| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E0465 |
Home vent invasive interface |
1,623 |
906 |
$907K |
| E0466 |
Home vent non-invasive inter |
985 |
820 |
$398K |
| E1390 |
Oxygen concentrator |
2,735 |
2,240 |
$145K |
| B4035 |
Enteral feed supp pump per d |
430 |
359 |
$102K |
| A4624 |
Tracheal suction tube |
666 |
533 |
$96K |
| A7526 |
Tracheostomy tube collar |
1,027 |
844 |
$56K |
| A7507 |
Integrated filter & holder |
592 |
474 |
$27K |
| A4606 |
Oxygen probe used w oximeter |
536 |
368 |
$22K |
| A7000 |
Disposable canister for pump |
1,350 |
1,105 |
$22K |
| E0431 |
Portable gaseous 02 |
1,522 |
1,258 |
$20K |
| K0738 |
Portable gas oxygen system |
443 |
351 |
$11K |
| E0445 |
Oximeter non-invasive |
209 |
115 |
$9K |
| A7520 |
Trach/laryn tube non-cuffed |
71 |
52 |
$8K |
| A4628 |
Oropharyngeal suction cath |
530 |
425 |
$7K |
| A7002 |
Tubing used w suction pump |
1,359 |
1,100 |
$6K |
| A4927 |
Non-sterile gloves |
476 |
397 |
$4K |
| A4605 |
Trach suction cath close sys |
73 |
52 |
$3K |
| A7003 |
Nebulizer administration set |
489 |
408 |
$2K |
| A7521 |
Trach/laryn tube cuffed |
21 |
13 |
$1K |
| A6402 |
Sterile gauze <= 16 sq in |
94 |
76 |
$663.84 |
| E0600 |
Suction pump portab hom modl |
13 |
12 |
$294.66 |
| A7525 |
Tracheostomy mask |
98 |
79 |
$285.12 |
| A4216 |
Sterile water/saline, 10 ml |
38 |
37 |
$182.40 |