| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
29,423 |
24,535 |
$2.57M |
| B4035 |
Enteral feed supp pump per d |
13,244 |
12,154 |
$2.35M |
| E0601 |
Cont airway pressure device |
35,701 |
32,681 |
$1.98M |
| A7030 |
Cpap full face mask |
11,900 |
11,240 |
$1.57M |
| B4160 |
Ef ped caloric dense>/=0.7kc |
7,346 |
6,129 |
$1.38M |
| B4149 |
Ef blenderized foods |
2,885 |
2,385 |
$1.18M |
| B4161 |
Ef ped hydrolyzed/amino acid |
2,299 |
1,897 |
$972K |
| B4088 |
Gastro/jejuno tube, low-pro |
10,948 |
8,118 |
$904K |
| E0562 |
Humidifier heated used w pap |
32,981 |
29,891 |
$883K |
| A7034 |
Nasal application device |
8,482 |
8,046 |
$705K |
| E0431 |
Portable gaseous 02 |
17,966 |
15,363 |
$687K |
| B4152 |
Ef calorie dense>/=1.5kcal |
3,563 |
2,872 |
$635K |
| E0465 |
Home vent invasive interface |
1,143 |
647 |
$629K |
| A7035 |
Pos airway press headgear |
19,611 |
18,434 |
$548K |
| A7037 |
Pos airway pressure tubing |
18,347 |
17,489 |
$496K |
| B4150 |
Ef complet w/intact nutrient |
2,513 |
1,964 |
$406K |
| E0470 |
Rad w/o backup non-inv intfc |
2,935 |
2,595 |
$268K |
| B9002 |
Enter nutr inf pump any type |
3,621 |
3,060 |
$219K |
| E0570 |
Nebulizer with compression |
5,989 |
5,136 |
$217K |
| T1999 |
Noc retail items andsupplies |
17,637 |
2,874 |
$182K |
| B4158 |
Ef ped complete intact nut |
1,263 |
1,144 |
$153K |
| E0143 |
Walker folding wheeled w/o s |
2,591 |
2,432 |
$144K |
| A7046 |
Repl water chamber, pap dev |
11,875 |
11,320 |
$143K |
| A4305 |
Drug delivery system >=50 ml |
1,447 |
482 |
$126K |
| A7038 |
Pos airway pressure filter |
21,071 |
19,915 |
$122K |
| B4034 |
Enter feed supkit syr by day |
1,906 |
1,630 |
$121K |
| A4624 |
Tracheal suction tube |
1,061 |
897 |
$119K |
| K0001 |
Standard wheelchair |
3,924 |
3,599 |
$116K |
| A4606 |
Oxygen probe used w oximeter |
2,079 |
1,667 |
$98K |
| A7526 |
Tracheostomy tube collar |
1,328 |
1,124 |
$97K |
| E0245 |
Tub stool or bench |
1,804 |
1,703 |
$92K |
| E0471 |
Rad w/backup non inv intrfc |
348 |
324 |
$87K |
| A7031 |
Replacement facemask interfa |
2,602 |
2,354 |
$78K |
| E1392 |
Portable oxygen concentrator |
4,086 |
3,617 |
$77K |
| E0260 |
Hosp bed semi-electr w/ matt |
1,463 |
1,327 |
$75K |
| A4483 |
Moisture exchanger |
453 |
407 |
$64K |
| E0445 |
Oximeter non-invasive |
1,144 |
959 |
$58K |
| A7008 |
Disposable nebulizer prefill |
622 |
531 |
$57K |
| E0114 |
Crutch underarm pair no wood |
1,498 |
1,457 |
$55K |
| B4155 |
Ef incomplete/modular |
1,453 |
1,250 |
$55K |
| A7005 |
Nondisposable nebulizer set |
2,486 |
2,361 |
$42K |
| E0600 |
Suction pump portab hom modl |
1,541 |
1,343 |
$42K |
| B4153 |
Ef hydrolyzed/amino acids |
77 |
61 |
$42K |
| A9276 |
Disposable sensor, cgm sys |
147 |
124 |
$36K |
| A4322 |
Irrigation syringe |
3,070 |
2,712 |
$29K |
| B4036 |
Enteral feed sup kit grav by |
261 |
223 |
$28K |
| S1015 |
Iv tubing extension set |
4,580 |
1,921 |
$25K |
| A6209 |
Foam drsg <=16 sq in w/o bdr |
642 |
413 |
$23K |
| E0156 |
Walker seat attachment |
1,447 |
1,349 |
$23K |
| A4216 |
Sterile water/saline, 10 ml |
6,197 |
3,043 |
$23K |
| A7520 |
Trach/laryn tube non-cuffed |
423 |
404 |
$21K |
| E1399 |
Durable medical equipment mi |
901 |
505 |
$19K |
| A4618 |
Breathing circuits |
537 |
442 |
$17K |
| A7000 |
Disposable canister for pump |
1,728 |
1,550 |
$16K |
| E0619 |
Apnea monitor w recorder |
136 |
123 |
$16K |
| E0244 |
Toilet seat raised |
442 |
428 |
$15K |
| A4623 |
Tracheostomy inner cannula |
83 |
74 |
$15K |
| A4628 |
Oropharyngeal suction cath |
1,101 |
986 |
$12K |
| 94762 |
|
221 |
200 |
$12K |
| A6402 |
Sterile gauze <= 16 sq in |
811 |
690 |
$12K |
| A4213 |
20+ cc syringe only |
1,876 |
994 |
$12K |
| A7002 |
Tubing used w suction pump |
1,169 |
1,068 |
$11K |
| A7003 |
Nebulizer administration set |
2,398 |
2,102 |
$11K |
| E0100 |
Cane adjust/fixed with tip |
558 |
535 |
$10K |
| E0149 |
Heavy duty wheeled walker |
619 |
542 |
$9K |
| A7032 |
Replacement nasal cushion |
479 |
421 |
$8K |
| A4604 |
Tubing with heating element |
1,291 |
1,194 |
$7K |
| A4230 |
Infus insulin pump non needl |
83 |
62 |
$7K |
| A4927 |
Non-sterile gloves |
1,026 |
708 |
$7K |
| K0006 |
Heavy duty wheelchair |
172 |
152 |
$6K |
| A4320 |
Irrigation tray |
297 |
257 |
$6K |
| E0776 |
Iv pole |
630 |
497 |
$6K |
| E0781 |
External ambulatory infus pu |
58 |
45 |
$6K |
| E0247 |
Trans bench w/wo comm open |
48 |
40 |
$5K |
| A7013 |
Disposable compressor filter |
3,804 |
3,615 |
$5K |
| E0630 |
Patient lift hydraulic |
60 |
58 |
$4K |
| A4629 |
Tracheostomy care kit |
41 |
37 |
$4K |
| A7033 |
Replacement nasal pillows |
198 |
181 |
$3K |
| A4217 |
Sterile water/saline, 500 ml |
115 |
91 |
$3K |
| A7525 |
Tracheostomy mask |
282 |
228 |
$2K |
| E0443 |
Portable 02 contents, gas |
154 |
147 |
$2K |
| A4232 |
Syringe w/needle insulin 3cc |
83 |
62 |
$2K |
| A4209 |
5+ cc sterile syringe&needle |
761 |
465 |
$2K |
| K0007 |
Extra heavy duty wheelchair |
36 |
26 |
$2K |
| A7015 |
Aerosol mask used w nebulize |
739 |
677 |
$1K |
| A4930 |
Sterile, gloves per pair |
1,245 |
588 |
$717.43 |
| A4452 |
Waterproof tape |
177 |
164 |
$717.28 |
| E0163 |
Commode chair with fixed arm |
15 |
14 |
$701.70 |
| A7036 |
Pos airway press chinstrap |
61 |
54 |
$696.84 |
| A4332 |
Lube sterile packet |
1,007 |
901 |
$684.48 |
| A7018 |
Water distilled w/nebulizer |
19 |
15 |
$650.52 |
| E0241 |
Bath tub wall rail |
13 |
13 |
$347.24 |
| A4626 |
Tracheostomy cleaning brush |
228 |
169 |
$85.77 |
| A9270 |
Non-covered item or service |
70 |
67 |
$0.00 |