| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E0465 |
Home vent invasive interface |
6,440 |
3,814 |
$5.07M |
| E1390 |
Oxygen concentrator |
110,915 |
101,359 |
$3.55M |
| E0570 |
Nebulizer with compression |
29,333 |
27,627 |
$1.08M |
| A4624 |
Tracheal suction tube |
4,739 |
3,648 |
$874K |
| E0431 |
Portable gaseous 02 |
95,829 |
90,884 |
$639K |
| E0601 |
Cont airway pressure device |
45,712 |
44,405 |
$621K |
| A7030 |
Cpap full face mask |
15,037 |
14,319 |
$552K |
| A4605 |
Trach suction cath close sys |
2,919 |
2,385 |
$523K |
| A7526 |
Tracheostomy tube collar |
6,195 |
5,221 |
$507K |
| K0001 |
Standard wheelchair |
21,428 |
20,238 |
$368K |
| A7520 |
Trach/laryn tube non-cuffed |
6,245 |
3,939 |
$366K |
| B4035 |
Enteral feed supp pump per d |
2,089 |
1,622 |
$354K |
| A4629 |
Tracheostomy care kit |
4,187 |
3,539 |
$278K |
| E0466 |
Home vent non-invasive inter |
1,206 |
1,007 |
$248K |
| E0143 |
Walker folding wheeled w/o s |
6,443 |
6,124 |
$228K |
| E0562 |
Humidifier heated used w pap |
8,706 |
8,415 |
$225K |
| A7005 |
Nondisposable nebulizer set |
21,940 |
21,213 |
$223K |
| E0470 |
Rad w/o backup non-inv intfc |
6,869 |
6,505 |
$221K |
| A7031 |
Replacement facemask interfa |
11,557 |
10,756 |
$214K |
| A7507 |
Integrated filter & holder |
2,790 |
2,434 |
$194K |
| B4161 |
Ef ped hydrolyzed/amino acid |
333 |
238 |
$193K |
| A4623 |
Tracheostomy inner cannula |
1,488 |
1,235 |
$184K |
| A7034 |
Nasal application device |
6,823 |
6,514 |
$172K |
| B4160 |
Ef ped caloric dense>/=0.7kc |
668 |
522 |
$168K |
| E0600 |
Suction pump portab hom modl |
3,395 |
3,139 |
$162K |
| A7037 |
Pos airway pressure tubing |
15,278 |
14,569 |
$154K |
| E0471 |
Rad w/backup non inv intrfc |
1,892 |
1,787 |
$148K |
| A7035 |
Pos airway press headgear |
15,349 |
14,650 |
$115K |
| A7032 |
Replacement nasal cushion |
6,713 |
6,307 |
$106K |
| A7000 |
Disposable canister for pump |
7,023 |
5,950 |
$83K |
| A7038 |
Pos airway pressure filter |
36,620 |
34,759 |
$76K |
| K0003 |
Lightweight wheelchair |
2,533 |
2,349 |
$59K |
| B4149 |
Ef blenderized foods |
251 |
186 |
$57K |
| E0260 |
Hosp bed semi-electr w/ matt |
4,775 |
4,333 |
$55K |
| A7033 |
Replacement nasal pillows |
4,068 |
3,833 |
$51K |
| E0163 |
Commode chair with fixed arm |
1,331 |
1,258 |
$48K |
| A7002 |
Tubing used w suction pump |
10,300 |
6,461 |
$48K |
| A4604 |
Tubing with heating element |
6,962 |
6,772 |
$46K |
| E0445 |
Oximeter non-invasive |
3,845 |
3,744 |
$38K |
| K0823 |
Pwc gp 2 std cap chair |
879 |
544 |
$34K |
| A6402 |
Sterile gauze <= 16 sq in |
3,791 |
2,836 |
$34K |
| A4628 |
Oropharyngeal suction cath |
5,877 |
4,157 |
$33K |
| B9002 |
Enter nutr inf pump any type |
1,039 |
841 |
$32K |
| K0007 |
Extra heavy duty wheelchair |
649 |
625 |
$30K |
| A7039 |
Filter, non disposable w pap |
7,937 |
7,584 |
$26K |
| K0195 |
Elevating whlchair leg rests |
5,087 |
4,910 |
$26K |
| A4223 |
Infusion supplies w/o pump |
144 |
69 |
$25K |
| E1392 |
Portable oxygen concentrator |
3,004 |
2,804 |
$23K |
| A7046 |
Repl water chamber, pap dev |
7,542 |
6,953 |
$22K |
| B4088 |
Gastro/jejuno tube, low-pro |
348 |
288 |
$21K |
| E0245 |
Tub stool or bench |
531 |
477 |
$20K |
| E0603 |
Electric breast pump |
126 |
124 |
$20K |
| A4606 |
Oxygen probe used w oximeter |
4,279 |
3,590 |
$16K |
| A7521 |
Trach/laryn tube cuffed |
506 |
304 |
$16K |
| A7003 |
Nebulizer administration set |
5,822 |
4,837 |
$15K |
| B4034 |
Enter feed supkit syr by day |
198 |
162 |
$15K |
| A4483 |
Moisture exchanger |
297 |
239 |
$14K |
| E0550 |
Humidif extens supple w ippb |
453 |
383 |
$14K |
| E0118 |
Crutch substitute |
70 |
43 |
$11K |
| A7509 |
Heat & moisture exchange sys |
217 |
209 |
$11K |
| E0776 |
Iv pole |
1,159 |
1,000 |
$11K |
| A4618 |
Breathing circuits |
653 |
380 |
$11K |
| A7012 |
Nebulizer water collec devic |
2,633 |
2,125 |
$11K |
| A7015 |
Aerosol mask used w nebulize |
12,420 |
11,975 |
$9K |
| E0149 |
Heavy duty wheeled walker |
129 |
121 |
$8K |
| E0565 |
Compressor air power source |
447 |
419 |
$7K |
| A7525 |
Tracheostomy mask |
3,744 |
2,915 |
$7K |
| E0630 |
Patient lift hydraulic |
566 |
508 |
$7K |
| E0277 |
Powered pres-redu air mattrs |
574 |
489 |
$5K |
| B4158 |
Ef ped complete intact nut |
30 |
24 |
$5K |
| L8501 |
Tracheostomy speaking valve |
58 |
49 |
$4K |
| E0247 |
Trans bench w/wo comm open |
144 |
136 |
$4K |
| E0240 |
Bath/shower chair |
119 |
115 |
$3K |
| A4221 |
Supp non-insulin inf cath/wk |
164 |
71 |
$3K |
| B4150 |
Ef complet w/intact nutrient |
17 |
12 |
$2K |
| A7527 |
Trach/laryn tube plug/stop |
395 |
335 |
$2K |
| E1399 |
Durable medical equipment mi |
14 |
12 |
$2K |
| E0100 |
Cane adjust/fixed with tip |
125 |
119 |
$1K |
| E0971 |
Wheelchair anti-tipping devi |
400 |
386 |
$1K |
| E0265 |
Hosp bed total electr w/ mat |
235 |
211 |
$946.81 |
| E1226 |
Manual fully reclining back |
15 |
15 |
$761.25 |
| E0156 |
Walker seat attachment |
459 |
441 |
$741.18 |
| E0303 |
Hosp bed hvy dty xtra wide |
51 |
49 |
$533.10 |
| A7010 |
Disposable corrugated tubing |
29 |
24 |
$420.47 |
| A4670 |
Automatic bp monitor, dial |
16 |
13 |
$387.27 |
| K0739 |
Repair/svc dme non-oxygen eq |
37 |
24 |
$317.04 |
| E1038 |
Transport chair pt wt<=300lb |
275 |
230 |
$295.33 |
| A7013 |
Disposable compressor filter |
1,681 |
1,622 |
$263.16 |
| E0443 |
Portable 02 contents, gas |
58 |
52 |
$154.81 |
| A6446 |
Conform band s w>=3" <5"/yd |
14 |
12 |
$127.83 |
| A4216 |
Sterile water/saline, 10 ml |
199 |
177 |
$100.00 |
| A6216 |
Non-sterile gauze<=16 sq in |
34 |
30 |
$49.70 |
| A7007 |
Lg vol nebulizer disposable |
91 |
79 |
$19.68 |
| A4649 |
Surgical supplies |
274 |
234 |
$18.76 |
| E0274 |
Over-bed table |
14 |
13 |
$13.50 |
| A4217 |
Sterile water/saline, 500 ml |
131 |
86 |
$0.00 |