| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| B4035 |
Enteral feed supp pump per d |
815 |
724 |
$134K |
| E0465 |
Home vent invasive interface |
521 |
487 |
$98K |
| A4606 |
Oxygen probe used w oximeter |
1,444 |
814 |
$76K |
| E1390 |
Oxygen concentrator |
1,196 |
1,169 |
$73K |
| B9998 |
Enteral supp not otherwise c |
1,408 |
1,041 |
$69K |
| A4554 |
Disposable underpads |
868 |
832 |
$63K |
| E0482 |
Cough stimulating device |
308 |
305 |
$47K |
| A7000 |
Disposable canister for pump |
1,210 |
1,161 |
$22K |
| A4629 |
Tracheostomy care kit |
669 |
643 |
$20K |
| E0431 |
Portable gaseous 02 |
1,161 |
1,142 |
$12K |
| A7526 |
Tracheostomy tube collar |
665 |
629 |
$11K |
| A4624 |
Tracheal suction tube |
207 |
193 |
$11K |
| A7002 |
Tubing used w suction pump |
1,221 |
1,175 |
$10K |
| T1999 |
Noc retail items andsupplies |
2,279 |
836 |
$5K |
| A4216 |
Sterile water/saline, 10 ml |
724 |
674 |
$4K |
| A4335 |
Incontinence supply |
962 |
888 |
$4K |
| A4322 |
Irrigation syringe |
959 |
918 |
$4K |
| A7520 |
Trach/laryn tube non-cuffed |
91 |
89 |
$4K |
| A4628 |
Oropharyngeal suction cath |
1,315 |
1,251 |
$3K |
| A6402 |
Sterile gauze <= 16 sq in |
1,062 |
980 |
$2K |
| B4152 |
Ef calorie dense>/=1.5kcal |
12 |
12 |
$2K |
| B9002 |
Enter nutr inf pump any type |
26 |
25 |
$2K |
| K0195 |
Elevating whlchair leg rests |
98 |
98 |
$760.84 |
| A7003 |
Nebulizer administration set |
583 |
546 |
$725.43 |
| A4927 |
Non-sterile gloves |
631 |
606 |
$660.06 |
| A4481 |
Tracheostoma filter |
41 |
38 |
$103.87 |