| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
26,199 |
24,391 |
$976K |
| B4035 |
Enteral feed supp pump per d |
4,629 |
4,167 |
$905K |
| E0466 |
Home vent non-invasive inter |
3,886 |
3,667 |
$884K |
| E0465 |
Home vent invasive interface |
1,685 |
1,614 |
$832K |
| B4161 |
Ef ped hydrolyzed/amino acid |
1,030 |
853 |
$579K |
| B4160 |
Ef ped caloric dense>/=0.7kc |
2,519 |
2,063 |
$268K |
| E0445 |
Oximeter non-invasive |
1,077 |
1,023 |
$208K |
| B4088 |
Gastro/jejuno tube, low-pro |
1,419 |
1,298 |
$202K |
| A4606 |
Oxygen probe used w oximeter |
2,321 |
2,109 |
$161K |
| A4217 |
Sterile water/saline, 500 ml |
2,067 |
1,859 |
$154K |
| E0570 |
Nebulizer with compression |
3,376 |
3,197 |
$139K |
| B4034 |
Enter feed supkit syr by day |
1,347 |
1,194 |
$113K |
| B4149 |
Ef blenderized foods |
239 |
181 |
$105K |
| E1392 |
Portable oxygen concentrator |
7,493 |
7,021 |
$93K |
| E0431 |
Portable gaseous 02 |
12,286 |
11,382 |
$93K |
| E0601 |
Cont airway pressure device |
6,452 |
5,929 |
$90K |
| B9998 |
Enteral supp not otherwise c |
1,195 |
860 |
$82K |
| E0603 |
Electric breast pump |
585 |
560 |
$68K |
| E0482 |
Cough stimulating device |
251 |
221 |
$61K |
| B4152 |
Ef calorie dense>/=1.5kcal |
982 |
780 |
$49K |
| E0260 |
Hosp bed semi-electr w/ matt |
913 |
829 |
$45K |
| A4216 |
Sterile water/saline, 10 ml |
1,257 |
1,163 |
$38K |
| K0001 |
Standard wheelchair |
3,102 |
2,794 |
$37K |
| E0562 |
Humidifier heated used w pap |
4,835 |
4,468 |
$32K |
| A7000 |
Disposable canister for pump |
3,214 |
3,039 |
$32K |
| A4605 |
Trach suction cath close sys |
884 |
817 |
$32K |
| A7002 |
Tubing used w suction pump |
3,326 |
3,061 |
$28K |
| A7526 |
Tracheostomy tube collar |
2,430 |
2,227 |
$22K |
| A4629 |
Tracheostomy care kit |
342 |
324 |
$21K |
| A4624 |
Tracheal suction tube |
177 |
158 |
$19K |
| A7030 |
Cpap full face mask |
1,873 |
1,794 |
$16K |
| E0143 |
Walker folding wheeled w/o s |
716 |
672 |
$16K |
| A4628 |
Oropharyngeal suction cath |
1,411 |
1,280 |
$12K |
| A4604 |
Tubing with heating element |
1,499 |
1,385 |
$11K |
| A7035 |
Pos airway press headgear |
2,444 |
2,325 |
$11K |
| E0471 |
Rad w/backup non inv intrfc |
98 |
83 |
$9K |
| A7031 |
Replacement facemask interfa |
1,904 |
1,797 |
$7K |
| A7038 |
Pos airway pressure filter |
3,440 |
3,207 |
$7K |
| A6402 |
Sterile gauze <= 16 sq in |
634 |
500 |
$7K |
| E0600 |
Suction pump portab hom modl |
52 |
49 |
$7K |
| E0470 |
Rad w/o backup non-inv intfc |
235 |
215 |
$6K |
| B4150 |
Ef complet w/intact nutrient |
46 |
39 |
$6K |
| A4450 |
Non-waterproof tape |
461 |
430 |
$6K |
| A4627 |
Spacer bag/reservoir |
261 |
253 |
$5K |
| E1399 |
Durable medical equipment mi |
188 |
128 |
$5K |
| A7034 |
Nasal application device |
657 |
629 |
$4K |
| B9002 |
Enter nutr inf pump any type |
25 |
24 |
$4K |
| A7037 |
Pos airway pressure tubing |
1,672 |
1,618 |
$3K |
| A6210 |
Foam drg >16<=48 sq in w/o b |
16 |
12 |
$2K |
| A7046 |
Repl water chamber, pap dev |
982 |
923 |
$2K |
| A7004 |
Disposable nebulizer sml vol |
1,508 |
1,427 |
$2K |
| A7520 |
Trach/laryn tube non-cuffed |
44 |
40 |
$2K |
| A7032 |
Replacement nasal cushion |
271 |
260 |
$2K |
| A4657 |
Syringe w/wo needle |
603 |
539 |
$2K |
| K0738 |
Portable gas oxygen system |
38 |
25 |
$1K |
| A7039 |
Filter, non disposable w pap |
561 |
548 |
$803.99 |
| K0195 |
Elevating whlchair leg rests |
173 |
166 |
$472.65 |
| A7525 |
Tracheostomy mask |
53 |
43 |
$185.17 |
| A7045 |
Repl exhalation port for pap |
13 |
13 |
$166.20 |
| A7007 |
Lg vol nebulizer disposable |
15 |
12 |
$148.04 |
| A7003 |
Nebulizer administration set |
956 |
894 |
$19.86 |
| A7507 |
Integrated filter & holder |
113 |
105 |
$0.00 |
| A7015 |
Aerosol mask used w nebulize |
12 |
12 |
$0.00 |