| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E0465 |
Home vent invasive interface |
1,983 |
1,517 |
$738K |
| A9900 |
Supply/accessory/service |
7,337 |
6,694 |
$469K |
| E1390 |
Oxygen concentrator |
5,297 |
4,479 |
$457K |
| T4534 |
Youth size pull-on |
2,966 |
2,911 |
$371K |
| A4624 |
Tracheal suction tube |
1,410 |
1,199 |
$297K |
| B4035 |
Enteral feed supp pump per d |
1,286 |
1,247 |
$264K |
| E0445 |
Oximeter non-invasive |
2,011 |
1,987 |
$155K |
| T4522 |
Adult size brief/diaper med |
1,395 |
1,360 |
$147K |
| T4530 |
Ped size brief/diaper lg |
1,454 |
1,408 |
$133K |
| A4554 |
Disposable underpads |
4,179 |
4,074 |
$130K |
| B9002 |
Enter nutr inf pump any type |
1,770 |
1,707 |
$118K |
| T4521 |
Adult size brief/diaper sm |
1,115 |
1,068 |
$116K |
| B4088 |
Gastro/jejuno tube, low-pro |
1,177 |
1,140 |
$98K |
| E0601 |
Cont airway pressure device |
2,113 |
1,885 |
$80K |
| E0260 |
Hosp bed semi-electr w/ matt |
2,706 |
2,019 |
$64K |
| B9998 |
Enteral supp not otherwise c |
1,702 |
1,610 |
$62K |
| E0431 |
Portable gaseous 02 |
2,683 |
2,227 |
$62K |
| A4927 |
Non-sterile gloves |
6,648 |
6,276 |
$60K |
| T4532 |
Ped size pull-on lg |
525 |
522 |
$58K |
| B4150 |
Ef complet w/intact nutrient |
290 |
280 |
$56K |
| A7508 |
Housing & integrated adhesiv |
1,128 |
980 |
$47K |
| A4629 |
Tracheostomy care kit |
759 |
644 |
$44K |
| T4526 |
Adult size pull-on med |
299 |
293 |
$36K |
| T4525 |
Adult size pull-on sm |
345 |
336 |
$36K |
| E1399 |
Durable medical equipment mi |
17 |
15 |
$36K |
| B4160 |
Ef ped caloric dense>/=0.7kc |
105 |
96 |
$34K |
| A7521 |
Trach/laryn tube cuffed |
208 |
184 |
$33K |
| E0600 |
Suction pump portab hom modl |
1,487 |
1,384 |
$33K |
| K0001 |
Standard wheelchair |
3,651 |
2,835 |
$27K |
| E0565 |
Compressor air power source |
1,076 |
985 |
$26K |
| B4149 |
Ef blenderized foods |
48 |
48 |
$25K |
| A7520 |
Trach/laryn tube non-cuffed |
505 |
447 |
$24K |
| A4209 |
5+ cc sterile syringe&needle |
1,324 |
1,271 |
$24K |
| A4606 |
Oxygen probe used w oximeter |
394 |
307 |
$23K |
| A7526 |
Tracheostomy tube collar |
1,845 |
1,606 |
$23K |
| B4034 |
Enter feed supkit syr by day |
234 |
224 |
$22K |
| A4216 |
Sterile water/saline, 10 ml |
843 |
731 |
$19K |
| E0630 |
Patient lift hydraulic |
716 |
544 |
$19K |
| A7002 |
Tubing used w suction pump |
2,935 |
2,622 |
$16K |
| A6402 |
Sterile gauze <= 16 sq in |
957 |
838 |
$12K |
| E0562 |
Humidifier heated used w pap |
1,431 |
1,343 |
$11K |
| A4351 |
Straight tip urine catheter |
139 |
109 |
$10K |
| A7003 |
Nebulizer administration set |
2,530 |
1,959 |
$9K |
| A7000 |
Disposable canister for pump |
1,628 |
1,409 |
$9K |
| T4527 |
Adult size pull-on lg |
48 |
48 |
$7K |
| E0570 |
Nebulizer with compression |
526 |
455 |
$7K |
| E1392 |
Portable oxygen concentrator |
333 |
291 |
$4K |
| A4605 |
Trach suction cath close sys |
348 |
291 |
$3K |
| A4623 |
Tracheostomy inner cannula |
154 |
125 |
$3K |
| E1028 |
W/c manual swingaway |
919 |
382 |
$2K |
| K0195 |
Elevating whlchair leg rests |
492 |
403 |
$2K |
| K0003 |
Lightweight wheelchair |
163 |
128 |
$2K |
| A4402 |
Lubricant per ounce |
423 |
366 |
$1K |
| A7015 |
Aerosol mask used w nebulize |
846 |
804 |
$1K |
| T4535 |
Disposable liner/shield/pad |
52 |
50 |
$761.56 |
| A7525 |
Tracheostomy mask |
331 |
248 |
$745.97 |
| A4213 |
20+ cc syringe only |
14 |
13 |
$683.26 |
| A7030 |
Cpap full face mask |
14 |
12 |
$612.42 |
| A7038 |
Pos airway pressure filter |
217 |
198 |
$456.18 |
| A7007 |
Lg vol nebulizer disposable |
62 |
53 |
$350.57 |
| A4628 |
Oropharyngeal suction cath |
161 |
106 |
$209.56 |
| A7035 |
Pos airway press headgear |
14 |
12 |
$166.21 |
| A7012 |
Nebulizer water collec devic |
44 |
39 |
$95.68 |
| A4244 |
Alcohol or peroxide per pint |
38 |
36 |
$89.25 |
| A4357 |
Bedside drainage bag |
35 |
24 |
$77.60 |
| A7037 |
Pos airway pressure tubing |
29 |
25 |
$57.88 |