| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
3,289 |
2,168 |
$123K |
| E0466 |
Home vent non-invasive inter |
769 |
532 |
$89K |
| B4152 |
Ef calorie dense>/=1.5kcal |
1,506 |
844 |
$45K |
| A4223 |
Infusion supplies w/o pump |
630 |
246 |
$42K |
| B4035 |
Enteral feed supp pump per d |
1,014 |
591 |
$24K |
| E0431 |
Portable gaseous 02 |
1,665 |
1,051 |
$13K |
| B4034 |
Enter feed supkit syr by day |
962 |
536 |
$10K |
| E0465 |
Home vent invasive interface |
32 |
24 |
$6K |
| B4150 |
Ef complet w/intact nutrient |
104 |
61 |
$6K |
| B9002 |
Enter nutr inf pump any type |
296 |
236 |
$6K |
| E1392 |
Portable oxygen concentrator |
1,073 |
776 |
$5K |
| E0601 |
Cont airway pressure device |
330 |
231 |
$5K |
| A4624 |
Tracheal suction tube |
356 |
200 |
$3K |
| A7526 |
Tracheostomy tube collar |
550 |
337 |
$2K |
| K0001 |
Standard wheelchair |
522 |
338 |
$1K |
| A4629 |
Tracheostomy care kit |
271 |
151 |
$1K |
| E0562 |
Humidifier heated used w pap |
518 |
389 |
$1K |
| A7000 |
Disposable canister for pump |
528 |
290 |
$551.58 |
| A4623 |
Tracheostomy inner cannula |
142 |
83 |
$537.65 |
| E0600 |
Suction pump portab hom modl |
146 |
115 |
$363.16 |
| A7002 |
Tubing used w suction pump |
732 |
416 |
$222.07 |
| B4088 |
Gastro/jejuno tube, low-pro |
16 |
13 |
$122.74 |
| E0260 |
Hosp bed semi-electr w/ matt |
55 |
38 |
$94.34 |
| A7525 |
Tracheostomy mask |
248 |
141 |
$51.24 |
| E0776 |
Iv pole |
155 |
102 |
$50.44 |
| A6402 |
Sterile gauze <= 16 sq in |
85 |
52 |
$32.50 |
| A7007 |
Lg vol nebulizer disposable |
26 |
12 |
$15.54 |
| E0570 |
Nebulizer with compression |
42 |
39 |
$2.08 |
| A4628 |
Oropharyngeal suction cath |
20 |
12 |
$0.00 |