| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
6,420 |
5,788 |
$321K |
| E0466 |
Home vent non-invasive inter |
267 |
240 |
$128K |
| E0431 |
Portable gaseous 02 |
3,870 |
3,395 |
$52K |
| A4624 |
Tracheal suction tube |
354 |
284 |
$46K |
| A4606 |
Oxygen probe used w oximeter |
182 |
169 |
$39K |
| E0445 |
Oximeter non-invasive |
323 |
320 |
$30K |
| E0261 |
Hosp bed semi-electr w/o mat |
1,982 |
1,920 |
$26K |
| K0738 |
Portable gas oxygen system |
1,272 |
1,163 |
$18K |
| E0600 |
Suction pump portab hom modl |
630 |
624 |
$13K |
| A7526 |
Tracheostomy tube collar |
361 |
288 |
$12K |
| E0570 |
Nebulizer with compression |
1,409 |
1,383 |
$12K |
| A7520 |
Trach/laryn tube non-cuffed |
149 |
118 |
$9K |
| A4927 |
Non-sterile gloves |
269 |
238 |
$7K |
| E0601 |
Cont airway pressure device |
219 |
206 |
$6K |
| A6196 |
Alginate dressing <=16 sq in |
107 |
84 |
$6K |
| E0630 |
Patient lift hydraulic |
409 |
395 |
$6K |
| K0001 |
Standard wheelchair |
277 |
248 |
$6K |
| A7030 |
Cpap full face mask |
94 |
81 |
$5K |
| A4628 |
Oropharyngeal suction cath |
434 |
377 |
$5K |
| A7038 |
Pos airway pressure filter |
424 |
374 |
$4K |
| A7000 |
Disposable canister for pump |
655 |
584 |
$4K |
| A4217 |
Sterile water/saline, 500 ml |
106 |
96 |
$2K |
| A7031 |
Replacement facemask interfa |
78 |
70 |
$2K |
| A6402 |
Sterile gauze <= 16 sq in |
404 |
353 |
$2K |
| K0195 |
Elevating whlchair leg rests |
260 |
243 |
$2K |
| A4604 |
Tubing with heating element |
83 |
74 |
$2K |
| A7003 |
Nebulizer administration set |
489 |
458 |
$1K |
| A7002 |
Tubing used w suction pump |
466 |
436 |
$1K |
| E0565 |
Compressor air power source |
52 |
51 |
$1K |
| A4216 |
Sterile water/saline, 10 ml |
77 |
70 |
$904.16 |
| A7035 |
Pos airway press headgear |
42 |
41 |
$666.62 |
| A6446 |
Conform band s w>=3" <5"/yd |
28 |
27 |
$622.78 |
| A7007 |
Lg vol nebulizer disposable |
111 |
103 |
$592.44 |
| A6216 |
Non-sterile gauze<=16 sq in |
70 |
66 |
$427.42 |
| A7012 |
Nebulizer water collec devic |
65 |
62 |
$351.99 |
| A7525 |
Tracheostomy mask |
199 |
173 |
$297.22 |
| A4450 |
Non-waterproof tape |
73 |
65 |
$269.81 |
| A7015 |
Aerosol mask used w nebulize |
169 |
158 |
$188.28 |
| A7037 |
Pos airway pressure tubing |
12 |
12 |
$162.45 |