| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
14,418 |
8,493 |
$578K |
| B4035 |
Enteral feed supp pump per d |
3,570 |
1,930 |
$438K |
| E0445 |
Oximeter non-invasive |
3,834 |
2,137 |
$360K |
| E0465 |
Home vent invasive interface |
519 |
190 |
$136K |
| E0601 |
Cont airway pressure device |
3,053 |
1,797 |
$70K |
| A7030 |
Cpap full face mask |
1,208 |
884 |
$69K |
| A4624 |
Tracheal suction tube |
647 |
432 |
$62K |
| E0431 |
Portable gaseous 02 |
9,133 |
5,466 |
$62K |
| A7031 |
Replacement facemask interfa |
1,670 |
1,242 |
$46K |
| A4629 |
Tracheostomy care kit |
574 |
349 |
$28K |
| E0562 |
Humidifier heated used w pap |
3,771 |
2,164 |
$24K |
| A7520 |
Trach/laryn tube non-cuffed |
512 |
301 |
$21K |
| A7526 |
Tracheostomy tube collar |
1,142 |
766 |
$19K |
| A4483 |
Moisture exchanger |
74 |
66 |
$18K |
| A7037 |
Pos airway pressure tubing |
1,342 |
1,011 |
$16K |
| A4217 |
Sterile water/saline, 500 ml |
383 |
283 |
$14K |
| E0570 |
Nebulizer with compression |
2,837 |
1,844 |
$14K |
| A7038 |
Pos airway pressure filter |
3,454 |
2,763 |
$13K |
| A7035 |
Pos airway press headgear |
1,019 |
769 |
$12K |
| A4623 |
Tracheostomy inner cannula |
303 |
171 |
$12K |
| A7000 |
Disposable canister for pump |
1,638 |
1,122 |
$10K |
| B4160 |
Ef ped caloric dense>/=0.7kc |
47 |
44 |
$6K |
| A7002 |
Tubing used w suction pump |
1,869 |
1,126 |
$4K |
| A7003 |
Nebulizer administration set |
1,329 |
1,021 |
$2K |
| L8501 |
Tracheostomy speaking valve |
22 |
14 |
$2K |
| A4628 |
Oropharyngeal suction cath |
288 |
229 |
$1K |
| E0260 |
Hosp bed semi-electr w/ matt |
77 |
56 |
$1K |
| B4088 |
Gastro/jejuno tube, low-pro |
23 |
12 |
$880.42 |
| A7034 |
Nasal application device |
14 |
13 |
$785.90 |
| A7046 |
Repl water chamber, pap dev |
149 |
109 |
$589.19 |
| E0600 |
Suction pump portab hom modl |
52 |
24 |
$572.01 |
| A4604 |
Tubing with heating element |
18 |
12 |
$288.49 |
| A7525 |
Tracheostomy mask |
371 |
203 |
$255.23 |
| A7007 |
Lg vol nebulizer disposable |
107 |
54 |
$209.89 |
| E0443 |
Portable 02 contents, gas |
22 |
12 |
$23.18 |