| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E0465 |
Home vent invasive interface |
1,423 |
1,422 |
$1.38M |
| E1390 |
Oxygen concentrator |
6,055 |
5,996 |
$537K |
| T4535 |
Disposable liner/shield/pad |
8,320 |
7,859 |
$436K |
| T4527 |
Adult size pull-on lg |
3,063 |
2,945 |
$291K |
| A4624 |
Tracheal suction tube |
1,667 |
1,648 |
$278K |
| T4526 |
Adult size pull-on med |
2,700 |
2,559 |
$228K |
| T4528 |
Adult size pull-on xl |
1,968 |
1,883 |
$205K |
| T4541 |
Large disposable underpad |
5,036 |
4,824 |
$197K |
| A4629 |
Tracheostomy care kit |
1,469 |
1,465 |
$128K |
| A4623 |
Tracheostomy inner cannula |
1,769 |
1,768 |
$125K |
| T1999 |
Noc retail items andsupplies |
522 |
491 |
$96K |
| A7526 |
Tracheostomy tube collar |
1,695 |
1,689 |
$80K |
| A4605 |
Trach suction cath close sys |
1,638 |
1,638 |
$78K |
| E0431 |
Portable gaseous 02 |
4,830 |
4,807 |
$75K |
| T4543 |
Adult disp brief/diap abv xl |
486 |
464 |
$71K |
| A7000 |
Disposable canister for pump |
1,798 |
1,795 |
$49K |
| A4628 |
Oropharyngeal suction cath |
1,722 |
1,721 |
$47K |
| T4537 |
Reusable underpad bed size |
300 |
296 |
$28K |
| K0001 |
Standard wheelchair |
829 |
826 |
$22K |
| A7521 |
Trach/laryn tube cuffed |
597 |
590 |
$20K |
| L0650 |
Lso sc r ant/pos pnl pre ots |
32 |
20 |
$19K |
| E0260 |
Hosp bed semi-electr w/ matt |
884 |
877 |
$18K |
| E0570 |
Nebulizer with compression |
886 |
860 |
$18K |
| T4525 |
Adult size pull-on sm |
237 |
228 |
$18K |
| A4927 |
Non-sterile gloves |
801 |
767 |
$15K |
| A7002 |
Tubing used w suction pump |
1,801 |
1,774 |
$10K |
| K0003 |
Lightweight wheelchair |
1,031 |
1,019 |
$8K |
| A7010 |
Disposable corrugated tubing |
421 |
420 |
$7K |
| A7012 |
Nebulizer water collec devic |
418 |
418 |
$6K |
| A7008 |
Disposable nebulizer prefill |
108 |
106 |
$5K |
| A4335 |
Incontinence supply |
274 |
271 |
$5K |
| A7525 |
Tracheostomy mask |
484 |
484 |
$3K |
| A4357 |
Bedside drainage bag |
230 |
210 |
$3K |
| E0143 |
Walker folding wheeled w/o s |
41 |
41 |
$2K |
| A7520 |
Trach/laryn tube non-cuffed |
35 |
33 |
$1K |
| A4344 |
Cath indw foley 2 way silicn |
92 |
81 |
$1K |
| A4310 |
Insert tray w/o bag/cath |
168 |
149 |
$792.99 |
| A7003 |
Nebulizer administration set |
17 |
17 |
$61.49 |
| A7013 |
Disposable compressor filter |
15 |
15 |
$16.05 |