| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
2,220 |
1,772 |
$93K |
| K0738 |
Portable gas oxygen system |
1,233 |
1,003 |
$63K |
| E0601 |
Cont airway pressure device |
1,239 |
1,005 |
$45K |
| B4035 |
Enteral feed supp pump per d |
298 |
207 |
$42K |
| A7030 |
Cpap full face mask |
315 |
264 |
$20K |
| E0562 |
Humidifier heated used w pap |
562 |
437 |
$20K |
| E0431 |
Portable gaseous 02 |
254 |
208 |
$18K |
| B4161 |
Ef ped hydrolyzed/amino acid |
51 |
40 |
$15K |
| E0445 |
Oximeter non-invasive |
89 |
79 |
$14K |
| E0465 |
Home vent invasive interface |
19 |
13 |
$13K |
| B9002 |
Enter nutr inf pump any type |
212 |
183 |
$11K |
| B4160 |
Ef ped caloric dense>/=0.7kc |
73 |
66 |
$11K |
| A4624 |
Tracheal suction tube |
82 |
72 |
$10K |
| E0570 |
Nebulizer with compression |
154 |
135 |
$10K |
| A7034 |
Nasal application device |
221 |
192 |
$10K |
| E0260 |
Hosp bed semi-electr w/ matt |
170 |
144 |
$8K |
| E0619 |
Apnea monitor w recorder |
50 |
49 |
$8K |
| A7507 |
Integrated filter & holder |
84 |
75 |
$8K |
| E0470 |
Rad w/o backup non-inv intfc |
189 |
149 |
$8K |
| A7035 |
Pos airway press headgear |
469 |
403 |
$7K |
| K0001 |
Standard wheelchair |
413 |
355 |
$7K |
| A7037 |
Pos airway pressure tubing |
377 |
293 |
$6K |
| E0143 |
Walker folding wheeled w/o s |
139 |
111 |
$5K |
| A7526 |
Tracheostomy tube collar |
107 |
99 |
$4K |
| B4088 |
Gastro/jejuno tube, low-pro |
33 |
32 |
$3K |
| A7031 |
Replacement facemask interfa |
141 |
136 |
$3K |
| A4605 |
Trach suction cath close sys |
34 |
33 |
$3K |
| A4629 |
Tracheostomy care kit |
63 |
53 |
$3K |
| A7038 |
Pos airway pressure filter |
586 |
498 |
$3K |
| E0255 |
Hospital bed var ht w/ mattr |
112 |
109 |
$2K |
| A4604 |
Tubing with heating element |
181 |
181 |
$2K |
| A4216 |
Sterile water/saline, 10 ml |
61 |
59 |
$2K |
| E0630 |
Patient lift hydraulic |
95 |
95 |
$2K |
| A7039 |
Filter, non disposable w pap |
316 |
267 |
$2K |
| K0003 |
Lightweight wheelchair |
32 |
26 |
$2K |
| K0195 |
Elevating whlchair leg rests |
196 |
176 |
$2K |
| A4606 |
Oxygen probe used w oximeter |
83 |
62 |
$1K |
| E0776 |
Iv pole |
75 |
68 |
$620.39 |
| A7033 |
Replacement nasal pillows |
26 |
26 |
$613.77 |
| A6402 |
Sterile gauze <= 16 sq in |
73 |
64 |
$607.69 |
| A7032 |
Replacement nasal cushion |
27 |
27 |
$605.09 |
| A7046 |
Repl water chamber, pap dev |
44 |
33 |
$500.04 |
| B4034 |
Enter feed supkit syr by day |
18 |
12 |
$403.51 |
| E0149 |
Heavy duty wheeled walker |
27 |
27 |
$313.81 |
| A4217 |
Sterile water/saline, 500 ml |
64 |
58 |
$272.69 |
| A4628 |
Oropharyngeal suction cath |
66 |
63 |
$171.97 |
| A7002 |
Tubing used w suction pump |
55 |
53 |
$159.57 |
| A7005 |
Nondisposable nebulizer set |
14 |
14 |
$155.82 |
| Z0020 |
|
43 |
38 |
$111.54 |
| S8189 |
Trach supply noc |
16 |
12 |
$95.00 |
| A7003 |
Nebulizer administration set |
12 |
12 |
$48.93 |
| E0971 |
Wheelchair anti-tipping devi |
40 |
37 |
$38.43 |