| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
11,122 |
11,026 |
$815K |
| B4035 |
Enteral feed supp pump per d |
1,775 |
1,649 |
$301K |
| E0601 |
Cont airway pressure device |
6,030 |
5,997 |
$272K |
| B4160 |
Ef ped caloric dense>/=0.7kc |
1,161 |
1,103 |
$174K |
| B4150 |
Ef complet w/intact nutrient |
1,488 |
1,420 |
$149K |
| E0570 |
Nebulizer with compression |
3,419 |
3,393 |
$128K |
| B4087 |
Gastro/jejuno tube, std |
1,894 |
1,720 |
$114K |
| E0470 |
Rad w/o backup non-inv intfc |
1,153 |
1,139 |
$98K |
| E0431 |
Portable gaseous 02 |
5,647 |
5,589 |
$96K |
| B4152 |
Ef calorie dense>/=1.5kcal |
750 |
713 |
$79K |
| A7030 |
Cpap full face mask |
1,388 |
1,372 |
$76K |
| E0260 |
Hosp bed semi-electr w/ matt |
1,525 |
1,501 |
$69K |
| B4088 |
Gastro/jejuno tube, low-pro |
634 |
616 |
$59K |
| E0562 |
Humidifier heated used w pap |
859 |
851 |
$51K |
| A7031 |
Replacement facemask interfa |
1,192 |
1,179 |
$34K |
| A7035 |
Pos airway press headgear |
2,067 |
2,036 |
$30K |
| A7037 |
Pos airway pressure tubing |
1,723 |
1,705 |
$29K |
| A7034 |
Nasal application device |
878 |
864 |
$28K |
| A7526 |
Tracheostomy tube collar |
476 |
467 |
$24K |
| K0003 |
Lightweight wheelchair |
642 |
632 |
$24K |
| A7005 |
Nondisposable nebulizer set |
1,607 |
1,588 |
$22K |
| E0603 |
Electric breast pump |
112 |
112 |
$14K |
| A7038 |
Pos airway pressure filter |
3,225 |
3,179 |
$13K |
| K0001 |
Standard wheelchair |
622 |
616 |
$12K |
| S8189 |
Trach supply noc |
70 |
64 |
$11K |
| T4541 |
Large disposable underpad |
349 |
333 |
$10K |
| K0738 |
Portable gas oxygen system |
1,409 |
1,409 |
$10K |
| A4927 |
Non-sterile gloves |
675 |
634 |
$7K |
| A7046 |
Repl water chamber, pap dev |
1,195 |
1,183 |
$6K |
| E0143 |
Walker folding wheeled w/o s |
147 |
141 |
$6K |
| A7520 |
Trach/laryn tube non-cuffed |
92 |
89 |
$6K |
| A7032 |
Replacement nasal cushion |
175 |
173 |
$5K |
| A7002 |
Tubing used w suction pump |
707 |
696 |
$5K |
| A4606 |
Oxygen probe used w oximeter |
36 |
36 |
$4K |
| A7000 |
Disposable canister for pump |
693 |
680 |
$4K |
| K0002 |
Stnd hemi (low seat) whlchr |
162 |
162 |
$3K |
| S5199 |
Personal care item nos each |
515 |
501 |
$3K |
| A4604 |
Tubing with heating element |
463 |
463 |
$3K |
| E0156 |
Walker seat attachment |
261 |
250 |
$2K |
| A6402 |
Sterile gauze <= 16 sq in |
468 |
440 |
$2K |
| A4624 |
Tracheal suction tube |
13 |
12 |
$2K |
| B4034 |
Enter feed supkit syr by day |
43 |
38 |
$1K |
| A6530 |
Compression stocking bk18-30 |
26 |
24 |
$1K |
| E0630 |
Patient lift hydraulic |
40 |
37 |
$1K |
| A4628 |
Oropharyngeal suction cath |
92 |
86 |
$904.22 |
| E0971 |
Wheelchair anti-tipping devi |
254 |
141 |
$666.79 |
| A7033 |
Replacement nasal pillows |
15 |
15 |
$645.36 |
| E0250 |
Hosp bed fixed ht w/ mattres |
40 |
40 |
$580.46 |
| A7015 |
Aerosol mask used w nebulize |
429 |
419 |
$420.27 |
| A4213 |
20+ cc syringe only |
91 |
82 |
$314.74 |
| A7003 |
Nebulizer administration set |
126 |
125 |
$246.96 |
| E0600 |
Suction pump portab hom modl |
12 |
12 |
$239.18 |
| A4450 |
Non-waterproof tape |
13 |
13 |
$44.23 |