| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E0465 |
Home vent invasive interface |
883 |
800 |
$1.10M |
| B4035 |
Enteral feed supp pump per d |
1,858 |
1,510 |
$301K |
| A4414 |
Ost sknbar w/o conv<=4 sq in |
3,751 |
3,061 |
$282K |
| E1390 |
Oxygen concentrator |
2,882 |
2,645 |
$217K |
| E0445 |
Oximeter non-invasive |
1,186 |
1,088 |
$215K |
| E0260 |
Hosp bed semi-electr w/ matt |
2,516 |
2,250 |
$154K |
| A5063 |
Drain ostomy pouch w/flange |
3,476 |
2,928 |
$149K |
| A5131 |
Appliance cleaner |
3,978 |
3,362 |
$144K |
| B9002 |
Enter nutr inf pump any type |
1,948 |
1,684 |
$132K |
| E0431 |
Portable gaseous 02 |
3,260 |
2,854 |
$76K |
| A4406 |
Pectin based ostomy paste |
4,091 |
3,337 |
$75K |
| E0601 |
Cont airway pressure device |
1,478 |
1,316 |
$72K |
| B4152 |
Ef calorie dense>/=1.5kcal |
339 |
246 |
$45K |
| E0562 |
Humidifier heated used w pap |
2,062 |
1,877 |
$33K |
| K0001 |
Standard wheelchair |
1,212 |
1,116 |
$30K |
| A4624 |
Tracheal suction tube |
403 |
326 |
$30K |
| E0600 |
Suction pump portab hom modl |
872 |
783 |
$26K |
| A4452 |
Waterproof tape |
2,303 |
1,951 |
$26K |
| B4034 |
Enter feed supkit syr by day |
259 |
209 |
$22K |
| E0776 |
Iv pole |
1,919 |
1,677 |
$21K |
| A4456 |
Adhesive remover, wipes |
4,257 |
3,604 |
$19K |
| A4629 |
Tracheostomy care kit |
295 |
232 |
$17K |
| A7520 |
Trach/laryn tube non-cuffed |
265 |
218 |
$16K |
| A4367 |
Ostomy belt |
2,420 |
2,072 |
$13K |
| A7037 |
Pos airway pressure tubing |
608 |
583 |
$11K |
| A7030 |
Cpap full face mask |
110 |
110 |
$10K |
| A7038 |
Pos airway pressure filter |
1,761 |
1,672 |
$9K |
| A7034 |
Nasal application device |
143 |
143 |
$9K |
| E0424 |
Stationary compressed gas 02 |
179 |
160 |
$9K |
| A4409 |
Ost skn barr convex <=4 sq i |
70 |
62 |
$8K |
| A5120 |
Skin barrier, wipe or swab |
4,146 |
3,482 |
$7K |
| A4371 |
Skin barrier powder per oz |
1,853 |
1,517 |
$7K |
| A7035 |
Pos airway press headgear |
348 |
334 |
$6K |
| A7000 |
Disposable canister for pump |
792 |
683 |
$4K |
| E0471 |
Rad w/backup non inv intrfc |
12 |
12 |
$4K |
| K0195 |
Elevating whlchair leg rests |
382 |
328 |
$3K |
| A5061 |
Pouch drainable w barrier at |
53 |
49 |
$3K |
| E0181 |
Press pad alternating w/ pum |
169 |
155 |
$3K |
| A4450 |
Non-waterproof tape |
836 |
719 |
$2K |
| E0470 |
Rad w/o backup non-inv intfc |
38 |
36 |
$2K |
| A7002 |
Tubing used w suction pump |
740 |
649 |
$1K |
| T1999 |
Noc retail items andsupplies |
48 |
37 |
$1K |
| A4419 |
Ost pch for bar w flange/flt |
14 |
13 |
$1K |
| E0973 |
W/ch access det adj armrest |
121 |
113 |
$739.06 |
| A7039 |
Filter, non disposable w pap |
106 |
99 |
$679.51 |
| A4425 |
Ost pch drain for barrier fl |
14 |
12 |
$618.70 |
| E0135 |
Walker folding adjust/fixed |
15 |
14 |
$536.13 |
| E0441 |
Stationary o2 contents, gas |
14 |
12 |
$529.46 |
| A7526 |
Tracheostomy tube collar |
12 |
12 |
$189.04 |