| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E0465 |
Home vent invasive interface |
5,064 |
2,546 |
$3.42M |
| E1390 |
Oxygen concentrator |
5,120 |
4,882 |
$702K |
| E0466 |
Home vent non-invasive inter |
806 |
661 |
$651K |
| A4624 |
Tracheal suction tube |
1,376 |
1,303 |
$432K |
| E0482 |
Cough stimulating device |
655 |
607 |
$275K |
| A4217 |
Sterile water/saline, 500 ml |
1,924 |
1,782 |
$249K |
| A4605 |
Trach suction cath close sys |
777 |
670 |
$235K |
| A4606 |
Oxygen probe used w oximeter |
3,003 |
2,872 |
$213K |
| A7526 |
Tracheostomy tube collar |
2,032 |
1,878 |
$194K |
| A6251 |
Absorpt drg <=16 sq in w/o b |
1,014 |
958 |
$137K |
| E0431 |
Portable gaseous 02 |
5,363 |
5,110 |
$135K |
| E0600 |
Suction pump portab hom modl |
2,487 |
2,380 |
$129K |
| A7509 |
Heat & moisture exchange sys |
1,796 |
1,584 |
$127K |
| A6209 |
Foam drsg <=16 sq in w/o bdr |
490 |
447 |
$121K |
| A7000 |
Disposable canister for pump |
2,857 |
2,723 |
$102K |
| A6402 |
Sterile gauze <= 16 sq in |
1,810 |
1,733 |
$89K |
| A7002 |
Tubing used w suction pump |
3,205 |
3,033 |
$72K |
| A4216 |
Sterile water/saline, 10 ml |
2,272 |
2,105 |
$68K |
| A7520 |
Trach/laryn tube non-cuffed |
849 |
786 |
$52K |
| K0003 |
Lightweight wheelchair |
600 |
576 |
$45K |
| A4927 |
Non-sterile gloves |
2,420 |
2,323 |
$37K |
| A7521 |
Trach/laryn tube cuffed |
654 |
582 |
$36K |
| E0439 |
Stationary liquid 02 |
280 |
261 |
$35K |
| A9900 |
Supply/accessory/service |
2,001 |
1,858 |
$34K |
| A4628 |
Oropharyngeal suction cath |
1,375 |
1,312 |
$19K |
| A6453 |
Self-adher band w <3"/yd |
862 |
828 |
$15K |
| E0471 |
Rad w/backup non inv intrfc |
28 |
26 |
$14K |
| A4627 |
Spacer bag/reservoir |
311 |
289 |
$8K |
| A7046 |
Repl water chamber, pap dev |
441 |
415 |
$7K |
| E0445 |
Oximeter non-invasive |
14 |
13 |
$6K |
| E0434 |
Portable liquid 02 |
168 |
160 |
$5K |
| S8189 |
Trach supply noc |
83 |
76 |
$4K |
| A7004 |
Disposable nebulizer sml vol |
1,103 |
1,047 |
$4K |
| A6211 |
Foam drg > 48 sq in w/o brdr |
12 |
12 |
$4K |
| A7034 |
Nasal application device |
36 |
36 |
$3K |
| A6216 |
Non-sterile gauze<=16 sq in |
234 |
227 |
$2K |
| A9999 |
Dme supply or accessory, nos |
540 |
495 |
$2K |
| E1060 |
Wheelchair detachable arms |
15 |
12 |
$2K |
| A7037 |
Pos airway pressure tubing |
30 |
28 |
$1K |
| A7013 |
Disposable compressor filter |
514 |
475 |
$803.73 |
| A7525 |
Tracheostomy mask |
165 |
157 |
$759.65 |
| E0442 |
Stationary o2 contents, liq |
15 |
12 |
$730.09 |
| E0565 |
Compressor air power source |
12 |
12 |
$708.81 |
| A7038 |
Pos airway pressure filter |
70 |
69 |
$684.54 |
| A4452 |
Waterproof tape |
112 |
103 |
$568.94 |
| A4245 |
Alcohol wipes per box |
215 |
214 |
$529.39 |
| A4332 |
Lube sterile packet |
267 |
257 |
$380.40 |
| A4649 |
Surgical supplies |
25 |
25 |
$273.86 |
| A4456 |
Adhesive remover, wipes |
57 |
54 |
$155.32 |
| A4209 |
5+ cc sterile syringe&needle |
170 |
166 |
$146.25 |
| A4618 |
Breathing circuits |
12 |
12 |
$110.24 |
| A5120 |
Skin barrier, wipe or swab |
28 |
25 |
$84.37 |
| A4450 |
Non-waterproof tape |
59 |
52 |
$70.19 |
| A4208 |
3 cc sterile syringe&needle |
54 |
53 |
$46.65 |