| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E0603 |
Electric breast pump |
3,621 |
3,333 |
$610K |
| E1390 |
Oxygen concentrator |
9,142 |
7,413 |
$455K |
| E0601 |
Cont airway pressure device |
7,636 |
6,764 |
$436K |
| A7030 |
Cpap full face mask |
3,648 |
3,083 |
$302K |
| A7034 |
Nasal application device |
4,721 |
4,171 |
$263K |
| A4604 |
Tubing with heating element |
7,350 |
6,342 |
$224K |
| E0470 |
Rad w/o backup non-inv intfc |
1,370 |
1,240 |
$204K |
| E0260 |
Hosp bed semi-electr w/ matt |
5,680 |
4,359 |
$164K |
| A7031 |
Replacement facemask interfa |
3,642 |
3,080 |
$156K |
| A7032 |
Replacement nasal cushion |
3,163 |
2,809 |
$139K |
| E0570 |
Nebulizer with compression |
5,168 |
3,936 |
$133K |
| E0562 |
Humidifier heated used w pap |
2,157 |
1,945 |
$126K |
| K0001 |
Standard wheelchair |
7,949 |
6,015 |
$116K |
| A7035 |
Pos airway press headgear |
5,140 |
4,455 |
$93K |
| E0143 |
Walker folding wheeled w/o s |
2,652 |
2,047 |
$92K |
| A7038 |
Pos airway pressure filter |
9,665 |
8,416 |
$62K |
| A7033 |
Replacement nasal pillows |
2,191 |
1,883 |
$57K |
| E0431 |
Portable gaseous 02 |
6,087 |
4,840 |
$54K |
| T4527 |
Adult size pull-on lg |
556 |
495 |
$42K |
| T4535 |
Disposable liner/shield/pad |
479 |
436 |
$32K |
| A7046 |
Repl water chamber, pap dev |
3,419 |
2,952 |
$30K |
| E2201 |
Man w/ch acc seat w>=20"<24" |
2,044 |
1,627 |
$29K |
| E0630 |
Patient lift hydraulic |
1,113 |
811 |
$29K |
| T4541 |
Large disposable underpad |
1,437 |
1,206 |
$25K |
| T4528 |
Adult size pull-on xl |
250 |
229 |
$22K |
| A7005 |
Nondisposable nebulizer set |
1,110 |
999 |
$20K |
| E1392 |
Portable oxygen concentrator |
1,098 |
960 |
$16K |
| K0007 |
Extra heavy duty wheelchair |
257 |
192 |
$16K |
| K0195 |
Elevating whlchair leg rests |
2,105 |
1,685 |
$15K |
| A4927 |
Non-sterile gloves |
1,265 |
957 |
$13K |
| E0156 |
Walker seat attachment |
1,633 |
1,295 |
$13K |
| T4526 |
Adult size pull-on med |
122 |
116 |
$10K |
| T4544 |
Adlt disp und/pull on abv xl |
38 |
28 |
$6K |
| T4523 |
Adult size brief/diaper lg |
27 |
26 |
$3K |
| E0277 |
Powered pres-redu air mattrs |
19 |
12 |
$2K |
| L4361 |
Pneuma/vac walk boot pre ots |
15 |
13 |
$2K |
| E0600 |
Suction pump portab hom modl |
57 |
51 |
$1K |
| A4606 |
Oxygen probe used w oximeter |
18 |
12 |
$832.26 |
| A7036 |
Pos airway press chinstrap |
95 |
87 |
$770.82 |
| E0240 |
Bath/shower chair |
15 |
13 |
$749.45 |
| E2601 |
Gen w/c cushion wdth < 22 in |
21 |
14 |
$475.70 |
| A7003 |
Nebulizer administration set |
113 |
101 |
$235.34 |
| E0181 |
Press pad alternating w/ pum |
27 |
26 |
$170.43 |
| A7000 |
Disposable canister for pump |
13 |
12 |
$143.47 |
| A7015 |
Aerosol mask used w nebulize |
90 |
85 |
$121.39 |
| A7002 |
Tubing used w suction pump |
16 |
12 |
$71.50 |
| A4520 |
Incontinence garment anytype |
43 |
31 |
$0.00 |