| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E0466 |
Home ventilator, any type, used with non-invasive interface, (e.g., mask, chest shell) |
1,919 |
1,848 |
$1.21M |
| E0465 |
Home ventilator, any type, used with invasive interface, (e.g., tracheostomy tube) |
1,054 |
895 |
$619K |
| E1390 |
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate |
2,404 |
2,395 |
$265K |
| A4624 |
Tracheal suction catheter, any type other than closed system, each |
856 |
788 |
$104K |
| E0445 |
Oximeter device for measuring blood oxygen levels non-invasively |
935 |
933 |
$73K |
| E0482 |
Cough stimulating device, alternating positive and negative airway pressure |
322 |
322 |
$64K |
| A7507 |
Filter holder and integrated filter without adhesive, for use in a tracheostoma heat and moisture exchange system, each |
731 |
632 |
$61K |
| A4629 |
Tracheostomy care kit for established tracheostomy |
610 |
562 |
$51K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
2,254 |
2,252 |
$44K |
| A4606 |
Oxygen probe for use with oximeter device, replacement |
768 |
652 |
$41K |
| A4605 |
Tracheal suction catheter, closed system, each |
500 |
459 |
$33K |
| E0600 |
Respiratory suction pump, home model, portable or stationary, electric |
1,164 |
1,150 |
$28K |
| A7526 |
Tracheostomy tube collar/holder, each |
971 |
885 |
$27K |
| A4927 |
Gloves, non-sterile, per 100 |
1,039 |
976 |
$23K |
| A4628 |
Oral and/or oropharyngeal suction catheter, each |
1,396 |
1,310 |
$14K |
| A7000 |
Canister, disposable, used with suction pump, each |
1,766 |
1,687 |
$13K |
| A6209 |
Foam dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
183 |
177 |
$11K |
| A4216 |
Sterile water, saline and/or dextrose, diluent/flush, 10 ml |
950 |
868 |
$11K |
| A7520 |
Tracheostomy/laryngectomy tube, non-cuffed, polyvinylchloride (pvc), silicone or equal, each |
121 |
116 |
$9K |
| E1399 |
Durable medical equipment, miscellaneous |
55 |
41 |
$8K |
| A7002 |
Tubing, used with suction pump, each |
1,437 |
1,371 |
$4K |
| E0565 |
Compressor, air power source for equipment which is not self-contained or cylinder driven |
134 |
128 |
$3K |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
1,024 |
984 |
$3K |
| A6402 |
Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
114 |
107 |
$964.27 |
| A7525 |
Tracheostomy mask, each |
462 |
450 |
$707.79 |
| A4402 |
Lubricant, per ounce |
134 |
132 |
$355.20 |
| A7007 |
Large volume nebulizer, disposable, unfilled, used with aerosol compressor |
61 |
52 |
$258.02 |
| A7010 |
Corrugated tubing, disposable, used with large volume nebulizer, 100 feet |
12 |
12 |
$149.30 |
| A7015 |
Aerosol mask, used with dme nebulizer |
26 |
25 |
$33.61 |
| A7020 |
Interface for cough stimulating device, includes all components, replacement only |
15 |
12 |
$31.58 |