| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate |
1,799 |
1,786 |
$52K |
| A4623 |
Tracheostomy, inner cannula |
2,156 |
2,142 |
$43K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
1,752 |
1,744 |
$27K |
| E0465 |
Home ventilator, any type, used with invasive interface, (e.g., tracheostomy tube) |
182 |
181 |
$21K |
| B4035 |
Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
629 |
593 |
$19K |
| K0001 |
Standard wheelchair |
1,880 |
1,878 |
$10K |
| A4629 |
Tracheostomy care kit for established tracheostomy |
729 |
723 |
$10K |
| A4605 |
Tracheal suction catheter, closed system, each |
111 |
110 |
$8K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
1,045 |
1,035 |
$6K |
| E0630 |
Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s) |
401 |
400 |
$6K |
| A4217 |
Sterile water/saline, 500 ml |
255 |
254 |
$5K |
| A7526 |
Tracheostomy tube collar/holder, each |
802 |
797 |
$5K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
425 |
423 |
$3K |
| B9002 |
Enteral nutrition infusion pump, any type |
286 |
283 |
$3K |
| K0195 |
Elevating leg rests, pair (for use with capped rental wheelchair base) |
1,536 |
1,532 |
$3K |
| A7000 |
Canister, disposable, used with suction pump, each |
196 |
195 |
$2K |
| E1392 |
Portable oxygen concentrator, rental |
185 |
185 |
$2K |
| A7002 |
Tubing, used with suction pump, each |
346 |
338 |
$2K |
| A7521 |
Tracheostomy/laryngectomy tube, cuffed, polyvinylchloride (pvc), silicone or equal, each |
320 |
319 |
$2K |
| E0163 |
Commode chair, mobile or stationary, with fixed arms |
151 |
148 |
$1K |
| A4628 |
Oral and/or oropharyngeal suction catheter, each |
169 |
166 |
$1K |
| E0776 |
Iv pole |
874 |
869 |
$1K |
| A4216 |
Sterile water, saline and/or dextrose, diluent/flush, 10 ml |
93 |
92 |
$1K |
| E1038 |
Transport chair, adult size, patient weight capacity up to and including 300 pounds |
333 |
332 |
$614.34 |
| E0600 |
Respiratory suction pump, home model, portable or stationary, electric |
12 |
12 |
$75.90 |