| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E0465 |
Home vent invasive interface |
669 |
358 |
$326K |
| E1390 |
Oxygen concentrator |
2,132 |
1,861 |
$173K |
| E0431 |
Portable gaseous 02 |
1,116 |
954 |
$48K |
| E0601 |
Cont airway pressure device |
933 |
809 |
$44K |
| A4624 |
Tracheal suction tube |
330 |
302 |
$33K |
| A7030 |
Cpap full face mask |
470 |
433 |
$32K |
| A4483 |
Moisture exchanger |
151 |
146 |
$24K |
| A4606 |
Oxygen probe used w oximeter |
361 |
328 |
$22K |
| A7034 |
Nasal application device |
512 |
481 |
$20K |
| E0562 |
Humidifier heated used w pap |
935 |
809 |
$17K |
| A7526 |
Tracheostomy tube collar |
426 |
346 |
$13K |
| A7035 |
Pos airway press headgear |
771 |
714 |
$12K |
| A4217 |
Sterile water/saline, 500 ml |
403 |
332 |
$12K |
| A7031 |
Replacement facemask interfa |
392 |
372 |
$11K |
| E0570 |
Nebulizer with compression |
997 |
946 |
$11K |
| A7037 |
Pos airway pressure tubing |
872 |
802 |
$10K |
| A7046 |
Repl water chamber, pap dev |
739 |
696 |
$10K |
| E0445 |
Oximeter non-invasive |
71 |
58 |
$8K |
| A6402 |
Sterile gauze <= 16 sq in |
468 |
404 |
$7K |
| A4618 |
Breathing circuits |
332 |
300 |
$6K |
| E0600 |
Suction pump portab hom modl |
186 |
139 |
$6K |
| A7520 |
Trach/laryn tube non-cuffed |
140 |
136 |
$6K |
| A7521 |
Trach/laryn tube cuffed |
155 |
147 |
$4K |
| A7032 |
Replacement nasal cushion |
241 |
227 |
$4K |
| K0738 |
Portable gas oxygen system |
534 |
512 |
$3K |
| K0001 |
Standard wheelchair |
368 |
318 |
$3K |
| A7000 |
Disposable canister for pump |
447 |
429 |
$3K |
| A4927 |
Non-sterile gloves |
343 |
302 |
$3K |
| A4628 |
Oropharyngeal suction cath |
281 |
258 |
$3K |
| A7038 |
Pos airway pressure filter |
890 |
821 |
$2K |
| A7003 |
Nebulizer administration set |
470 |
438 |
$2K |
| A7039 |
Filter, non disposable w pap |
459 |
433 |
$1K |
| A7002 |
Tubing used w suction pump |
154 |
140 |
$1K |
| A4456 |
Adhesive remover, wipes |
226 |
165 |
$1K |
| A5120 |
Skin barrier, wipe or swab |
280 |
209 |
$974.51 |
| A6216 |
Non-sterile gauze<=16 sq in |
76 |
61 |
$581.64 |
| A7033 |
Replacement nasal pillows |
26 |
25 |
$334.38 |
| A4604 |
Tubing with heating element |
12 |
12 |
$244.75 |
| A4627 |
Spacer bag/reservoir |
16 |
15 |
$156.50 |
| A4452 |
Waterproof tape |
16 |
14 |
$73.36 |
| E0260 |
Hosp bed semi-electr w/ matt |
14 |
14 |
$32.59 |
| A4626 |
Tracheostomy cleaning brush |
182 |
174 |
$20.82 |
| A4351 |
Straight tip urine catheter |
17 |
14 |
$0.00 |