| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E0465 |
Home vent invasive interface |
982 |
793 |
$334K |
| A4554 |
Disposable underpads |
3,107 |
3,098 |
$255K |
| A4624 |
Tracheal suction tube |
1,093 |
1,046 |
$197K |
| E1390 |
Oxygen concentrator |
2,392 |
2,384 |
$183K |
| A4629 |
Tracheostomy care kit |
1,395 |
1,372 |
$91K |
| E0445 |
Oximeter non-invasive |
404 |
404 |
$66K |
| T4537 |
Reusable underpad bed size |
1,590 |
1,587 |
$57K |
| T4523 |
Adult size brief/diaper lg |
374 |
372 |
$56K |
| T4522 |
Adult size brief/diaper med |
482 |
482 |
$55K |
| B4035 |
Enteral feed supp pump per d |
328 |
327 |
$47K |
| E0431 |
Portable gaseous 02 |
2,488 |
2,468 |
$47K |
| A6402 |
Sterile gauze <= 16 sq in |
1,072 |
1,061 |
$24K |
| A7000 |
Disposable canister for pump |
1,652 |
1,622 |
$21K |
| A4927 |
Non-sterile gloves |
2,543 |
2,533 |
$11K |
| A4217 |
Sterile water/saline, 500 ml |
458 |
453 |
$5K |
| A7002 |
Tubing used w suction pump |
1,620 |
1,594 |
$4K |
| A4628 |
Oropharyngeal suction cath |
769 |
751 |
$4K |
| A7526 |
Tracheostomy tube collar |
83 |
80 |
$2K |
| A7520 |
Trach/laryn tube non-cuffed |
50 |
49 |
$2K |
| A4623 |
Tracheostomy inner cannula |
41 |
38 |
$2K |
| T4521 |
Adult size brief/diaper sm |
12 |
12 |
$1K |
| A4216 |
Sterile water/saline, 10 ml |
65 |
60 |
$982.35 |
| A7003 |
Nebulizer administration set |
274 |
232 |
$704.87 |