| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E0465 |
Home vent invasive interface |
1,578 |
716 |
$503K |
| E1390 |
Oxygen concentrator |
15,609 |
11,891 |
$465K |
| E0466 |
Home vent non-invasive inter |
1,005 |
586 |
$365K |
| A7030 |
Cpap full face mask |
5,998 |
4,679 |
$258K |
| E0601 |
Cont airway pressure device |
9,974 |
5,592 |
$161K |
| A4604 |
Tubing with heating element |
6,989 |
5,611 |
$137K |
| A4624 |
Tracheal suction tube |
998 |
666 |
$134K |
| A7034 |
Nasal application device |
4,314 |
3,454 |
$109K |
| A6196 |
Alginate dressing <=16 sq in |
1,258 |
867 |
$90K |
| E0562 |
Humidifier heated used w pap |
8,586 |
4,832 |
$78K |
| E0482 |
Cough stimulating device |
428 |
191 |
$74K |
| A7031 |
Replacement facemask interfa |
4,683 |
3,593 |
$71K |
| A7035 |
Pos airway press headgear |
6,467 |
5,070 |
$63K |
| E0431 |
Portable gaseous 02 |
8,090 |
6,274 |
$58K |
| A7526 |
Tracheostomy tube collar |
920 |
588 |
$40K |
| A7032 |
Replacement nasal cushion |
2,560 |
2,126 |
$39K |
| A4606 |
Oxygen probe used w oximeter |
1,757 |
1,087 |
$38K |
| E0600 |
Suction pump portab hom modl |
2,371 |
1,205 |
$37K |
| A7038 |
Pos airway pressure filter |
12,968 |
10,071 |
$29K |
| A7046 |
Repl water chamber, pap dev |
4,449 |
3,637 |
$29K |
| A7000 |
Disposable canister for pump |
1,530 |
1,113 |
$26K |
| A7520 |
Trach/laryn tube non-cuffed |
647 |
316 |
$25K |
| E0445 |
Oximeter non-invasive |
1,499 |
720 |
$24K |
| A6212 |
Foam drg <=16 sq in w/border |
355 |
282 |
$21K |
| A7507 |
Integrated filter & holder |
504 |
341 |
$19K |
| E0570 |
Nebulizer with compression |
5,569 |
3,586 |
$18K |
| E0470 |
Rad w/o backup non-inv intfc |
588 |
333 |
$18K |
| A7521 |
Trach/laryn tube cuffed |
322 |
149 |
$17K |
| A7037 |
Pos airway pressure tubing |
3,229 |
2,426 |
$17K |
| A7033 |
Replacement nasal pillows |
1,079 |
935 |
$15K |
| A6446 |
Conform band s w>=3" <5"/yd |
791 |
636 |
$13K |
| A4217 |
Sterile water/saline, 500 ml |
680 |
411 |
$13K |
| E1392 |
Portable oxygen concentrator |
1,181 |
768 |
$13K |
| A4628 |
Oropharyngeal suction cath |
1,077 |
778 |
$12K |
| E0261 |
Hosp bed semi-electr w/o mat |
909 |
735 |
$11K |
| A7039 |
Filter, non disposable w pap |
2,545 |
2,002 |
$9K |
| A6258 |
Transparent film >16<=48 in |
139 |
86 |
$7K |
| A4452 |
Waterproof tape |
435 |
373 |
$6K |
| A6402 |
Sterile gauze <= 16 sq in |
1,114 |
820 |
$4K |
| A7002 |
Tubing used w suction pump |
1,097 |
768 |
$4K |
| A4629 |
Tracheostomy care kit |
37 |
25 |
$4K |
| K0738 |
Portable gas oxygen system |
170 |
125 |
$3K |
| K0001 |
Standard wheelchair |
719 |
618 |
$3K |
| A4927 |
Non-sterile gloves |
433 |
249 |
$3K |
| A7003 |
Nebulizer administration set |
1,303 |
983 |
$3K |
| E0143 |
Walker folding wheeled w/o s |
70 |
65 |
$3K |
| A6222 |
Gauze <=16 in no w/sal w/o b |
109 |
90 |
$3K |
| K0195 |
Elevating whlchair leg rests |
670 |
542 |
$2K |
| A6216 |
Non-sterile gauze<=16 sq in |
331 |
275 |
$1K |
| A6251 |
Absorpt drg <=16 sq in w/o b |
30 |
28 |
$869.66 |
| A7525 |
Tracheostomy mask |
222 |
154 |
$528.52 |
| A4450 |
Non-waterproof tape |
144 |
130 |
$495.52 |
| A7015 |
Aerosol mask used w nebulize |
188 |
152 |
$215.12 |
| A9279 |
Monitoring feature/devicenoc |
410 |
274 |
$205.80 |
| A7007 |
Lg vol nebulizer disposable |
49 |
41 |
$203.45 |
| E1399 |
Durable medical equipment mi |
30 |
21 |
$0.00 |