| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A4606 |
Oxygen probe used w oximeter |
7,342 |
3,292 |
$1.50M |
| A7521 |
Trach/laryn tube cuffed |
2,582 |
1,049 |
$1.17M |
| B4035 |
Enteral feed supp pump per d |
10,131 |
5,860 |
$1.16M |
| A4624 |
Tracheal suction tube |
6,285 |
2,538 |
$871K |
| B9998 |
Enteral supp not otherwise c |
18,354 |
7,145 |
$808K |
| B4088 |
Gastro/jejuno tube, low-pro |
8,057 |
4,076 |
$806K |
| E0465 |
Home vent invasive interface |
1,237 |
1,000 |
$724K |
| E1390 |
Oxygen concentrator |
7,762 |
6,147 |
$574K |
| A7520 |
Trach/laryn tube non-cuffed |
2,087 |
845 |
$265K |
| A7526 |
Tracheostomy tube collar |
5,286 |
2,458 |
$215K |
| E0466 |
Home vent non-invasive inter |
340 |
292 |
$194K |
| E0445 |
Oximeter non-invasive |
240 |
124 |
$189K |
| T4522 |
Adult size brief/diaper med |
2,707 |
1,654 |
$186K |
| A4217 |
Sterile water/saline, 500 ml |
5,334 |
2,311 |
$172K |
| A9900 |
Supply/accessory/service |
4,997 |
1,352 |
$145K |
| A4629 |
Tracheostomy care kit |
3,062 |
1,275 |
$143K |
| T4530 |
Ped size brief/diaper lg |
2,025 |
1,357 |
$136K |
| A4483 |
Moisture exchanger |
1,484 |
907 |
$127K |
| T4523 |
Adult size brief/diaper lg |
1,258 |
792 |
$108K |
| E0619 |
Apnea monitor w recorder |
774 |
541 |
$106K |
| A4628 |
Oropharyngeal suction cath |
3,515 |
1,874 |
$106K |
| E1399 |
Durable medical equipment mi |
362 |
129 |
$105K |
| A7508 |
Housing & integrated adhesiv |
3,311 |
770 |
$76K |
| B4034 |
Enter feed supkit syr by day |
2,723 |
1,691 |
$73K |
| S8189 |
Trach supply noc |
3,571 |
1,040 |
$72K |
| B9002 |
Enter nutr inf pump any type |
388 |
216 |
$59K |
| A9999 |
Dme supply or accessory, nos |
21,167 |
3,463 |
$55K |
| A6402 |
Sterile gauze <= 16 sq in |
6,520 |
3,320 |
$48K |
| A4554 |
Disposable underpads |
1,463 |
844 |
$45K |
| A4216 |
Sterile water/saline, 10 ml |
4,083 |
1,778 |
$34K |
| A7000 |
Disposable canister for pump |
6,540 |
3,594 |
$28K |
| A6209 |
Foam drsg <=16 sq in w/o bdr |
468 |
148 |
$24K |
| A4930 |
Sterile, gloves per pair |
534 |
312 |
$23K |
| E0443 |
Portable 02 contents, gas |
766 |
467 |
$19K |
| T4534 |
Youth size pull-on |
191 |
122 |
$15K |
| A7002 |
Tubing used w suction pump |
7,615 |
3,612 |
$13K |
| A4927 |
Non-sterile gloves |
1,736 |
1,121 |
$11K |
| E0570 |
Nebulizer with compression |
372 |
300 |
$11K |
| E0601 |
Cont airway pressure device |
214 |
195 |
$10K |
| T4521 |
Adult size brief/diaper sm |
165 |
89 |
$9K |
| E1150 |
Wheelchair standard w/ leg r |
69 |
64 |
$5K |
| A7525 |
Tracheostomy mask |
1,701 |
498 |
$4K |
| A7003 |
Nebulizer administration set |
3,365 |
1,848 |
$3K |
| A7046 |
Repl water chamber, pap dev |
982 |
282 |
$3K |
| A4657 |
Syringe w/wo needle |
2,249 |
955 |
$3K |
| E0431 |
Portable gaseous 02 |
225 |
166 |
$3K |
| A4322 |
Irrigation syringe |
207 |
90 |
$2K |
| E0562 |
Humidifier heated used w pap |
58 |
51 |
$1K |
| E0600 |
Suction pump portab hom modl |
12 |
12 |
$1K |
| E0261 |
Hosp bed semi-electr w/o mat |
12 |
12 |
$1K |
| E0971 |
Wheelchair anti-tipping devi |
191 |
92 |
$1K |
| A7037 |
Pos airway pressure tubing |
72 |
42 |
$876.98 |
| A4450 |
Non-waterproof tape |
156 |
113 |
$535.48 |
| A4402 |
Lubricant per ounce |
176 |
60 |
$318.96 |