| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E0465 |
Home vent invasive interface |
2,536 |
2,277 |
$1.69M |
| E0466 |
Home vent non-invasive inter |
1,765 |
1,715 |
$1.28M |
| E1390 |
Oxygen concentrator |
11,260 |
11,127 |
$1.12M |
| B4035 |
Enteral feed supp pump per d |
4,862 |
4,659 |
$1.02M |
| B4161 |
Ef ped hydrolyzed/amino acid |
1,474 |
1,418 |
$974K |
| E0482 |
Cough stimulating device |
3,043 |
3,012 |
$675K |
| A4606 |
Oxygen probe used w oximeter |
27,000 |
6,625 |
$663K |
| B9998 |
Enteral supp not otherwise c |
8,167 |
6,246 |
$578K |
| B4160 |
Ef ped caloric dense>/=0.7kc |
2,107 |
2,037 |
$532K |
| B4149 |
Ef blenderized foods |
1,270 |
1,185 |
$354K |
| E0445 |
Oximeter non-invasive |
1,129 |
1,096 |
$279K |
| A6210 |
Foam drg >16<=48 sq in w/o b |
1,378 |
1,105 |
$226K |
| A7520 |
Trach/laryn tube non-cuffed |
1,802 |
1,706 |
$226K |
| E0471 |
Rad w/backup non inv intrfc |
734 |
727 |
$203K |
| E0431 |
Portable gaseous 02 |
11,631 |
11,508 |
$198K |
| A4624 |
Tracheal suction tube |
1,692 |
1,627 |
$173K |
| E1399 |
Durable medical equipment mi |
1,071 |
839 |
$155K |
| A4605 |
Trach suction cath close sys |
1,240 |
1,021 |
$147K |
| B4155 |
Ef incomplete/modular |
1,010 |
954 |
$142K |
| A7000 |
Disposable canister for pump |
6,162 |
5,816 |
$134K |
| B4150 |
Ef complet w/intact nutrient |
452 |
420 |
$126K |
| A7526 |
Tracheostomy tube collar |
3,425 |
2,572 |
$97K |
| T1999 |
Noc retail items andsupplies |
12,719 |
5,669 |
$94K |
| A4483 |
Moisture exchanger |
1,152 |
740 |
$79K |
| A4629 |
Tracheostomy care kit |
1,147 |
1,117 |
$71K |
| A4554 |
Disposable underpads |
2,328 |
2,265 |
$60K |
| A7002 |
Tubing used w suction pump |
6,045 |
5,921 |
$54K |
| A4216 |
Sterile water/saline, 10 ml |
2,603 |
2,215 |
$47K |
| T4530 |
Ped size brief/diaper lg |
627 |
578 |
$47K |
| B9002 |
Enter nutr inf pump any type |
272 |
264 |
$42K |
| A9900 |
Supply/accessory/service |
2,396 |
2,120 |
$41K |
| A4322 |
Irrigation syringe |
4,791 |
4,620 |
$32K |
| A4628 |
Oropharyngeal suction cath |
11,864 |
5,896 |
$29K |
| T4522 |
Adult size brief/diaper med |
247 |
243 |
$23K |
| A7003 |
Nebulizer administration set |
7,335 |
7,196 |
$20K |
| E0601 |
Cont airway pressure device |
389 |
384 |
$19K |
| A6216 |
Non-sterile gauze<=16 sq in |
5,216 |
4,468 |
$16K |
| A4335 |
Incontinence supply |
3,783 |
3,502 |
$15K |
| E0562 |
Humidifier heated used w pap |
993 |
979 |
$12K |
| A4927 |
Non-sterile gloves |
1,906 |
1,766 |
$10K |
| B4103 |
Ef ped fluid and electrolyte |
83 |
76 |
$9K |
| T4532 |
Ped size pull-on lg |
62 |
62 |
$9K |
| A4402 |
Lubricant per ounce |
1,630 |
1,532 |
$7K |
| A7015 |
Aerosol mask used w nebulize |
5,037 |
4,973 |
$5K |
| B4104 |
Additive for enteral formula |
39 |
39 |
$3K |
| E0570 |
Nebulizer with compression |
39 |
38 |
$3K |
| A4450 |
Non-waterproof tape |
2,085 |
2,001 |
$3K |
| A7038 |
Pos airway pressure filter |
971 |
903 |
$2K |
| A4213 |
20+ cc syringe only |
1,206 |
1,097 |
$2K |
| A7037 |
Pos airway pressure tubing |
95 |
93 |
$1K |
| A7525 |
Tracheostomy mask |
778 |
326 |
$975.94 |
| A7013 |
Disposable compressor filter |
1,416 |
1,324 |
$597.56 |
| A4209 |
5+ cc sterile syringe&needle |
312 |
297 |
$223.30 |
| A5055 |
Stoma cap |
12 |
12 |
$17.03 |