| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
5,380 |
5,308 |
$350K |
| E0465 |
Home vent invasive interface |
348 |
341 |
$158K |
| E0601 |
Cont airway pressure device |
3,168 |
3,094 |
$138K |
| E0603 |
Electric breast pump |
659 |
658 |
$95K |
| E0570 |
Nebulizer with compression |
2,177 |
2,161 |
$84K |
| A7030 |
Cpap full face mask |
1,122 |
1,115 |
$63K |
| E1392 |
Portable oxygen concentrator |
1,063 |
1,057 |
$57K |
| E0562 |
Humidifier heated used w pap |
1,076 |
1,043 |
$45K |
| E0431 |
Portable gaseous 02 |
2,402 |
2,364 |
$38K |
| E0470 |
Rad w/o backup non-inv intfc |
238 |
233 |
$30K |
| A4624 |
Tracheal suction tube |
239 |
219 |
$28K |
| A7034 |
Nasal application device |
579 |
577 |
$15K |
| A7031 |
Replacement facemask interfa |
576 |
573 |
$14K |
| A7035 |
Pos airway press headgear |
1,333 |
1,325 |
$13K |
| E0114 |
Crutch underarm pair no wood |
616 |
614 |
$12K |
| E0143 |
Walker folding wheeled w/o s |
225 |
225 |
$11K |
| A7037 |
Pos airway pressure tubing |
1,446 |
1,443 |
$10K |
| K0001 |
Standard wheelchair |
411 |
397 |
$8K |
| K0738 |
Portable gas oxygen system |
656 |
654 |
$5K |
| A7038 |
Pos airway pressure filter |
2,283 |
2,268 |
$5K |
| A7520 |
Trach/laryn tube non-cuffed |
110 |
108 |
$4K |
| A7032 |
Replacement nasal cushion |
176 |
176 |
$3K |
| A7000 |
Disposable canister for pump |
316 |
301 |
$3K |
| A7003 |
Nebulizer administration set |
1,266 |
1,240 |
$3K |
| A7039 |
Filter, non disposable w pap |
1,203 |
1,199 |
$3K |
| E0260 |
Hosp bed semi-electr w/ matt |
196 |
194 |
$2K |
| A4217 |
Sterile water/saline, 500 ml |
195 |
175 |
$2K |
| E0445 |
Oximeter non-invasive |
12 |
12 |
$2K |
| A7002 |
Tubing used w suction pump |
615 |
389 |
$1K |
| A6402 |
Sterile gauze <= 16 sq in |
176 |
156 |
$1K |
| A4629 |
Tracheostomy care kit |
12 |
12 |
$568.06 |
| L1902 |
Afo ankle gauntlet pre ots |
12 |
12 |
$418.85 |
| A7046 |
Repl water chamber, pap dev |
198 |
198 |
$383.50 |
| A4927 |
Non-sterile gloves |
61 |
58 |
$204.55 |
| A4618 |
Breathing circuits |
41 |
37 |
$161.01 |
| A7007 |
Lg vol nebulizer disposable |
13 |
13 |
$95.62 |
| A7015 |
Aerosol mask used w nebulize |
97 |
94 |
$89.17 |
| A4604 |
Tubing with heating element |
12 |
12 |
$26.89 |