| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
5,058 |
4,828 |
$429K |
| T4527 |
Adult size pull-on lg |
3,049 |
2,831 |
$294K |
| A7030 |
Cpap full face mask |
2,051 |
1,949 |
$198K |
| E0601 |
Cont airway pressure device |
4,704 |
4,418 |
$188K |
| T2029 |
Special med equip, noswaiver |
1,354 |
1,127 |
$160K |
| A4604 |
Tubing with heating element |
3,678 |
3,490 |
$144K |
| T4528 |
Adult size pull-on xl |
1,117 |
1,030 |
$115K |
| E0603 |
Electric breast pump |
453 |
445 |
$105K |
| T4535 |
Disposable liner/shield/pad |
1,849 |
1,702 |
$104K |
| T4526 |
Adult size pull-on med |
1,129 |
1,012 |
$90K |
| A7034 |
Nasal application device |
1,346 |
1,296 |
$86K |
| E0470 |
Rad w/o backup non-inv intfc |
501 |
477 |
$67K |
| A7031 |
Replacement facemask interfa |
1,625 |
1,533 |
$61K |
| T4534 |
Youth size pull-on |
535 |
477 |
$61K |
| L4361 |
Pneuma/vac walk boot pre ots |
249 |
244 |
$60K |
| A7035 |
Pos airway press headgear |
2,597 |
2,482 |
$54K |
| E0562 |
Humidifier heated used w pap |
299 |
280 |
$49K |
| E0570 |
Nebulizer with compression |
915 |
876 |
$44K |
| T4541 |
Large disposable underpad |
1,057 |
988 |
$40K |
| E0260 |
Hosp bed semi-electr w/ matt |
489 |
451 |
$29K |
| A7038 |
Pos airway pressure filter |
5,945 |
5,679 |
$27K |
| A7032 |
Replacement nasal cushion |
604 |
580 |
$20K |
| A7046 |
Repl water chamber, pap dev |
1,402 |
1,351 |
$19K |
| E1392 |
Portable oxygen concentrator |
533 |
521 |
$18K |
| E0431 |
Portable gaseous 02 |
1,025 |
986 |
$18K |
| T4525 |
Adult size pull-on sm |
137 |
132 |
$17K |
| T4523 |
Adult size brief/diaper lg |
94 |
87 |
$14K |
| L3908 |
Who cock-up nonmolde pre ots |
222 |
200 |
$13K |
| K0001 |
Standard wheelchair |
449 |
424 |
$12K |
| K0738 |
Portable gas oxygen system |
322 |
290 |
$9K |
| L0621 |
Sio flex pelvic/sacr pre ots |
78 |
77 |
$6K |
| T4544 |
Adlt disp und/pull on abv xl |
27 |
25 |
$5K |
| A4357 |
Bedside drainage bag |
268 |
245 |
$4K |
| L1902 |
Afo ankle gauntlet pre ots |
42 |
42 |
$3K |
| E0114 |
Crutch underarm pair no wood |
49 |
49 |
$3K |
| E0143 |
Walker folding wheeled w/o s |
41 |
37 |
$2K |
| A4670 |
Automatic bp monitor, dial |
27 |
27 |
$2K |
| T4522 |
Adult size brief/diaper med |
20 |
13 |
$1K |
| A4310 |
Insert tray w/o bag/cath |
159 |
148 |
$1K |
| A7005 |
Nondisposable nebulizer set |
31 |
31 |
$728.90 |
| A7003 |
Nebulizer administration set |
331 |
315 |
$702.65 |
| A4338 |
Indwelling catheter latex |
69 |
62 |
$650.68 |
| A7039 |
Filter, non disposable w pap |
67 |
55 |
$372.66 |