| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
4,926 |
4,686 |
$410K |
| E0601 |
Cont airway pressure device |
1,604 |
1,603 |
$97K |
| A7030 |
Cpap full face mask |
999 |
986 |
$93K |
| E0570 |
Nebulizer with compression |
1,280 |
1,275 |
$66K |
| T4527 |
Adult size pull-on lg |
441 |
436 |
$61K |
| B4035 |
Enteral feed supp pump per d |
294 |
282 |
$60K |
| E0431 |
Portable gaseous 02 |
4,119 |
3,816 |
$60K |
| A7031 |
Replacement facemask interfa |
917 |
907 |
$57K |
| K0001 |
Standard wheelchair |
2,050 |
2,031 |
$45K |
| T4526 |
Adult size pull-on med |
318 |
315 |
$41K |
| E0603 |
Electric breast pump |
259 |
259 |
$32K |
| E0260 |
Hosp bed semi-electr w/ matt |
510 |
502 |
$26K |
| A4604 |
Tubing with heating element |
671 |
669 |
$25K |
| T4541 |
Large disposable underpad |
359 |
350 |
$25K |
| A9901 |
Delivery/set up/dispensing |
2,345 |
2,155 |
$17K |
| A7038 |
Pos airway pressure filter |
1,362 |
1,344 |
$16K |
| E0470 |
Rad w/o backup non-inv intfc |
99 |
99 |
$13K |
| A7035 |
Pos airway press headgear |
672 |
664 |
$13K |
| E0445 |
Oximeter non-invasive |
42 |
36 |
$6K |
| T4522 |
Adult size brief/diaper med |
50 |
50 |
$5K |
| A7046 |
Repl water chamber, pap dev |
398 |
392 |
$4K |
| K0003 |
Lightweight wheelchair |
89 |
89 |
$4K |
| A7037 |
Pos airway pressure tubing |
197 |
197 |
$4K |
| E0143 |
Walker folding wheeled w/o s |
91 |
90 |
$3K |
| T4524 |
Adult size brief/diaper xl |
13 |
12 |
$2K |
| A4927 |
Non-sterile gloves |
383 |
368 |
$2K |
| A7004 |
Disposable nebulizer sml vol |
725 |
718 |
$784.73 |
| K0195 |
Elevating whlchair leg rests |
60 |
60 |
$658.54 |
| A7015 |
Aerosol mask used w nebulize |
378 |
368 |
$454.58 |
| A7003 |
Nebulizer administration set |
200 |
200 |
$362.75 |