| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| B4035 |
Enteral feed supp pump per d |
6,162 |
4,942 |
$1.50M |
| E0465 |
Home vent invasive interface |
1,666 |
1,187 |
$1.32M |
| E1390 |
Oxygen concentrator |
14,390 |
12,930 |
$1.21M |
| B4161 |
Ef ped hydrolyzed/amino acid |
2,361 |
1,796 |
$1.07M |
| E0466 |
Home vent non-invasive inter |
1,347 |
1,145 |
$906K |
| B9002 |
Enter nutr inf pump any type |
9,342 |
8,103 |
$808K |
| B4149 |
Ef blenderized foods |
2,157 |
1,575 |
$798K |
| E0445 |
Oximeter non-invasive |
3,102 |
2,667 |
$557K |
| B9998 |
Enteral supp not otherwise c |
5,623 |
2,542 |
$510K |
| E0482 |
Cough stimulating device |
688 |
612 |
$216K |
| A4605 |
Trach suction cath close sys |
571 |
355 |
$204K |
| K0001 |
Standard wheelchair |
7,546 |
6,716 |
$203K |
| E0260 |
Hosp bed semi-electr w/ matt |
3,451 |
2,921 |
$191K |
| B4160 |
Ef ped caloric dense>/=0.7kc |
1,514 |
1,183 |
$184K |
| B4153 |
Ef hydrolyzed/amino acids |
292 |
220 |
$173K |
| S8189 |
Trach supply noc |
893 |
430 |
$162K |
| E0431 |
Portable gaseous 02 |
7,282 |
6,427 |
$141K |
| E0619 |
Apnea monitor w recorder |
717 |
685 |
$139K |
| E0601 |
Cont airway pressure device |
2,191 |
1,996 |
$99K |
| E0600 |
Suction pump portab hom modl |
1,910 |
1,687 |
$96K |
| B4152 |
Ef calorie dense>/=1.5kcal |
731 |
556 |
$95K |
| B4087 |
Gastro/jejuno tube, std |
5,220 |
3,322 |
$92K |
| A7000 |
Disposable canister for pump |
1,510 |
1,108 |
$92K |
| A4628 |
Oropharyngeal suction cath |
1,388 |
854 |
$85K |
| E0143 |
Walker folding wheeled w/o s |
3,442 |
3,071 |
$82K |
| A4629 |
Tracheostomy care kit |
898 |
657 |
$66K |
| K0738 |
Portable gas oxygen system |
2,348 |
2,195 |
$66K |
| E0630 |
Patient lift hydraulic |
1,496 |
1,303 |
$64K |
| E0776 |
Iv pole |
5,770 |
5,009 |
$58K |
| B4034 |
Enter feed supkit syr by day |
847 |
694 |
$58K |
| A7526 |
Tracheostomy tube collar |
1,413 |
904 |
$54K |
| B4088 |
Gastro/jejuno tube, low-pro |
1,894 |
1,551 |
$51K |
| E0570 |
Nebulizer with compression |
2,290 |
1,919 |
$47K |
| B4104 |
Additive for enteral formula |
836 |
322 |
$46K |
| A4606 |
Oxygen probe used w oximeter |
1,414 |
679 |
$40K |
| A4322 |
Irrigation syringe |
3,003 |
2,344 |
$39K |
| A7507 |
Integrated filter & holder |
664 |
442 |
$35K |
| K0195 |
Elevating whlchair leg rests |
3,394 |
2,788 |
$35K |
| A9999 |
Dme supply or accessory, nos |
407 |
224 |
$35K |
| B4155 |
Ef incomplete/modular |
999 |
688 |
$29K |
| A4624 |
Tracheal suction tube |
255 |
176 |
$29K |
| A6402 |
Sterile gauze <= 16 sq in |
2,036 |
1,513 |
$29K |
| K0003 |
Lightweight wheelchair |
624 |
507 |
$28K |
| E0163 |
Commode chair with fixed arm |
536 |
492 |
$23K |
| E0470 |
Rad w/o backup non-inv intfc |
138 |
132 |
$20K |
| B4150 |
Ef complet w/intact nutrient |
127 |
90 |
$18K |
| A4217 |
Sterile water/saline, 500 ml |
975 |
371 |
$18K |
| E0562 |
Humidifier heated used w pap |
162 |
127 |
$18K |
| A7520 |
Trach/laryn tube non-cuffed |
555 |
440 |
$18K |
| A4604 |
Tubing with heating element |
691 |
561 |
$15K |
| A7034 |
Nasal application device |
326 |
244 |
$14K |
| A4927 |
Non-sterile gloves |
1,247 |
787 |
$11K |
| E1392 |
Portable oxygen concentrator |
1,226 |
967 |
$10K |
| A7002 |
Tubing used w suction pump |
1,926 |
1,317 |
$9K |
| A7030 |
Cpap full face mask |
154 |
110 |
$8K |
| A4213 |
20+ cc syringe only |
1,307 |
966 |
$8K |
| E0565 |
Compressor air power source |
250 |
188 |
$8K |
| A7035 |
Pos airway press headgear |
462 |
392 |
$8K |
| B4103 |
Ef ped fluid and electrolyte |
64 |
53 |
$8K |
| A6209 |
Foam drsg <=16 sq in w/o bdr |
24 |
12 |
$7K |
| A4216 |
Sterile water/saline, 10 ml |
741 |
277 |
$6K |
| A4623 |
Tracheostomy inner cannula |
76 |
61 |
$6K |
| A7031 |
Replacement facemask interfa |
184 |
136 |
$6K |
| A7038 |
Pos airway pressure filter |
1,504 |
1,200 |
$6K |
| E1226 |
Manual fully reclining back |
286 |
206 |
$6K |
| E0149 |
Heavy duty wheeled walker |
237 |
225 |
$5K |
| A7046 |
Repl water chamber, pap dev |
462 |
335 |
$4K |
| A7008 |
Disposable nebulizer prefill |
14 |
14 |
$3K |
| A4618 |
Breathing circuits |
142 |
64 |
$3K |
| A7032 |
Replacement nasal cushion |
83 |
58 |
$2K |
| A7005 |
Nondisposable nebulizer set |
66 |
56 |
$1K |
| A7521 |
Trach/laryn tube cuffed |
60 |
28 |
$891.43 |
| A7525 |
Tracheostomy mask |
144 |
86 |
$806.74 |
| A7003 |
Nebulizer administration set |
128 |
93 |
$644.80 |
| A7033 |
Replacement nasal pillows |
15 |
12 |
$337.08 |
| A7010 |
Disposable corrugated tubing |
12 |
12 |
$279.84 |
| A5120 |
Skin barrier, wipe or swab |
42 |
24 |
$209.65 |
| A4406 |
Pectin based ostomy paste |
33 |
25 |
$173.87 |
| A7015 |
Aerosol mask used w nebulize |
125 |
100 |
$147.32 |
| A7013 |
Disposable compressor filter |
73 |
53 |
$97.72 |
| E0156 |
Walker seat attachment |
16 |
12 |
$43.09 |