| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E0465 |
Home vent invasive interface |
2,783 |
1,287 |
$1.09M |
| E1390 |
Oxygen concentrator |
13,518 |
10,331 |
$593K |
| A7030 |
Cpap full face mask |
5,845 |
4,696 |
$492K |
| E0601 |
Cont airway pressure device |
11,623 |
9,543 |
$452K |
| E0603 |
Electric breast pump |
2,747 |
2,423 |
$363K |
| A7034 |
Nasal application device |
5,632 |
4,534 |
$283K |
| E0562 |
Humidifier heated used w pap |
10,799 |
8,683 |
$260K |
| E0431 |
Portable gaseous 02 |
6,429 |
5,119 |
$224K |
| A7031 |
Replacement facemask interfa |
5,165 |
4,089 |
$181K |
| A7035 |
Pos airway press headgear |
9,103 |
7,459 |
$179K |
| A7037 |
Pos airway pressure tubing |
7,332 |
6,193 |
$157K |
| A4624 |
Tracheal suction tube |
1,264 |
830 |
$70K |
| A7038 |
Pos airway pressure filter |
11,684 |
9,347 |
$58K |
| E0202 |
Phototherapy light w/ photom |
101 |
85 |
$48K |
| A4606 |
Oxygen probe used w oximeter |
1,784 |
938 |
$48K |
| E0570 |
Nebulizer with compression |
4,693 |
3,801 |
$46K |
| A7032 |
Replacement nasal cushion |
2,920 |
2,314 |
$45K |
| A7046 |
Repl water chamber, pap dev |
7,048 |
5,405 |
$43K |
| E0470 |
Rad w/o backup non-inv intfc |
793 |
647 |
$41K |
| A7526 |
Tracheostomy tube collar |
1,523 |
1,063 |
$38K |
| A7033 |
Replacement nasal pillows |
1,760 |
1,390 |
$30K |
| K0001 |
Standard wheelchair |
3,403 |
2,632 |
$29K |
| E0143 |
Walker folding wheeled w/o s |
1,459 |
1,088 |
$26K |
| E0482 |
Cough stimulating device |
231 |
157 |
$24K |
| E0445 |
Oximeter non-invasive |
681 |
455 |
$23K |
| A6402 |
Sterile gauze <= 16 sq in |
2,144 |
1,326 |
$22K |
| A4604 |
Tubing with heating element |
3,497 |
2,725 |
$21K |
| A6530 |
Compression stocking bk18-30 |
821 |
312 |
$21K |
| K0738 |
Portable gas oxygen system |
3,620 |
2,945 |
$21K |
| E0600 |
Suction pump portab hom modl |
1,165 |
879 |
$20K |
| E0260 |
Hosp bed semi-electr w/ matt |
1,500 |
1,087 |
$20K |
| A4927 |
Non-sterile gloves |
2,652 |
1,463 |
$18K |
| A7520 |
Trach/laryn tube non-cuffed |
570 |
379 |
$15K |
| A4409 |
Ost skn barr convex <=4 sq i |
266 |
222 |
$10K |
| E0149 |
Heavy duty wheeled walker |
843 |
642 |
$8K |
| A7039 |
Filter, non disposable w pap |
1,661 |
1,344 |
$8K |
| A4385 |
Ost skn barrier sld ext wear |
440 |
314 |
$8K |
| A4456 |
Adhesive remover, wipes |
1,956 |
1,506 |
$7K |
| A6216 |
Non-sterile gauze<=16 sq in |
916 |
562 |
$7K |
| A7000 |
Disposable canister for pump |
1,740 |
1,259 |
$6K |
| A4618 |
Breathing circuits |
626 |
449 |
$6K |
| A7003 |
Nebulizer administration set |
3,191 |
2,127 |
$6K |
| E0156 |
Walker seat attachment |
815 |
583 |
$6K |
| A5120 |
Skin barrier, wipe or swab |
2,023 |
1,540 |
$6K |
| E0245 |
Tub stool or bench |
139 |
115 |
$5K |
| E0604 |
Hosp grade elec breast pump |
358 |
233 |
$5K |
| A4670 |
Automatic bp monitor, dial |
81 |
81 |
$5K |
| A4362 |
Solid skin barrier |
186 |
139 |
$4K |
| E0471 |
Rad w/backup non inv intrfc |
15 |
12 |
$3K |
| A4351 |
Straight tip urine catheter |
97 |
77 |
$3K |
| A4628 |
Oropharyngeal suction cath |
593 |
430 |
$3K |
| A7002 |
Tubing used w suction pump |
429 |
316 |
$2K |
| A4357 |
Bedside drainage bag |
782 |
572 |
$2K |
| A4217 |
Sterile water/saline, 500 ml |
351 |
234 |
$2K |
| A4407 |
Ext wear ost skn barr <=4sq" |
53 |
37 |
$2K |
| A4425 |
Ost pch drain for barrier fl |
73 |
61 |
$2K |
| A4629 |
Tracheostomy care kit |
115 |
76 |
$2K |
| A7007 |
Lg vol nebulizer disposable |
199 |
86 |
$2K |
| E0247 |
Trans bench w/wo comm open |
22 |
13 |
$1K |
| A4452 |
Waterproof tape |
272 |
200 |
$1K |
| E1226 |
Manual fully reclining back |
61 |
37 |
$1K |
| A7036 |
Pos airway press chinstrap |
86 |
73 |
$599.77 |
| B4152 |
Ef calorie dense>/=1.5kcal |
202 |
106 |
$573.49 |
| K0739 |
Repair/svc dme non-oxygen eq |
78 |
44 |
$521.19 |
| A5063 |
Drain ostomy pouch w/flange |
14 |
13 |
$473.76 |
| K0195 |
Elevating whlchair leg rests |
340 |
253 |
$388.05 |
| E0971 |
Wheelchair anti-tipping devi |
286 |
117 |
$380.00 |
| K0007 |
Extra heavy duty wheelchair |
13 |
12 |
$282.94 |
| K0003 |
Lightweight wheelchair |
41 |
24 |
$260.75 |
| A7013 |
Disposable compressor filter |
225 |
158 |
$227.99 |
| E0565 |
Compressor air power source |
17 |
14 |
$202.39 |
| A7521 |
Trach/laryn tube cuffed |
24 |
12 |
$156.99 |
| E0630 |
Patient lift hydraulic |
15 |
13 |
$150.98 |
| A4216 |
Sterile water/saline, 10 ml |
17 |
12 |
$130.26 |
| A7015 |
Aerosol mask used w nebulize |
41 |
29 |
$36.31 |
| A4358 |
Urinary leg or abdomen bag |
16 |
12 |
$29.69 |
| A4371 |
Skin barrier powder per oz |
20 |
14 |
$26.59 |
| A4626 |
Tracheostomy cleaning brush |
18 |
12 |
$14.82 |