| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
10,921 |
9,476 |
$441K |
| A4624 |
Tracheal suction tube |
653 |
492 |
$222K |
| E0465 |
Home vent invasive interface |
530 |
268 |
$212K |
| E0466 |
Home vent non-invasive inter |
455 |
316 |
$97K |
| A7526 |
Tracheostomy tube collar |
1,405 |
1,082 |
$76K |
| E0443 |
Portable 02 contents, gas |
1,617 |
703 |
$76K |
| E0431 |
Portable gaseous 02 |
6,835 |
5,896 |
$70K |
| A4629 |
Tracheostomy care kit |
711 |
566 |
$59K |
| B4035 |
Enteral feed supp pump per d |
373 |
240 |
$54K |
| A7520 |
Trach/laryn tube non-cuffed |
317 |
172 |
$25K |
| E0570 |
Nebulizer with compression |
1,770 |
1,491 |
$18K |
| E0445 |
Oximeter non-invasive |
333 |
195 |
$15K |
| A7000 |
Disposable canister for pump |
1,479 |
1,053 |
$14K |
| A4927 |
Non-sterile gloves |
846 |
598 |
$11K |
| A7509 |
Heat & moisture exchange sys |
110 |
79 |
$10K |
| A4628 |
Oropharyngeal suction cath |
728 |
574 |
$6K |
| E0565 |
Compressor air power source |
220 |
155 |
$5K |
| B9998 |
Enteral supp not otherwise c |
347 |
178 |
$5K |
| A4217 |
Sterile water/saline, 500 ml |
130 |
98 |
$5K |
| A6402 |
Sterile gauze <= 16 sq in |
248 |
199 |
$3K |
| A7003 |
Nebulizer administration set |
1,882 |
1,500 |
$3K |
| A7002 |
Tubing used w suction pump |
1,833 |
1,013 |
$3K |
| B4088 |
Gastro/jejuno tube, low-pro |
19 |
12 |
$2K |
| J7620 |
Albuterol ipratrop non-comp |
575 |
512 |
$2K |
| E1372 |
Oxy suppl heater for nebuliz |
138 |
106 |
$1K |
| E0601 |
Cont airway pressure device |
168 |
114 |
$1K |
| Q0513 |
Disp fee inhal drugs/30 days |
55 |
48 |
$894.67 |
| A4402 |
Lubricant per ounce |
485 |
339 |
$874.34 |
| E0562 |
Humidifier heated used w pap |
196 |
138 |
$770.89 |
| A4216 |
Sterile water/saline, 10 ml |
52 |
38 |
$320.90 |
| A4245 |
Alcohol wipes per box |
153 |
130 |
$319.96 |
| A4452 |
Waterproof tape |
47 |
37 |
$200.71 |
| J7613 |
Albuterol non-comp unit |
14 |
12 |
$90.96 |
| A7046 |
Repl water chamber, pap dev |
32 |
27 |
$75.94 |