| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A4606 |
Oxygen probe used w oximeter |
6,216 |
2,750 |
$1.23M |
| B4035 |
Enteral feed supp pump per d |
6,982 |
4,410 |
$874K |
| A4624 |
Tracheal suction tube |
4,129 |
2,422 |
$742K |
| E0465 |
Home vent invasive interface |
1,479 |
1,078 |
$719K |
| E1390 |
Oxygen concentrator |
8,915 |
7,319 |
$717K |
| B9998 |
Enteral supp not otherwise c |
13,463 |
5,173 |
$702K |
| B4088 |
Gastro/jejuno tube, low-pro |
4,171 |
2,295 |
$427K |
| A7520 |
Trach/laryn tube non-cuffed |
3,069 |
1,406 |
$352K |
| E0466 |
Home vent non-invasive inter |
339 |
279 |
$206K |
| A9900 |
Supply/accessory/service |
2,837 |
781 |
$199K |
| A7526 |
Tracheostomy tube collar |
3,701 |
2,074 |
$179K |
| A4628 |
Oropharyngeal suction cath |
5,166 |
3,267 |
$160K |
| T4530 |
Ped size brief/diaper lg |
1,844 |
1,340 |
$142K |
| A4217 |
Sterile water/saline, 500 ml |
4,914 |
2,302 |
$99K |
| A4483 |
Moisture exchanger |
905 |
646 |
$87K |
| T4522 |
Adult size brief/diaper med |
1,027 |
790 |
$82K |
| A9999 |
Dme supply or accessory, nos |
27,292 |
4,568 |
$81K |
| A4629 |
Tracheostomy care kit |
2,181 |
1,312 |
$73K |
| A6402 |
Sterile gauze <= 16 sq in |
6,657 |
4,054 |
$69K |
| A7508 |
Housing & integrated adhesiv |
2,492 |
779 |
$54K |
| S8189 |
Trach supply noc |
1,282 |
525 |
$54K |
| E0603 |
Electric breast pump |
440 |
246 |
$49K |
| E0445 |
Oximeter non-invasive |
30 |
14 |
$37K |
| A4216 |
Sterile water/saline, 10 ml |
3,052 |
1,625 |
$37K |
| A7000 |
Disposable canister for pump |
6,573 |
4,064 |
$31K |
| B4034 |
Enter feed supkit syr by day |
1,287 |
857 |
$29K |
| A6209 |
Foam drsg <=16 sq in w/o bdr |
364 |
113 |
$24K |
| A4930 |
Sterile, gloves per pair |
555 |
347 |
$24K |
| A4927 |
Non-sterile gloves |
3,317 |
1,990 |
$22K |
| A7002 |
Tubing used w suction pump |
7,784 |
4,054 |
$15K |
| A7525 |
Tracheostomy mask |
2,797 |
1,184 |
$9K |
| A7046 |
Repl water chamber, pap dev |
1,361 |
798 |
$9K |
| E0443 |
Portable 02 contents, gas |
270 |
194 |
$7K |
| A4402 |
Lubricant per ounce |
1,941 |
1,153 |
$6K |
| E0601 |
Cont airway pressure device |
154 |
127 |
$5K |
| A7003 |
Nebulizer administration set |
4,030 |
2,467 |
$5K |
| K0738 |
Portable gas oxygen system |
147 |
126 |
$5K |
| E0570 |
Nebulizer with compression |
85 |
63 |
$4K |
| A4657 |
Syringe w/wo needle |
2,749 |
1,607 |
$3K |
| A4322 |
Irrigation syringe |
297 |
158 |
$3K |
| K0003 |
Lightweight wheelchair |
310 |
228 |
$3K |
| A7007 |
Lg vol nebulizer disposable |
680 |
337 |
$2K |
| T4523 |
Adult size brief/diaper lg |
20 |
12 |
$2K |
| E0971 |
Wheelchair anti-tipping devi |
722 |
275 |
$2K |
| T4529 |
Ped size brief/diaper sm/med |
32 |
12 |
$2K |
| E0562 |
Humidifier heated used w pap |
62 |
50 |
$1K |
| E1392 |
Portable oxygen concentrator |
40 |
36 |
$1K |
| A7010 |
Disposable corrugated tubing |
194 |
71 |
$966.78 |
| E0431 |
Portable gaseous 02 |
84 |
67 |
$914.39 |
| A4244 |
Alcohol or peroxide per pint |
1,076 |
516 |
$819.74 |
| E2601 |
Gen w/c cushion wdth < 22 in |
41 |
13 |
$349.69 |
| A4332 |
Lube sterile packet |
121 |
56 |
$269.19 |
| A7037 |
Pos airway pressure tubing |
13 |
12 |
$255.51 |
| A7005 |
Nondisposable nebulizer set |
14 |
13 |
$96.80 |