| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
77,761 |
70,231 |
$5.11M |
| E0465 |
Home vent invasive interface |
1,949 |
1,459 |
$1.93M |
| E0466 |
Home vent non-invasive inter |
2,552 |
2,323 |
$1.91M |
| K0738 |
Portable gas oxygen system |
25,001 |
23,248 |
$788K |
| A7030 |
Cpap full face mask |
8,181 |
7,047 |
$617K |
| E0445 |
Oximeter non-invasive |
2,420 |
2,089 |
$568K |
| E0601 |
Cont airway pressure device |
8,012 |
6,817 |
$390K |
| A4606 |
Oxygen probe used w oximeter |
5,082 |
3,012 |
$374K |
| E0441 |
Stationary o2 contents, gas |
7,772 |
6,884 |
$351K |
| E0424 |
Stationary compressed gas 02 |
3,896 |
3,530 |
$318K |
| A7031 |
Replacement facemask interfa |
10,261 |
8,727 |
$311K |
| A4624 |
Tracheal suction tube |
1,345 |
1,097 |
$301K |
| E0562 |
Humidifier heated used w pap |
2,328 |
1,926 |
$294K |
| E0431 |
Portable gaseous 02 |
19,895 |
17,405 |
$259K |
| A7034 |
Nasal application device |
4,715 |
3,986 |
$219K |
| E0471 |
Rad w/backup non inv intrfc |
586 |
510 |
$209K |
| E1392 |
Portable oxygen concentrator |
9,974 |
8,182 |
$189K |
| A4604 |
Tubing with heating element |
6,402 |
5,158 |
$152K |
| A7035 |
Pos airway press headgear |
7,463 |
6,457 |
$122K |
| A7526 |
Tracheostomy tube collar |
1,421 |
1,240 |
$107K |
| E0600 |
Suction pump portab hom modl |
1,989 |
1,851 |
$98K |
| A7520 |
Trach/laryn tube non-cuffed |
1,331 |
860 |
$88K |
| E0470 |
Rad w/o backup non-inv intfc |
769 |
651 |
$83K |
| A7032 |
Replacement nasal cushion |
3,854 |
3,217 |
$74K |
| A7038 |
Pos airway pressure filter |
17,387 |
14,639 |
$74K |
| A7037 |
Pos airway pressure tubing |
4,319 |
3,751 |
$72K |
| A7046 |
Repl water chamber, pap dev |
6,922 |
5,921 |
$72K |
| A9999 |
Dme supply or accessory, nos |
5,434 |
2,082 |
$54K |
| A4481 |
Tracheostoma filter |
460 |
398 |
$46K |
| A4216 |
Sterile water/saline, 10 ml |
1,407 |
1,005 |
$38K |
| E0570 |
Nebulizer with compression |
3,519 |
2,926 |
$32K |
| A7033 |
Replacement nasal pillows |
1,755 |
1,453 |
$25K |
| A4629 |
Tracheostomy care kit |
354 |
295 |
$18K |
| K0001 |
Standard wheelchair |
1,561 |
1,134 |
$17K |
| A4605 |
Trach suction cath close sys |
206 |
145 |
$13K |
| A4927 |
Non-sterile gloves |
1,021 |
655 |
$13K |
| A7002 |
Tubing used w suction pump |
2,797 |
2,117 |
$13K |
| A7000 |
Disposable canister for pump |
3,008 |
2,528 |
$11K |
| A4628 |
Oropharyngeal suction cath |
2,592 |
2,043 |
$10K |
| A6402 |
Sterile gauze <= 16 sq in |
799 |
595 |
$9K |
| E0260 |
Hosp bed semi-electr w/ matt |
391 |
278 |
$8K |
| E0143 |
Walker folding wheeled w/o s |
487 |
335 |
$8K |
| K0002 |
Stnd hemi (low seat) whlchr |
510 |
331 |
$5K |
| A7003 |
Nebulizer administration set |
1,863 |
1,584 |
$5K |
| A4618 |
Breathing circuits |
470 |
381 |
$4K |
| E0971 |
Wheelchair anti-tipping devi |
1,770 |
662 |
$4K |
| A7005 |
Nondisposable nebulizer set |
388 |
296 |
$4K |
| E2601 |
Gen w/c cushion wdth < 22 in |
238 |
175 |
$4K |
| K0195 |
Elevating whlchair leg rests |
544 |
407 |
$2K |
| A4483 |
Moisture exchanger |
34 |
25 |
$2K |
| E2611 |
Gen use back cush wdth <22in |
22 |
12 |
$955.31 |
| E0951 |
Loop heel |
1,330 |
483 |
$922.50 |
| S8189 |
Trach supply noc |
106 |
52 |
$736.63 |
| E0114 |
Crutch underarm pair no wood |
14 |
13 |
$557.25 |
| A7039 |
Filter, non disposable w pap |
112 |
93 |
$435.61 |
| A7045 |
Repl exhalation port for pap |
36 |
27 |
$310.24 |
| S8186 |
Swivel adaptor |
38 |
24 |
$248.55 |
| A7020 |
Interface, cough stim device |
18 |
13 |
$148.75 |
| A7015 |
Aerosol mask used w nebulize |
30 |
29 |
$26.02 |