| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
10,684 |
10,496 |
$1.04M |
| E0601 |
Cont airway pressure device |
7,485 |
7,438 |
$455K |
| A7030 |
Cpap full face mask |
2,269 |
2,235 |
$255K |
| E0431 |
Portable gaseous 02 |
8,613 |
8,386 |
$155K |
| E0570 |
Nebulizer with compression |
6,510 |
6,439 |
$147K |
| E0470 |
Rad w/o backup non-inv intfc |
1,035 |
1,018 |
$142K |
| A7031 |
Replacement facemask interfa |
2,161 |
2,137 |
$125K |
| E0562 |
Humidifier heated used w pap |
1,983 |
1,975 |
$103K |
| K0001 |
Standard wheelchair |
3,234 |
3,207 |
$84K |
| T4541 |
Large disposable underpad |
824 |
802 |
$84K |
| A7034 |
Nasal application device |
1,163 |
1,152 |
$81K |
| T4527 |
Adult size pull-on lg |
530 |
522 |
$77K |
| A4604 |
Tubing with heating element |
1,662 |
1,650 |
$73K |
| E0603 |
Electric breast pump |
568 |
564 |
$69K |
| A7032 |
Replacement nasal cushion |
913 |
902 |
$59K |
| T4526 |
Adult size pull-on med |
412 |
403 |
$53K |
| A7035 |
Pos airway press headgear |
2,354 |
2,310 |
$51K |
| A7038 |
Pos airway pressure filter |
6,027 |
5,928 |
$51K |
| T4523 |
Adult size brief/diaper lg |
249 |
246 |
$41K |
| A7037 |
Pos airway pressure tubing |
1,811 |
1,785 |
$37K |
| E0445 |
Oximeter non-invasive |
200 |
198 |
$37K |
| T4522 |
Adult size brief/diaper med |
314 |
310 |
$36K |
| A7046 |
Repl water chamber, pap dev |
1,426 |
1,409 |
$18K |
| E0143 |
Walker folding wheeled w/o s |
298 |
298 |
$17K |
| A9901 |
Delivery/set up/dispensing |
2,693 |
2,486 |
$16K |
| B4035 |
Enteral feed supp pump per d |
79 |
64 |
$15K |
| E0260 |
Hosp bed semi-electr w/ matt |
303 |
300 |
$11K |
| A4927 |
Non-sterile gloves |
759 |
740 |
$9K |
| K0003 |
Lightweight wheelchair |
133 |
133 |
$7K |
| E1392 |
Portable oxygen concentrator |
165 |
164 |
$6K |
| T4534 |
Youth size pull-on |
36 |
36 |
$4K |
| A4520 |
Incontinence garment anytype |
28 |
27 |
$4K |
| K0195 |
Elevating whlchair leg rests |
216 |
216 |
$3K |
| B4160 |
Ef ped caloric dense>/=0.7kc |
14 |
12 |
$3K |
| B9002 |
Enter nutr inf pump any type |
27 |
25 |
$2K |
| A7015 |
Aerosol mask used w nebulize |
745 |
745 |
$1K |
| A7033 |
Replacement nasal pillows |
25 |
25 |
$1K |
| A7004 |
Disposable nebulizer sml vol |
800 |
793 |
$996.51 |
| A7003 |
Nebulizer administration set |
270 |
269 |
$647.20 |
| A4335 |
Incontinence supply |
24 |
24 |
$303.36 |
| A6402 |
Sterile gauze <= 16 sq in |
12 |
12 |
$103.90 |