| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E0465 |
Home vent invasive interface |
2,553 |
2,279 |
$2.06M |
| E0466 |
Home vent non-invasive inter |
1,514 |
1,502 |
$1.36M |
| E1390 |
Oxygen concentrator |
10,604 |
10,517 |
$997K |
| B4161 |
Ef ped hydrolyzed/amino acid |
1,316 |
1,241 |
$604K |
| A4624 |
Tracheal suction tube |
2,315 |
2,094 |
$471K |
| B4160 |
Ef ped caloric dense>/=0.7kc |
2,381 |
2,262 |
$335K |
| S9342 |
Hit enteral pump diem |
1,115 |
692 |
$287K |
| E0445 |
Oximeter non-invasive |
2,898 |
2,894 |
$249K |
| A7507 |
Integrated filter & holder |
1,408 |
1,210 |
$206K |
| E0482 |
Cough stimulating device |
596 |
578 |
$169K |
| A7521 |
Trach/laryn tube cuffed |
1,239 |
1,080 |
$159K |
| A7526 |
Tracheostomy tube collar |
2,985 |
2,519 |
$143K |
| E0431 |
Portable gaseous 02 |
6,384 |
6,364 |
$127K |
| A6209 |
Foam drsg <=16 sq in w/o bdr |
1,032 |
888 |
$110K |
| E0600 |
Suction pump portab hom modl |
3,224 |
3,201 |
$93K |
| A4629 |
Tracheostomy care kit |
923 |
879 |
$88K |
| A7520 |
Trach/laryn tube non-cuffed |
1,032 |
864 |
$87K |
| A4605 |
Trach suction cath close sys |
813 |
760 |
$87K |
| K0738 |
Portable gas oxygen system |
3,807 |
3,774 |
$84K |
| E0570 |
Nebulizer with compression |
1,713 |
1,663 |
$80K |
| A4927 |
Non-sterile gloves |
2,339 |
2,199 |
$65K |
| A4217 |
Sterile water/saline, 500 ml |
1,822 |
1,705 |
$54K |
| A4628 |
Oropharyngeal suction cath |
2,954 |
2,831 |
$34K |
| E0565 |
Compressor air power source |
1,100 |
1,078 |
$31K |
| A4606 |
Oxygen probe used w oximeter |
273 |
264 |
$29K |
| A7000 |
Disposable canister for pump |
3,971 |
3,811 |
$28K |
| E0601 |
Cont airway pressure device |
746 |
742 |
$27K |
| B4088 |
Gastro/jejuno tube, low-pro |
198 |
180 |
$27K |
| A4216 |
Sterile water/saline, 10 ml |
1,458 |
1,371 |
$22K |
| A6402 |
Sterile gauze <= 16 sq in |
1,738 |
1,650 |
$22K |
| A4483 |
Moisture exchanger |
130 |
128 |
$20K |
| A7002 |
Tubing used w suction pump |
3,218 |
3,121 |
$11K |
| A7003 |
Nebulizer administration set |
2,899 |
2,828 |
$11K |
| K0001 |
Standard wheelchair |
339 |
339 |
$10K |
| A6216 |
Non-sterile gauze<=16 sq in |
1,460 |
1,397 |
$9K |
| A4604 |
Tubing with heating element |
251 |
248 |
$8K |
| A7030 |
Cpap full face mask |
79 |
78 |
$7K |
| E0562 |
Humidifier heated used w pap |
146 |
141 |
$6K |
| A7012 |
Nebulizer water collec devic |
846 |
806 |
$4K |
| A7035 |
Pos airway press headgear |
203 |
202 |
$4K |
| A7007 |
Lg vol nebulizer disposable |
625 |
609 |
$4K |
| E0424 |
Stationary compressed gas 02 |
25 |
25 |
$3K |
| A4618 |
Breathing circuits |
88 |
76 |
$3K |
| K0195 |
Elevating whlchair leg rests |
242 |
242 |
$2K |
| B4152 |
Ef calorie dense>/=1.5kcal |
27 |
24 |
$2K |
| A4332 |
Lube sterile packet |
215 |
213 |
$2K |
| A7015 |
Aerosol mask used w nebulize |
1,480 |
1,469 |
$2K |
| A7525 |
Tracheostomy mask |
1,149 |
1,070 |
$2K |
| A7038 |
Pos airway pressure filter |
420 |
407 |
$2K |
| A7034 |
Nasal application device |
29 |
29 |
$2K |
| A7046 |
Repl water chamber, pap dev |
127 |
126 |
$1K |
| B4150 |
Ef complet w/intact nutrient |
13 |
13 |
$1K |
| A4481 |
Tracheostoma filter |
377 |
367 |
$392.64 |
| A7010 |
Disposable corrugated tubing |
13 |
13 |
$219.66 |
| A4244 |
Alcohol or peroxide per pint |
14 |
12 |
$29.46 |