| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E0465 |
Home vent invasive interface |
4,012 |
2,928 |
$1.50M |
| E0466 |
Home vent non-invasive inter |
1,704 |
1,457 |
$894K |
| E1390 |
Oxygen concentrator |
10,838 |
9,705 |
$610K |
| A4624 |
Tracheal suction tube |
1,299 |
1,037 |
$144K |
| A4606 |
Oxygen probe used w oximeter |
1,450 |
916 |
$131K |
| E0445 |
Oximeter non-invasive |
1,084 |
1,044 |
$106K |
| E0431 |
Portable gaseous 02 |
7,220 |
6,516 |
$96K |
| A6196 |
Alginate dressing <=16 sq in |
575 |
484 |
$71K |
| A4483 |
Moisture exchanger |
482 |
372 |
$66K |
| A7521 |
Trach/laryn tube cuffed |
978 |
686 |
$65K |
| A7526 |
Tracheostomy tube collar |
1,657 |
1,330 |
$57K |
| A7030 |
Cpap full face mask |
837 |
672 |
$48K |
| A7507 |
Integrated filter & holder |
430 |
358 |
$45K |
| A4605 |
Trach suction cath close sys |
681 |
577 |
$42K |
| A6209 |
Foam drsg <=16 sq in w/o bdr |
657 |
526 |
$40K |
| A4629 |
Tracheostomy care kit |
500 |
417 |
$39K |
| E0600 |
Suction pump portab hom modl |
1,237 |
1,182 |
$35K |
| A4217 |
Sterile water/saline, 500 ml |
1,044 |
856 |
$35K |
| A7520 |
Trach/laryn tube non-cuffed |
624 |
486 |
$29K |
| A4604 |
Tubing with heating element |
1,170 |
963 |
$28K |
| K0738 |
Portable gas oxygen system |
1,234 |
1,160 |
$25K |
| E1392 |
Portable oxygen concentrator |
678 |
591 |
$25K |
| A4927 |
Non-sterile gloves |
985 |
851 |
$23K |
| E0601 |
Cont airway pressure device |
897 |
728 |
$21K |
| A6212 |
Foam drg <=16 sq in w/border |
291 |
241 |
$19K |
| E0570 |
Nebulizer with compression |
1,904 |
1,845 |
$18K |
| A7031 |
Replacement facemask interfa |
923 |
600 |
$18K |
| A7034 |
Nasal application device |
396 |
347 |
$17K |
| A6446 |
Conform band s w>=3" <5"/yd |
552 |
494 |
$15K |
| E0482 |
Cough stimulating device |
75 |
68 |
$15K |
| A4216 |
Sterile water/saline, 10 ml |
996 |
866 |
$15K |
| A4623 |
Tracheostomy inner cannula |
150 |
109 |
$14K |
| A4628 |
Oropharyngeal suction cath |
1,543 |
1,237 |
$13K |
| A7000 |
Disposable canister for pump |
2,157 |
1,827 |
$12K |
| E0562 |
Humidifier heated used w pap |
729 |
628 |
$11K |
| A6402 |
Sterile gauze <= 16 sq in |
1,653 |
1,412 |
$11K |
| A7035 |
Pos airway press headgear |
841 |
680 |
$10K |
| A4649 |
Surgical supplies |
23 |
14 |
$10K |
| A6021 |
Collagen dressing <=16 sq in |
38 |
37 |
$9K |
| E0470 |
Rad w/o backup non-inv intfc |
186 |
160 |
$8K |
| A6266 |
Impreg gauze no h20/sal/yard |
62 |
53 |
$7K |
| E0565 |
Compressor air power source |
312 |
305 |
$7K |
| A6252 |
Absorpt drg >16 <=48 w/o bdr |
97 |
89 |
$6K |
| A7038 |
Pos airway pressure filter |
1,708 |
1,150 |
$6K |
| A6216 |
Non-sterile gauze<=16 sq in |
817 |
692 |
$5K |
| A7002 |
Tubing used w suction pump |
1,658 |
1,411 |
$5K |
| A6222 |
Gauze <=16 in no w/sal w/o b |
104 |
87 |
$4K |
| A7032 |
Replacement nasal cushion |
144 |
114 |
$4K |
| E0260 |
Hosp bed semi-electr w/ matt |
79 |
79 |
$4K |
| K0001 |
Standard wheelchair |
164 |
157 |
$4K |
| A7003 |
Nebulizer administration set |
1,255 |
1,133 |
$4K |
| A7046 |
Repl water chamber, pap dev |
560 |
455 |
$4K |
| A4452 |
Waterproof tape |
276 |
251 |
$3K |
| A6251 |
Absorpt drg <=16 sq in w/o b |
105 |
95 |
$3K |
| A4450 |
Non-waterproof tape |
421 |
374 |
$2K |
| E0630 |
Patient lift hydraulic |
26 |
26 |
$2K |
| A7007 |
Lg vol nebulizer disposable |
469 |
409 |
$2K |
| A7012 |
Nebulizer water collec devic |
370 |
332 |
$1K |
| A7525 |
Tracheostomy mask |
716 |
607 |
$1K |
| L8501 |
Tracheostomy speaking valve |
12 |
12 |
$1K |
| K0195 |
Elevating whlchair leg rests |
137 |
130 |
$942.49 |
| A7015 |
Aerosol mask used w nebulize |
403 |
354 |
$431.58 |
| A6457 |
Tubular dressing |
13 |
12 |
$165.33 |
| A6219 |
Gauze <= 16 sq in w/border |
31 |
26 |
$147.06 |
| A4332 |
Lube sterile packet |
16 |
13 |
$124.86 |