| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| B4035 |
Enteral feed supp pump per d |
4,102 |
3,404 |
$586K |
| E0465 |
Home vent invasive interface |
1,811 |
1,399 |
$574K |
| E0445 |
Oximeter non-invasive |
3,555 |
3,473 |
$369K |
| E1390 |
Oxygen concentrator |
12,804 |
9,547 |
$363K |
| B4161 |
Ef ped hydrolyzed/amino acid |
447 |
426 |
$297K |
| A4624 |
Tracheal suction tube |
888 |
693 |
$188K |
| E0431 |
Portable gaseous 02 |
6,093 |
4,700 |
$146K |
| B4160 |
Ef ped caloric dense>/=0.7kc |
586 |
561 |
$109K |
| B9998 |
Enteral supp not otherwise c |
1,643 |
1,555 |
$71K |
| A4629 |
Tracheostomy care kit |
894 |
666 |
$38K |
| E0601 |
Cont airway pressure device |
1,585 |
1,301 |
$37K |
| A7526 |
Tracheostomy tube collar |
1,996 |
1,549 |
$31K |
| E0600 |
Suction pump portab hom modl |
1,631 |
1,556 |
$31K |
| E0562 |
Humidifier heated used w pap |
1,515 |
1,356 |
$26K |
| B4088 |
Gastro/jejuno tube, low-pro |
522 |
500 |
$26K |
| B9002 |
Enter nutr inf pump any type |
346 |
318 |
$19K |
| A7520 |
Trach/laryn tube non-cuffed |
653 |
521 |
$19K |
| A4245 |
Alcohol wipes per box |
474 |
384 |
$18K |
| E1392 |
Portable oxygen concentrator |
2,233 |
1,608 |
$13K |
| B4150 |
Ef complet w/intact nutrient |
226 |
163 |
$10K |
| A4927 |
Non-sterile gloves |
834 |
663 |
$9K |
| A7508 |
Housing & integrated adhesiv |
251 |
223 |
$9K |
| B4034 |
Enter feed supkit syr by day |
163 |
133 |
$8K |
| A7504 |
Tracheostoma hmes filter |
565 |
496 |
$8K |
| A7000 |
Disposable canister for pump |
1,559 |
1,198 |
$8K |
| B4152 |
Ef calorie dense>/=1.5kcal |
303 |
262 |
$7K |
| E0570 |
Nebulizer with compression |
2,997 |
2,167 |
$7K |
| E0466 |
Home vent non-invasive inter |
38 |
24 |
$6K |
| A4605 |
Trach suction cath close sys |
158 |
111 |
$6K |
| A6402 |
Sterile gauze <= 16 sq in |
894 |
608 |
$6K |
| A7521 |
Trach/laryn tube cuffed |
292 |
223 |
$6K |
| A7003 |
Nebulizer administration set |
3,791 |
2,692 |
$6K |
| A4450 |
Non-waterproof tape |
450 |
360 |
$5K |
| A4244 |
Alcohol or peroxide per pint |
58 |
52 |
$4K |
| A6216 |
Non-sterile gauze<=16 sq in |
558 |
415 |
$3K |
| A4217 |
Sterile water/saline, 500 ml |
167 |
138 |
$3K |
| A7002 |
Tubing used w suction pump |
2,698 |
2,105 |
$3K |
| A7525 |
Tracheostomy mask |
829 |
647 |
$2K |
| E0776 |
Iv pole |
175 |
164 |
$2K |
| A4554 |
Disposable underpads |
27 |
26 |
$1K |
| A4623 |
Tracheostomy inner cannula |
57 |
38 |
$1K |
| B4154 |
Ef spec metabolic noninherit |
87 |
80 |
$1K |
| E0565 |
Compressor air power source |
41 |
41 |
$856.44 |
| A7038 |
Pos airway pressure filter |
1,323 |
945 |
$682.88 |
| A4618 |
Breathing circuits |
48 |
40 |
$376.96 |
| A7037 |
Pos airway pressure tubing |
291 |
246 |
$120.96 |
| A7030 |
Cpap full face mask |
15 |
13 |
$26.62 |
| A7035 |
Pos airway press headgear |
124 |
102 |
$24.55 |
| A7015 |
Aerosol mask used w nebulize |
59 |
51 |
$20.53 |
| A7046 |
Repl water chamber, pap dev |
127 |
91 |
$15.90 |
| A7034 |
Nasal application device |
44 |
38 |
$8.32 |