| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E0465 |
Home vent invasive interface |
2,143 |
1,047 |
$1.18M |
| E0466 |
Home vent non-invasive inter |
2,498 |
2,011 |
$1.11M |
| E1390 |
Oxygen concentrator |
20,001 |
16,077 |
$969K |
| E0601 |
Cont airway pressure device |
6,759 |
5,752 |
$458K |
| E0445 |
Oximeter non-invasive |
3,093 |
2,255 |
$290K |
| A7030 |
Cpap full face mask |
4,010 |
3,371 |
$271K |
| E0562 |
Humidifier heated used w pap |
3,975 |
3,474 |
$208K |
| A4606 |
Oxygen probe used w oximeter |
2,636 |
1,872 |
$187K |
| A4217 |
Sterile water/saline, 500 ml |
2,809 |
1,533 |
$186K |
| B4035 |
Enteral feed supp pump per d |
2,051 |
1,367 |
$186K |
| B4161 |
Ef ped hydrolyzed/amino acid |
1,760 |
683 |
$179K |
| B9998 |
Enteral supp not otherwise c |
2,884 |
1,426 |
$177K |
| A7034 |
Nasal application device |
3,917 |
3,242 |
$159K |
| A4624 |
Tracheal suction tube |
1,054 |
842 |
$133K |
| A7526 |
Tracheostomy tube collar |
1,685 |
1,289 |
$116K |
| A7031 |
Replacement facemask interfa |
3,604 |
2,966 |
$113K |
| E0470 |
Rad w/o backup non-inv intfc |
1,423 |
1,290 |
$110K |
| A4604 |
Tubing with heating element |
4,173 |
3,538 |
$104K |
| E0431 |
Portable gaseous 02 |
8,050 |
6,583 |
$103K |
| A7520 |
Trach/laryn tube non-cuffed |
1,505 |
724 |
$81K |
| A7035 |
Pos airway press headgear |
5,957 |
4,949 |
$80K |
| A4629 |
Tracheostomy care kit |
1,026 |
813 |
$77K |
| A7507 |
Integrated filter & holder |
806 |
627 |
$71K |
| S8189 |
Trach supply noc |
1,476 |
627 |
$64K |
| E0600 |
Suction pump portab hom modl |
2,440 |
1,631 |
$60K |
| K0738 |
Portable gas oxygen system |
4,407 |
3,553 |
$56K |
| B9002 |
Enter nutr inf pump any type |
1,302 |
898 |
$54K |
| A7032 |
Replacement nasal cushion |
1,981 |
1,544 |
$52K |
| A4628 |
Oropharyngeal suction cath |
2,077 |
1,376 |
$46K |
| A4605 |
Trach suction cath close sys |
135 |
118 |
$40K |
| B4160 |
Ef ped caloric dense>/=0.7kc |
637 |
279 |
$39K |
| A7000 |
Disposable canister for pump |
2,087 |
1,600 |
$36K |
| E0570 |
Nebulizer with compression |
2,135 |
1,840 |
$36K |
| B4034 |
Enter feed supkit syr by day |
1,439 |
944 |
$35K |
| E0482 |
Cough stimulating device |
201 |
132 |
$33K |
| E0143 |
Walker folding wheeled w/o s |
901 |
831 |
$29K |
| A7046 |
Repl water chamber, pap dev |
3,635 |
3,061 |
$28K |
| E1392 |
Portable oxygen concentrator |
2,186 |
1,817 |
$27K |
| A7037 |
Pos airway pressure tubing |
3,831 |
3,176 |
$26K |
| E0260 |
Hosp bed semi-electr w/ matt |
1,407 |
1,088 |
$22K |
| A4623 |
Tracheostomy inner cannula |
144 |
114 |
$22K |
| A9900 |
Supply/accessory/service |
1,923 |
656 |
$21K |
| E0603 |
Electric breast pump |
147 |
138 |
$20K |
| A7038 |
Pos airway pressure filter |
14,450 |
7,940 |
$20K |
| A4452 |
Waterproof tape |
1,999 |
1,201 |
$20K |
| A7002 |
Tubing used w suction pump |
2,020 |
1,568 |
$19K |
| A7033 |
Replacement nasal pillows |
903 |
734 |
$19K |
| A6402 |
Sterile gauze <= 16 sq in |
2,465 |
1,616 |
$19K |
| A4618 |
Breathing circuits |
860 |
501 |
$17K |
| A4927 |
Non-sterile gloves |
1,471 |
1,003 |
$16K |
| K0001 |
Standard wheelchair |
1,081 |
912 |
$15K |
| B4036 |
Enteral feed sup kit grav by |
219 |
142 |
$14K |
| B4088 |
Gastro/jejuno tube, low-pro |
504 |
393 |
$14K |
| A7521 |
Trach/laryn tube cuffed |
305 |
162 |
$13K |
| E0565 |
Compressor air power source |
329 |
273 |
$10K |
| E0604 |
Hosp grade elec breast pump |
206 |
193 |
$8K |
| A9999 |
Dme supply or accessory, nos |
1,815 |
586 |
$8K |
| A4483 |
Moisture exchanger |
160 |
92 |
$6K |
| E0163 |
Commode chair with fixed arm |
120 |
111 |
$5K |
| A7003 |
Nebulizer administration set |
1,924 |
1,482 |
$4K |
| E0424 |
Stationary compressed gas 02 |
101 |
82 |
$4K |
| E0156 |
Walker seat attachment |
311 |
285 |
$3K |
| A7005 |
Nondisposable nebulizer set |
313 |
258 |
$3K |
| A7525 |
Tracheostomy mask |
816 |
627 |
$3K |
| A7039 |
Filter, non disposable w pap |
629 |
529 |
$2K |
| E1140 |
Wheelchair standard detach a |
72 |
67 |
$2K |
| A4332 |
Lube sterile packet |
1,236 |
962 |
$2K |
| A7036 |
Pos airway press chinstrap |
179 |
151 |
$1K |
| E0240 |
Bath/shower chair |
12 |
12 |
$1K |
| A4244 |
Alcohol or peroxide per pint |
471 |
399 |
$839.50 |
| A6260 |
Wound cleanser any type/size |
35 |
33 |
$820.33 |
| A6453 |
Self-adher band w <3"/yd |
705 |
421 |
$755.77 |
| E0776 |
Iv pole |
66 |
50 |
$614.39 |
| A7013 |
Disposable compressor filter |
757 |
611 |
$605.25 |
| E0990 |
Wheelchair elevating leg res |
133 |
113 |
$535.35 |
| K0003 |
Lightweight wheelchair |
13 |
12 |
$330.53 |
| E1399 |
Durable medical equipment mi |
99 |
63 |
$194.94 |
| A7015 |
Aerosol mask used w nebulize |
93 |
83 |
$165.85 |