| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E0465 |
Home vent invasive interface |
471 |
258 |
$234K |
| E1390 |
Oxygen concentrator |
5,179 |
4,265 |
$227K |
| E0601 |
Cont airway pressure device |
3,566 |
3,108 |
$148K |
| E0445 |
Oximeter non-invasive |
988 |
862 |
$107K |
| B9998 |
Enteral supp not otherwise c |
601 |
401 |
$74K |
| A7030 |
Cpap full face mask |
1,065 |
905 |
$70K |
| E0562 |
Humidifier heated used w pap |
2,585 |
2,349 |
$68K |
| B4035 |
Enteral feed supp pump per d |
577 |
424 |
$63K |
| A4606 |
Oxygen probe used w oximeter |
763 |
623 |
$58K |
| E0466 |
Home vent non-invasive inter |
145 |
114 |
$48K |
| A4604 |
Tubing with heating element |
1,564 |
1,329 |
$43K |
| A7526 |
Tracheostomy tube collar |
537 |
462 |
$38K |
| A4624 |
Tracheal suction tube |
203 |
174 |
$34K |
| A7034 |
Nasal application device |
859 |
723 |
$33K |
| A4217 |
Sterile water/saline, 500 ml |
552 |
346 |
$33K |
| E0431 |
Portable gaseous 02 |
2,483 |
2,198 |
$33K |
| B4161 |
Ef ped hydrolyzed/amino acid |
88 |
53 |
$31K |
| E0470 |
Rad w/o backup non-inv intfc |
420 |
365 |
$23K |
| E0600 |
Suction pump portab hom modl |
781 |
626 |
$21K |
| A7031 |
Replacement facemask interfa |
901 |
773 |
$20K |
| A7035 |
Pos airway press headgear |
1,456 |
1,247 |
$19K |
| A7520 |
Trach/laryn tube non-cuffed |
204 |
153 |
$16K |
| A4629 |
Tracheostomy care kit |
184 |
151 |
$13K |
| A7000 |
Disposable canister for pump |
747 |
624 |
$13K |
| A4628 |
Oropharyngeal suction cath |
568 |
451 |
$10K |
| E0570 |
Nebulizer with compression |
561 |
509 |
$9K |
| A7032 |
Replacement nasal cushion |
441 |
352 |
$8K |
| A7046 |
Repl water chamber, pap dev |
820 |
716 |
$7K |
| K0738 |
Portable gas oxygen system |
543 |
375 |
$7K |
| A7002 |
Tubing used w suction pump |
688 |
610 |
$7K |
| B4034 |
Enter feed supkit syr by day |
172 |
144 |
$6K |
| K0001 |
Standard wheelchair |
482 |
448 |
$5K |
| A6402 |
Sterile gauze <= 16 sq in |
678 |
504 |
$5K |
| A9900 |
Supply/accessory/service |
267 |
129 |
$5K |
| A7038 |
Pos airway pressure filter |
3,063 |
2,113 |
$5K |
| S8189 |
Trach supply noc |
87 |
55 |
$5K |
| E1392 |
Portable oxygen concentrator |
310 |
292 |
$3K |
| A7037 |
Pos airway pressure tubing |
388 |
318 |
$3K |
| B4036 |
Enteral feed sup kit grav by |
34 |
29 |
$3K |
| A4452 |
Waterproof tape |
205 |
187 |
$3K |
| A7507 |
Integrated filter & holder |
32 |
24 |
$2K |
| A4927 |
Non-sterile gloves |
251 |
179 |
$2K |
| A7033 |
Replacement nasal pillows |
138 |
119 |
$2K |
| E0260 |
Hosp bed semi-electr w/ matt |
146 |
120 |
$2K |
| A7003 |
Nebulizer administration set |
828 |
662 |
$2K |
| A9999 |
Dme supply or accessory, nos |
265 |
118 |
$2K |
| A7036 |
Pos airway press chinstrap |
192 |
156 |
$2K |
| A4618 |
Breathing circuits |
34 |
27 |
$971.00 |
| B4088 |
Gastro/jejuno tube, low-pro |
17 |
14 |
$362.13 |
| A7525 |
Tracheostomy mask |
119 |
107 |
$249.94 |
| A4332 |
Lube sterile packet |
152 |
136 |
$132.86 |
| A7013 |
Disposable compressor filter |
66 |
60 |
$41.54 |
| A4244 |
Alcohol or peroxide per pint |
14 |
12 |
$17.19 |