| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
37,114 |
32,741 |
$859K |
| E0465 |
Home vent invasive interface |
1,133 |
796 |
$443K |
| B4035 |
Enteral feed supp pump per d |
3,027 |
2,078 |
$120K |
| E0431 |
Portable gaseous 02 |
17,562 |
15,491 |
$90K |
| A7030 |
Cpap full face mask |
2,320 |
2,135 |
$77K |
| A7031 |
Replacement facemask interfa |
3,695 |
3,425 |
$72K |
| E0466 |
Home vent non-invasive inter |
324 |
226 |
$69K |
| A4604 |
Tubing with heating element |
4,149 |
3,753 |
$67K |
| A7032 |
Replacement nasal cushion |
2,487 |
2,262 |
$55K |
| E0601 |
Cont airway pressure device |
2,920 |
2,685 |
$52K |
| A7034 |
Nasal application device |
2,184 |
1,983 |
$46K |
| E1392 |
Portable oxygen concentrator |
5,450 |
4,901 |
$44K |
| A4623 |
Tracheostomy inner cannula |
394 |
337 |
$29K |
| B4160 |
Ef ped caloric dense>/=0.7kc |
189 |
177 |
$26K |
| E0570 |
Nebulizer with compression |
6,420 |
5,859 |
$25K |
| E0562 |
Humidifier heated used w pap |
3,465 |
3,126 |
$20K |
| A4629 |
Tracheostomy care kit |
364 |
337 |
$20K |
| A7038 |
Pos airway pressure filter |
8,716 |
7,986 |
$20K |
| A7035 |
Pos airway press headgear |
2,633 |
2,404 |
$19K |
| A7033 |
Replacement nasal pillows |
970 |
898 |
$15K |
| B4152 |
Ef calorie dense>/=1.5kcal |
720 |
518 |
$13K |
| B4034 |
Enter feed supkit syr by day |
311 |
195 |
$12K |
| B4150 |
Ef complet w/intact nutrient |
407 |
252 |
$12K |
| A4605 |
Trach suction cath close sys |
69 |
66 |
$11K |
| A7046 |
Repl water chamber, pap dev |
2,275 |
2,082 |
$11K |
| E0260 |
Hosp bed semi-electr w/ matt |
781 |
712 |
$9K |
| A7526 |
Tracheostomy tube collar |
407 |
355 |
$8K |
| K0001 |
Standard wheelchair |
966 |
868 |
$7K |
| A4624 |
Tracheal suction tube |
88 |
83 |
$6K |
| A7000 |
Disposable canister for pump |
586 |
472 |
$5K |
| A7002 |
Tubing used w suction pump |
560 |
489 |
$4K |
| A7003 |
Nebulizer administration set |
4,357 |
3,730 |
$3K |
| E0443 |
Portable 02 contents, gas |
452 |
433 |
$3K |
| A4628 |
Oropharyngeal suction cath |
325 |
292 |
$3K |
| A7521 |
Trach/laryn tube cuffed |
146 |
132 |
$2K |
| B9002 |
Enter nutr inf pump any type |
81 |
69 |
$2K |
| A7036 |
Pos airway press chinstrap |
249 |
225 |
$1K |
| A7037 |
Pos airway pressure tubing |
206 |
186 |
$1K |
| A7005 |
Nondisposable nebulizer set |
284 |
265 |
$943.32 |
| A6402 |
Sterile gauze <= 16 sq in |
210 |
161 |
$657.50 |
| A7039 |
Filter, non disposable w pap |
121 |
105 |
$290.30 |
| K0003 |
Lightweight wheelchair |
32 |
24 |
$276.48 |
| A7013 |
Disposable compressor filter |
741 |
654 |
$159.32 |
| A7015 |
Aerosol mask used w nebulize |
321 |
284 |
$137.14 |
| E0434 |
Portable liquid 02 |
14 |
12 |
$115.85 |
| A7018 |
Water distilled w/nebulizer |
13 |
12 |
$54.40 |
| A7525 |
Tracheostomy mask |
15 |
13 |
$7.54 |