| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E0465 |
Home vent invasive interface |
2,413 |
1,879 |
$965K |
| E0601 |
Cont airway pressure device |
15,068 |
13,172 |
$747K |
| A7030 |
Cpap full face mask |
6,406 |
5,563 |
$535K |
| E1390 |
Oxygen concentrator |
6,072 |
4,961 |
$389K |
| A7034 |
Nasal application device |
7,360 |
6,325 |
$379K |
| A4604 |
Tubing with heating element |
12,773 |
11,038 |
$375K |
| A7031 |
Replacement facemask interfa |
9,287 |
7,858 |
$280K |
| E0562 |
Humidifier heated used w pap |
12,212 |
11,080 |
$257K |
| A7032 |
Replacement nasal cushion |
5,946 |
4,933 |
$185K |
| A7035 |
Pos airway press headgear |
9,021 |
7,813 |
$153K |
| E0470 |
Rad w/o backup non-inv intfc |
1,742 |
1,501 |
$149K |
| A4217 |
Sterile water/saline, 500 ml |
1,803 |
1,104 |
$113K |
| A4606 |
Oxygen probe used w oximeter |
1,196 |
608 |
$108K |
| A7038 |
Pos airway pressure filter |
18,348 |
15,647 |
$88K |
| A7526 |
Tracheostomy tube collar |
1,888 |
1,389 |
$87K |
| A7033 |
Replacement nasal pillows |
3,678 |
3,139 |
$85K |
| E0603 |
Electric breast pump |
324 |
316 |
$58K |
| A7046 |
Repl water chamber, pap dev |
6,462 |
5,593 |
$53K |
| E1392 |
Portable oxygen concentrator |
1,842 |
1,533 |
$39K |
| A7520 |
Trach/laryn tube non-cuffed |
602 |
341 |
$36K |
| A7000 |
Disposable canister for pump |
2,068 |
1,544 |
$34K |
| E0570 |
Nebulizer with compression |
736 |
642 |
$34K |
| A6209 |
Foam drsg <=16 sq in w/o bdr |
231 |
179 |
$26K |
| A4605 |
Trach suction cath close sys |
276 |
163 |
$26K |
| E0431 |
Portable gaseous 02 |
1,500 |
1,257 |
$22K |
| A7002 |
Tubing used w suction pump |
2,118 |
1,596 |
$14K |
| K0738 |
Portable gas oxygen system |
523 |
458 |
$12K |
| A4216 |
Sterile water/saline, 10 ml |
483 |
360 |
$9K |
| A4624 |
Tracheal suction tube |
100 |
57 |
$8K |
| A6216 |
Non-sterile gauze<=16 sq in |
779 |
524 |
$6K |
| A6402 |
Sterile gauze <= 16 sq in |
388 |
286 |
$5K |
| A4649 |
Surgical supplies |
199 |
130 |
$4K |
| A7003 |
Nebulizer administration set |
1,424 |
1,131 |
$4K |
| E0600 |
Suction pump portab hom modl |
315 |
162 |
$4K |
| A4628 |
Oropharyngeal suction cath |
159 |
119 |
$840.41 |
| A7037 |
Pos airway pressure tubing |
16 |
16 |
$501.76 |
| A7004 |
Disposable nebulizer sml vol |
148 |
124 |
$315.14 |
| A7039 |
Filter, non disposable w pap |
17 |
17 |
$199.24 |
| A7036 |
Pos airway press chinstrap |
14 |
12 |
$147.35 |
| A7013 |
Disposable compressor filter |
44 |
41 |
$54.11 |
| A7015 |
Aerosol mask used w nebulize |
38 |
32 |
$44.49 |