| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E0601 |
Cont airway pressure device |
1,037 |
870 |
$273K |
| E1390 |
Oxygen concentrator |
3,776 |
3,326 |
$246K |
| E0570 |
Nebulizer with compression |
1,133 |
1,077 |
$142K |
| S8189 |
Trach supply noc |
1,728 |
367 |
$112K |
| E0445 |
Oximeter non-invasive |
353 |
321 |
$75K |
| A7030 |
Cpap full face mask |
594 |
563 |
$46K |
| E1399 |
Durable medical equipment mi |
368 |
229 |
$44K |
| E0562 |
Humidifier heated used w pap |
1,114 |
945 |
$40K |
| E0431 |
Portable gaseous 02 |
2,353 |
2,177 |
$34K |
| A4606 |
Oxygen probe used w oximeter |
242 |
222 |
$34K |
| A4624 |
Tracheal suction tube |
172 |
154 |
$31K |
| A4217 |
Sterile water/saline, 500 ml |
254 |
215 |
$29K |
| A7526 |
Tracheostomy tube collar |
253 |
232 |
$26K |
| A7035 |
Pos airway press headgear |
1,105 |
1,053 |
$19K |
| A4604 |
Tubing with heating element |
430 |
410 |
$15K |
| A7005 |
Nondisposable nebulizer set |
1,459 |
1,390 |
$14K |
| A4629 |
Tracheostomy care kit |
115 |
109 |
$14K |
| A4618 |
Breathing circuits |
228 |
207 |
$12K |
| B9998 |
Enteral supp not otherwise c |
74 |
37 |
$11K |
| A7507 |
Integrated filter & holder |
76 |
68 |
$11K |
| A7034 |
Nasal application device |
209 |
199 |
$11K |
| A7031 |
Replacement facemask interfa |
288 |
276 |
$9K |
| A7520 |
Trach/laryn tube non-cuffed |
57 |
52 |
$8K |
| A7000 |
Disposable canister for pump |
340 |
313 |
$8K |
| A4627 |
Spacer bag/reservoir |
289 |
284 |
$7K |
| K0001 |
Standard wheelchair |
100 |
88 |
$6K |
| A7006 |
Filtered nebulizer admin set |
971 |
925 |
$6K |
| E0600 |
Suction pump portab hom modl |
76 |
49 |
$5K |
| A7003 |
Nebulizer administration set |
1,856 |
1,765 |
$5K |
| A7002 |
Tubing used w suction pump |
341 |
309 |
$5K |
| A4628 |
Oropharyngeal suction cath |
245 |
226 |
$4K |
| A7038 |
Pos airway pressure filter |
2,071 |
1,986 |
$4K |
| E0443 |
Portable 02 contents, gas |
84 |
81 |
$4K |
| A7015 |
Aerosol mask used w nebulize |
2,235 |
2,120 |
$4K |
| A7037 |
Pos airway pressure tubing |
263 |
250 |
$3K |
| A6402 |
Sterile gauze <= 16 sq in |
231 |
215 |
$3K |
| A7014 |
Compressor nondispos filter |
885 |
848 |
$2K |
| A4452 |
Waterproof tape |
167 |
151 |
$2K |
| A4216 |
Sterile water/saline, 10 ml |
116 |
106 |
$2K |
| A7046 |
Repl water chamber, pap dev |
178 |
164 |
$2K |
| B4035 |
Enteral feed supp pump per d |
14 |
12 |
$2K |
| A4927 |
Non-sterile gloves |
225 |
205 |
$2K |
| A7525 |
Tracheostomy mask |
166 |
156 |
$1K |
| E0143 |
Walker folding wheeled w/o s |
12 |
12 |
$426.83 |
| A7013 |
Disposable compressor filter |
729 |
690 |
$344.74 |
| A7039 |
Filter, non disposable w pap |
53 |
52 |
$289.86 |
| A4332 |
Lube sterile packet |
119 |
108 |
$127.42 |