| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| B4035 |
Enteral feed supp pump per d |
3,213 |
2,785 |
$1.72M |
| B9998 |
Enteral supp not otherwise c |
6,660 |
3,196 |
$1.01M |
| B4161 |
Ef ped hydrolyzed/amino acid |
1,538 |
1,057 |
$667K |
| E0445 |
Oximeter non-invasive |
3,218 |
2,989 |
$605K |
| B4160 |
Ef ped caloric dense>/=0.7kc |
1,124 |
824 |
$275K |
| B4088 |
Gastro/jejuno tube, low-pro |
1,695 |
1,435 |
$268K |
| A4606 |
Oxygen probe used w oximeter |
1,350 |
812 |
$199K |
| B4149 |
Ef blenderized foods |
570 |
402 |
$177K |
| B9002 |
Enter nutr inf pump any type |
1,680 |
1,548 |
$141K |
| A9999 |
Dme supply or accessory, nos |
4,100 |
1,140 |
$98K |
| E1390 |
Oxygen concentrator |
857 |
787 |
$96K |
| E0431 |
Portable gaseous 02 |
2,027 |
1,915 |
$37K |
| T4534 |
Youth size pull-on |
168 |
117 |
$24K |
| A4657 |
Syringe w/wo needle |
2,475 |
1,765 |
$21K |
| A4927 |
Non-sterile gloves |
311 |
233 |
$18K |
| E0465 |
Home vent invasive interface |
16 |
12 |
$14K |
| A4217 |
Sterile water/saline, 500 ml |
105 |
76 |
$7K |
| E0562 |
Humidifier heated used w pap |
12 |
12 |
$421.94 |
| A7046 |
Repl water chamber, pap dev |
13 |
12 |
$262.80 |
| A4452 |
Waterproof tape |
13 |
13 |
$77.20 |