| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
1,799 |
1,786 |
$52K |
| A4623 |
Tracheostomy inner cannula |
2,156 |
2,142 |
$43K |
| E0260 |
Hosp bed semi-electr w/ matt |
1,752 |
1,744 |
$27K |
| E0465 |
Home vent invasive interface |
182 |
181 |
$21K |
| B4035 |
Enteral feed supp pump per d |
629 |
593 |
$19K |
| K0001 |
Standard wheelchair |
1,880 |
1,878 |
$10K |
| A4629 |
Tracheostomy care kit |
729 |
723 |
$10K |
| A4605 |
Trach suction cath close sys |
111 |
110 |
$8K |
| E0431 |
Portable gaseous 02 |
1,045 |
1,035 |
$6K |
| E0630 |
Patient lift hydraulic |
401 |
400 |
$6K |
| A4217 |
Sterile water/saline, 500 ml |
255 |
254 |
$5K |
| A7526 |
Tracheostomy tube collar |
802 |
797 |
$5K |
| E0143 |
Walker folding wheeled w/o s |
425 |
423 |
$3K |
| B9002 |
Enter nutr inf pump any type |
286 |
283 |
$3K |
| K0195 |
Elevating whlchair leg rests |
1,536 |
1,532 |
$3K |
| A7000 |
Disposable canister for pump |
196 |
195 |
$2K |
| E1392 |
Portable oxygen concentrator |
185 |
185 |
$2K |
| A7002 |
Tubing used w suction pump |
346 |
338 |
$2K |
| A7521 |
Trach/laryn tube cuffed |
320 |
319 |
$2K |
| E0163 |
Commode chair with fixed arm |
151 |
148 |
$1K |
| A4628 |
Oropharyngeal suction cath |
169 |
166 |
$1K |
| E0776 |
Iv pole |
874 |
869 |
$1K |
| A4216 |
Sterile water/saline, 10 ml |
93 |
92 |
$1K |
| E1038 |
Transport chair pt wt<=300lb |
333 |
332 |
$614.34 |
| E0600 |
Suction pump portab hom modl |
12 |
12 |
$75.90 |