| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E0465 |
Home vent invasive interface |
2,702 |
2,406 |
$1.53M |
| E0466 |
Home vent non-invasive inter |
1,431 |
1,239 |
$855K |
| E1390 |
Oxygen concentrator |
10,135 |
9,755 |
$641K |
| A4624 |
Tracheal suction tube |
3,116 |
2,277 |
$449K |
| A7030 |
Cpap full face mask |
5,502 |
5,178 |
$429K |
| E0601 |
Cont airway pressure device |
6,780 |
6,403 |
$367K |
| A4606 |
Oxygen probe used w oximeter |
6,395 |
3,238 |
$271K |
| A4604 |
Tubing with heating element |
7,634 |
7,218 |
$266K |
| A7521 |
Trach/laryn tube cuffed |
1,665 |
1,066 |
$245K |
| A7031 |
Replacement facemask interfa |
7,854 |
7,285 |
$243K |
| B4035 |
Enteral feed supp pump per d |
1,290 |
1,075 |
$230K |
| A7520 |
Trach/laryn tube non-cuffed |
2,343 |
1,328 |
$230K |
| A7526 |
Tracheostomy tube collar |
3,403 |
2,622 |
$202K |
| A7507 |
Integrated filter & holder |
3,267 |
1,881 |
$180K |
| E0562 |
Humidifier heated used w pap |
7,032 |
6,712 |
$166K |
| A7034 |
Nasal application device |
3,116 |
2,982 |
$159K |
| E1399 |
Durable medical equipment mi |
2,905 |
2,753 |
$119K |
| E0445 |
Oximeter non-invasive |
1,075 |
903 |
$116K |
| A7032 |
Replacement nasal cushion |
3,548 |
3,373 |
$107K |
| A7000 |
Disposable canister for pump |
4,237 |
3,579 |
$102K |
| E0470 |
Rad w/o backup non-inv intfc |
629 |
594 |
$93K |
| A7035 |
Pos airway press headgear |
5,207 |
4,970 |
$89K |
| A4629 |
Tracheostomy care kit |
1,123 |
941 |
$72K |
| A7038 |
Pos airway pressure filter |
17,567 |
16,457 |
$66K |
| E0431 |
Portable gaseous 02 |
4,252 |
4,132 |
$63K |
| A7033 |
Replacement nasal pillows |
2,470 |
2,327 |
$61K |
| B9998 |
Enteral supp not otherwise c |
534 |
485 |
$60K |
| E0570 |
Nebulizer with compression |
1,120 |
1,093 |
$49K |
| A7046 |
Repl water chamber, pap dev |
4,105 |
3,862 |
$45K |
| A4217 |
Sterile water/saline, 500 ml |
1,547 |
1,121 |
$42K |
| E0600 |
Suction pump portab hom modl |
1,278 |
1,194 |
$36K |
| A6251 |
Absorpt drg <=16 sq in w/o b |
793 |
585 |
$31K |
| A4623 |
Tracheostomy inner cannula |
832 |
387 |
$30K |
| A4628 |
Oropharyngeal suction cath |
2,893 |
2,366 |
$27K |
| A7005 |
Nondisposable nebulizer set |
1,434 |
1,338 |
$23K |
| A6402 |
Sterile gauze <= 16 sq in |
2,086 |
1,594 |
$22K |
| K0001 |
Standard wheelchair |
862 |
812 |
$13K |
| A4927 |
Non-sterile gloves |
966 |
733 |
$12K |
| A7002 |
Tubing used w suction pump |
2,927 |
2,281 |
$11K |
| A7003 |
Nebulizer administration set |
3,049 |
2,607 |
$11K |
| A7037 |
Pos airway pressure tubing |
1,031 |
924 |
$9K |
| A7525 |
Tracheostomy mask |
1,512 |
1,265 |
$7K |
| K0195 |
Elevating whlchair leg rests |
786 |
765 |
$7K |
| A7007 |
Lg vol nebulizer disposable |
575 |
494 |
$5K |
| E0471 |
Rad w/backup non inv intrfc |
13 |
13 |
$3K |
| A7015 |
Aerosol mask used w nebulize |
1,860 |
1,674 |
$3K |
| A7039 |
Filter, non disposable w pap |
218 |
199 |
$996.24 |
| A7020 |
Interface, cough stim device |
96 |
76 |
$851.92 |
| E0978 |
W/c acc,saf belt pelv strap |
249 |
237 |
$655.93 |
| B4088 |
Gastro/jejuno tube, low-pro |
12 |
12 |
$294.00 |
| E0260 |
Hosp bed semi-electr w/ matt |
12 |
12 |
$61.29 |
| B4224 |
Parenteral administration ki |
15 |
12 |
$0.00 |
| B4220 |
Parenteral supply kit premix |
15 |
12 |
$0.00 |