| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate |
169 |
167 |
$19K |
| A4624 |
Tracheal suction catheter, any type other than closed system, each |
38 |
37 |
$7K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
94 |
93 |
$6K |
| A4927 |
Gloves, non-sterile, per 100 |
300 |
253 |
$4K |
| E0445 |
Oximeter device for measuring blood oxygen levels non-invasively |
67 |
67 |
$4K |
| B9002 |
Enteral nutrition infusion pump, any type |
47 |
47 |
$3K |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
465 |
164 |
$2K |
| B9998 |
Noc for enteral supplies |
12 |
12 |
$2K |
| E0570 |
Nebulizer, with compressor |
12 |
12 |
$1K |
| B4088 |
Gastrostomy/jejunostomy tube, low-profile, any material, any type, each |
14 |
14 |
$805.00 |
| A7526 |
Tracheostomy tube collar/holder, each |
55 |
54 |
$734.26 |
| A4209 |
Syringe with needle, sterile 5 cc or greater, each |
26 |
25 |
$728.30 |
| A7520 |
Tracheostomy/laryngectomy tube, non-cuffed, polyvinylchloride (pvc), silicone or equal, each |
13 |
13 |
$497.62 |
| A4213 |
Syringe, sterile, 20 cc or greater, each |
12 |
12 |
$423.41 |