| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E0465 |
Home vent invasive interface |
1,594 |
1,077 |
$953K |
| B4035 |
Enteral feed supp pump per d |
3,125 |
2,627 |
$625K |
| B4161 |
Ef ped hydrolyzed/amino acid |
896 |
798 |
$544K |
| E1390 |
Oxygen concentrator |
3,564 |
3,402 |
$346K |
| A4606 |
Oxygen probe used w oximeter |
3,457 |
2,601 |
$283K |
| B4160 |
Ef ped caloric dense>/=0.7kc |
1,291 |
1,101 |
$278K |
| B9998 |
Enteral supp not otherwise c |
4,631 |
3,189 |
$271K |
| E0445 |
Oximeter non-invasive |
1,426 |
1,352 |
$175K |
| E1399 |
Durable medical equipment mi |
269 |
174 |
$160K |
| E0482 |
Cough stimulating device |
615 |
603 |
$143K |
| A4605 |
Trach suction cath close sys |
990 |
764 |
$139K |
| A4629 |
Tracheostomy care kit |
1,568 |
1,310 |
$110K |
| K0001 |
Standard wheelchair |
2,331 |
2,267 |
$105K |
| A4624 |
Tracheal suction tube |
812 |
783 |
$95K |
| B4149 |
Ef blenderized foods |
325 |
316 |
$93K |
| A7000 |
Disposable canister for pump |
2,658 |
2,355 |
$85K |
| A6210 |
Foam drg >16<=48 sq in w/o b |
350 |
291 |
$73K |
| E1236 |
Folding ped wc adjustable |
374 |
363 |
$66K |
| B9002 |
Enter nutr inf pump any type |
763 |
744 |
$65K |
| B4155 |
Ef incomplete/modular |
416 |
401 |
$62K |
| A7526 |
Tracheostomy tube collar |
1,985 |
1,611 |
$61K |
| A7521 |
Trach/laryn tube cuffed |
491 |
427 |
$60K |
| E0431 |
Portable gaseous 02 |
3,453 |
3,314 |
$60K |
| A7520 |
Trach/laryn tube non-cuffed |
786 |
713 |
$57K |
| A4554 |
Disposable underpads |
1,472 |
1,407 |
$50K |
| A7002 |
Tubing used w suction pump |
2,514 |
2,426 |
$37K |
| K0195 |
Elevating whlchair leg rests |
2,996 |
2,919 |
$33K |
| E0466 |
Home vent non-invasive inter |
40 |
37 |
$25K |
| T1999 |
Noc retail items andsupplies |
7,089 |
2,903 |
$21K |
| A6209 |
Foam drsg <=16 sq in w/o bdr |
161 |
139 |
$21K |
| A4216 |
Sterile water/saline, 10 ml |
1,940 |
1,619 |
$20K |
| E0601 |
Cont airway pressure device |
488 |
478 |
$18K |
| A4322 |
Irrigation syringe |
2,682 |
2,555 |
$17K |
| A9279 |
Monitoring feature/devicenoc |
97 |
94 |
$14K |
| E0971 |
Wheelchair anti-tipping devi |
231 |
221 |
$12K |
| E1225 |
Manual semi-reclining back |
439 |
422 |
$11K |
| E0978 |
W/c acc,saf belt pelv strap |
446 |
428 |
$11K |
| A6402 |
Sterile gauze <= 16 sq in |
2,070 |
1,883 |
$11K |
| A4628 |
Oropharyngeal suction cath |
2,358 |
2,269 |
$11K |
| A4927 |
Non-sterile gloves |
1,719 |
1,639 |
$9K |
| A4481 |
Tracheostoma filter |
989 |
827 |
$8K |
| A4335 |
Incontinence supply |
1,747 |
1,641 |
$7K |
| A7003 |
Nebulizer administration set |
2,315 |
2,223 |
$6K |
| A4402 |
Lubricant per ounce |
1,521 |
1,461 |
$6K |
| E0143 |
Walker folding wheeled w/o s |
86 |
85 |
$5K |
| T4532 |
Ped size pull-on lg |
37 |
36 |
$5K |
| B4104 |
Additive for enteral formula |
28 |
25 |
$2K |
| A7525 |
Tracheostomy mask |
882 |
758 |
$2K |
| A4245 |
Alcohol wipes per box |
695 |
677 |
$1K |
| E0247 |
Trans bench w/wo comm open |
16 |
16 |
$1K |
| A4450 |
Non-waterproof tape |
584 |
568 |
$1K |
| A7015 |
Aerosol mask used w nebulize |
643 |
632 |
$641.85 |
| E0562 |
Humidifier heated used w pap |
177 |
169 |
$483.51 |
| A7013 |
Disposable compressor filter |
690 |
663 |
$417.65 |
| A4244 |
Alcohol or peroxide per pint |
552 |
531 |
$321.49 |
| A6216 |
Non-sterile gauze<=16 sq in |
15 |
14 |
$56.95 |