| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
13,233 |
12,096 |
$829K |
| E0601 |
Cont airway pressure device |
19,077 |
18,063 |
$697K |
| A7030 |
Cpap full face mask |
8,806 |
8,277 |
$608K |
| A7031 |
Replacement facemask interfa |
13,622 |
12,893 |
$592K |
| A4604 |
Tubing with heating element |
15,474 |
14,566 |
$527K |
| A4606 |
Oxygen probe used w oximeter |
1,339 |
1,132 |
$386K |
| E0465 |
Home vent invasive interface |
394 |
296 |
$340K |
| A7038 |
Pos airway pressure filter |
26,985 |
25,468 |
$287K |
| A7034 |
Nasal application device |
5,844 |
5,491 |
$261K |
| E0562 |
Humidifier heated used w pap |
1,995 |
1,831 |
$234K |
| A7032 |
Replacement nasal cushion |
5,865 |
5,521 |
$231K |
| K0738 |
Portable gas oxygen system |
9,395 |
8,599 |
$226K |
| A7035 |
Pos airway press headgear |
9,863 |
9,260 |
$220K |
| B9998 |
Enteral supp not otherwise c |
1,323 |
709 |
$171K |
| A7046 |
Repl water chamber, pap dev |
7,240 |
6,842 |
$112K |
| A7033 |
Replacement nasal pillows |
4,225 |
3,975 |
$106K |
| E0470 |
Rad w/o backup non-inv intfc |
1,354 |
1,221 |
$102K |
| B4035 |
Enteral feed supp pump per d |
554 |
529 |
$78K |
| A4649 |
Surgical supplies |
208 |
172 |
$65K |
| A4629 |
Tracheostomy care kit |
615 |
567 |
$50K |
| A7526 |
Tracheostomy tube collar |
640 |
575 |
$39K |
| E0466 |
Home vent non-invasive inter |
103 |
86 |
$36K |
| A4624 |
Tracheal suction tube |
242 |
213 |
$30K |
| A7507 |
Integrated filter & holder |
414 |
382 |
$30K |
| E0445 |
Oximeter non-invasive |
287 |
244 |
$29K |
| A7000 |
Disposable canister for pump |
1,141 |
1,049 |
$24K |
| E0570 |
Nebulizer with compression |
2,374 |
2,220 |
$23K |
| A4217 |
Sterile water/saline, 500 ml |
510 |
472 |
$22K |
| E0600 |
Suction pump portab hom modl |
583 |
492 |
$16K |
| A4927 |
Non-sterile gloves |
837 |
755 |
$12K |
| A4628 |
Oropharyngeal suction cath |
838 |
776 |
$9K |
| A7037 |
Pos airway pressure tubing |
477 |
451 |
$9K |
| A7002 |
Tubing used w suction pump |
1,172 |
1,081 |
$7K |
| E1392 |
Portable oxygen concentrator |
337 |
282 |
$5K |
| A7005 |
Nondisposable nebulizer set |
222 |
213 |
$4K |
| A4623 |
Tracheostomy inner cannula |
13 |
12 |
$4K |
| E0431 |
Portable gaseous 02 |
305 |
232 |
$4K |
| A6402 |
Sterile gauze <= 16 sq in |
432 |
410 |
$4K |
| E0482 |
Cough stimulating device |
12 |
12 |
$3K |
| A7003 |
Nebulizer administration set |
616 |
568 |
$3K |
| T4535 |
Disposable liner/shield/pad |
75 |
55 |
$2K |
| A7039 |
Filter, non disposable w pap |
292 |
275 |
$2K |
| E0114 |
Crutch underarm pair no wood |
26 |
25 |
$819.51 |
| A4450 |
Non-waterproof tape |
115 |
110 |
$579.20 |
| A7036 |
Pos airway press chinstrap |
27 |
25 |
$550.05 |
| A7013 |
Disposable compressor filter |
273 |
263 |
$164.86 |
| A7015 |
Aerosol mask used w nebulize |
49 |
48 |
$51.52 |