
$638.36 |
| A7003 |
Nebulizer administration set |
897 |
797 |
$589.36 |
| A7526 |
Tracheostomy tube collar |
27 |
24 |
$582.84 |
| A4624 |
Tracheal suction tube |
14 |
12 |
$459.63 |
| K0001 |
Standard wheelchair |
34 |
26 |
$260.33 |
| A4606 |
Oxygen probe used w oximeter |
15 |
13 |
$11.26 |