| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A4606 |
Oxygen probe used w oximeter |
3,363 |
1,471 |
$683K |
| B4035 |
Enteral feed supp pump per d |
4,059 |
2,828 |
$614K |
| E0465 |
Home vent invasive interface |
868 |
613 |
$442K |
| B4088 |
Gastro/jejuno tube, low-pro |
3,908 |
2,064 |
$400K |
| B9998 |
Enteral supp not otherwise c |
7,866 |
3,343 |
$387K |
| E1390 |
Oxygen concentrator |
5,296 |
4,428 |
$380K |
| A4624 |
Tracheal suction tube |
1,376 |
898 |
$302K |
| A4628 |
Oropharyngeal suction cath |
2,297 |
1,398 |
$102K |
| A4217 |
Sterile water/saline, 500 ml |
2,171 |
1,203 |
$99K |
| A7526 |
Tracheostomy tube collar |
1,447 |
982 |
$92K |
| A4483 |
Moisture exchanger |
819 |
590 |
$75K |
| A7520 |
Trach/laryn tube non-cuffed |
218 |
153 |
$69K |
| A6402 |
Sterile gauze <= 16 sq in |
4,288 |
2,556 |
$50K |
| A9999 |
Dme supply or accessory, nos |
13,625 |
2,097 |
$42K |
| A9900 |
Supply/accessory/service |
1,455 |
414 |
$41K |
| A4629 |
Tracheostomy care kit |
618 |
419 |
$39K |
| E1392 |
Portable oxygen concentrator |
1,316 |
1,104 |
$28K |
| B9002 |
Enter nutr inf pump any type |
79 |
63 |
$27K |
| A7521 |
Trach/laryn tube cuffed |
44 |
26 |
$25K |
| A7000 |
Disposable canister for pump |
3,091 |
2,011 |
$19K |
| T4530 |
Ped size brief/diaper lg |
209 |
166 |
$17K |
| A4216 |
Sterile water/saline, 10 ml |
1,422 |
864 |
$15K |
| E0619 |
Apnea monitor w recorder |
93 |
74 |
$14K |
| A4927 |
Non-sterile gloves |
1,514 |
885 |
$10K |
| S8189 |
Trach supply noc |
92 |
65 |
$10K |
| A7002 |
Tubing used w suction pump |
3,365 |
2,013 |
$7K |
| A4605 |
Trach suction cath close sys |
15 |
14 |
$6K |
| E0601 |
Cont airway pressure device |
257 |
227 |
$5K |
| A4930 |
Sterile, gloves per pair |
132 |
79 |
$5K |
| A6209 |
Foam drsg <=16 sq in w/o bdr |
29 |
12 |
$5K |
| A4657 |
Syringe w/wo needle |
2,329 |
1,130 |
$4K |
| A7003 |
Nebulizer administration set |
1,783 |
1,252 |
$4K |
| A7046 |
Repl water chamber, pap dev |
767 |
328 |
$4K |
| A4402 |
Lubricant per ounce |
773 |
525 |
$4K |
| A4322 |
Irrigation syringe |
343 |
186 |
$3K |
| B4034 |
Enter feed supkit syr by day |
31 |
28 |
$3K |
| T4534 |
Youth size pull-on |
42 |
25 |
$2K |
| A7038 |
Pos airway pressure filter |
415 |
160 |
$886.32 |
| A7525 |
Tracheostomy mask |
86 |
61 |
$583.46 |
| A7030 |
Cpap full face mask |
15 |
12 |
$436.20 |
| A4244 |
Alcohol or peroxide per pint |
140 |
85 |
$241.80 |
| A7020 |
Interface, cough stim device |
15 |
12 |
$140.69 |