| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E0466 |
Home vent non-invasive inter |
19,751 |
14,958 |
$8.20M |
| E0465 |
Home vent invasive interface |
4,456 |
2,889 |
$2.21M |
| B4150 |
Ef complet w/intact nutrient |
6,972 |
6,127 |
$530K |
| B4154 |
Ef spec metabolic noninherit |
3,769 |
3,296 |
$466K |
| A4554 |
Disposable underpads |
11,958 |
11,021 |
$457K |
| T4527 |
Adult size pull-on lg |
4,750 |
4,440 |
$353K |
| E0482 |
Cough stimulating device |
2,029 |
1,374 |
$283K |
| T4526 |
Adult size pull-on med |
3,059 |
2,809 |
$198K |
| T4535 |
Disposable liner/shield/pad |
6,062 |
5,299 |
$194K |
| A4623 |
Tracheostomy inner cannula |
2,604 |
1,723 |
$184K |
| E0445 |
Oximeter non-invasive |
1,533 |
1,104 |
$181K |
| T4528 |
Adult size pull-on xl |
2,274 |
2,103 |
$150K |
| A4927 |
Non-sterile gloves |
6,007 |
5,478 |
$115K |
| A4624 |
Tracheal suction tube |
2,126 |
1,558 |
$106K |
| E1390 |
Oxygen concentrator |
1,068 |
715 |
$93K |
| T4544 |
Adlt disp und/pull on abv xl |
588 |
567 |
$75K |
| A4217 |
Sterile water/saline, 500 ml |
2,099 |
1,315 |
$58K |
| A4629 |
Tracheostomy care kit |
1,280 |
830 |
$57K |
| E0483 |
Hi freq chest wall oscil sys |
73 |
54 |
$45K |
| E0550 |
Humidif extens supple w ippb |
1,579 |
1,363 |
$45K |
| A4483 |
Moisture exchanger |
581 |
351 |
$44K |
| E0600 |
Suction pump portab hom modl |
2,720 |
1,933 |
$43K |
| A7526 |
Tracheostomy tube collar |
2,093 |
1,469 |
$31K |
| T4523 |
Adult size brief/diaper lg |
352 |
311 |
$29K |
| A7000 |
Disposable canister for pump |
2,029 |
1,553 |
$17K |
| T4522 |
Adult size brief/diaper med |
135 |
114 |
$13K |
| A7521 |
Trach/laryn tube cuffed |
506 |
328 |
$10K |
| A4628 |
Oropharyngeal suction cath |
1,046 |
729 |
$7K |
| A7002 |
Tubing used w suction pump |
1,615 |
1,255 |
$4K |
| E0565 |
Compressor air power source |
175 |
121 |
$4K |
| T4543 |
Adult disp brief/diap abv xl |
26 |
24 |
$3K |
| A7038 |
Pos airway pressure filter |
425 |
322 |
$2K |
| A6216 |
Non-sterile gauze<=16 sq in |
437 |
314 |
$691.54 |
| K0738 |
Portable gas oxygen system |
17 |
12 |
$370.55 |
| A7509 |
Heat & moisture exchange sys |
51 |
27 |
$355.32 |
| A7003 |
Nebulizer administration set |
28 |
24 |
$93.51 |
| A7525 |
Tracheostomy mask |
19 |
12 |
$57.34 |
| A7013 |
Disposable compressor filter |
20 |
12 |
$6.70 |