| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
23,475 |
13,098 |
$1.10M |
| E0465 |
Home vent invasive interface |
1,774 |
870 |
$941K |
| E0445 |
Oximeter non-invasive |
3,470 |
2,053 |
$367K |
| B4035 |
Enteral feed supp pump per d |
2,156 |
1,123 |
$292K |
| E0466 |
Home vent non-invasive inter |
1,181 |
540 |
$243K |
| B4160 |
Ef ped caloric dense>/=0.7kc |
824 |
691 |
$119K |
| E0431 |
Portable gaseous 02 |
11,250 |
6,334 |
$99K |
| E0601 |
Cont airway pressure device |
3,753 |
2,210 |
$92K |
| A4624 |
Tracheal suction tube |
654 |
517 |
$69K |
| E1392 |
Portable oxygen concentrator |
4,590 |
2,683 |
$59K |
| A7030 |
Cpap full face mask |
680 |
489 |
$41K |
| A7031 |
Replacement facemask interfa |
1,325 |
965 |
$40K |
| A7520 |
Trach/laryn tube non-cuffed |
709 |
441 |
$38K |
| E0570 |
Nebulizer with compression |
4,974 |
3,346 |
$36K |
| E0562 |
Humidifier heated used w pap |
4,438 |
2,613 |
$32K |
| A4483 |
Moisture exchanger |
104 |
89 |
$26K |
| A7526 |
Tracheostomy tube collar |
925 |
736 |
$25K |
| A4217 |
Sterile water/saline, 500 ml |
462 |
366 |
$22K |
| B4161 |
Ef ped hydrolyzed/amino acid |
48 |
39 |
$20K |
| A7037 |
Pos airway pressure tubing |
1,690 |
1,217 |
$19K |
| A7000 |
Disposable canister for pump |
848 |
698 |
$18K |
| A7038 |
Pos airway pressure filter |
4,276 |
3,237 |
$16K |
| A7034 |
Nasal application device |
480 |
330 |
$16K |
| A7035 |
Pos airway press headgear |
1,170 |
862 |
$15K |
| A7032 |
Replacement nasal cushion |
323 |
239 |
$11K |
| B4158 |
Ef ped complete intact nut |
53 |
51 |
$7K |
| K0001 |
Standard wheelchair |
622 |
314 |
$6K |
| A7002 |
Tubing used w suction pump |
722 |
604 |
$3K |
| A7003 |
Nebulizer administration set |
1,803 |
1,406 |
$3K |
| A4628 |
Oropharyngeal suction cath |
303 |
240 |
$3K |
| L8501 |
Tracheostomy speaking valve |
20 |
12 |
$2K |
| A7046 |
Repl water chamber, pap dev |
151 |
113 |
$861.64 |
| A4604 |
Tubing with heating element |
36 |
28 |
$682.42 |
| A7005 |
Nondisposable nebulizer set |
27 |
24 |
$356.89 |
| Q0513 |
Disp fee inhal drugs/30 days |
15 |
12 |
$290.11 |
| A7033 |
Replacement nasal pillows |
16 |
13 |
$264.94 |
| K0195 |
Elevating whlchair leg rests |
103 |
50 |
$242.07 |
| A7013 |
Disposable compressor filter |
27 |
25 |
$11.22 |