| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
8,695 |
8,266 |
$360K |
| E0601 |
Cont airway pressure device |
2,141 |
2,092 |
$80K |
| E0431 |
Portable gaseous 02 |
7,235 |
6,925 |
$55K |
| A7030 |
Cpap full face mask |
777 |
770 |
$46K |
| A7031 |
Replacement facemask interfa |
1,174 |
1,143 |
$35K |
| E0562 |
Humidifier heated used w pap |
672 |
659 |
$28K |
| E0470 |
Rad w/o backup non-inv intfc |
361 |
348 |
$20K |
| E0260 |
Hosp bed semi-electr w/ matt |
790 |
729 |
$19K |
| A4351 |
Straight tip urine catheter |
69 |
63 |
$18K |
| E0471 |
Rad w/backup non inv intrfc |
128 |
126 |
$16K |
| A7034 |
Nasal application device |
329 |
321 |
$15K |
| K0001 |
Standard wheelchair |
1,293 |
1,212 |
$12K |
| A7035 |
Pos airway press headgear |
889 |
867 |
$11K |
| A7032 |
Replacement nasal cushion |
301 |
279 |
$9K |
| A7037 |
Pos airway pressure tubing |
989 |
982 |
$9K |
| A4604 |
Tubing with heating element |
239 |
239 |
$7K |
| A7038 |
Pos airway pressure filter |
2,151 |
2,097 |
$6K |
| E0570 |
Nebulizer with compression |
402 |
395 |
$6K |
| A7033 |
Replacement nasal pillows |
186 |
179 |
$5K |
| B4035 |
Enteral feed supp pump per d |
689 |
657 |
$4K |
| E1392 |
Portable oxygen concentrator |
370 |
359 |
$4K |
| T4534 |
Youth size pull-on |
53 |
52 |
$2K |
| T4526 |
Adult size pull-on med |
26 |
26 |
$2K |
| A7046 |
Repl water chamber, pap dev |
261 |
257 |
$2K |
| T4530 |
Ped size brief/diaper lg |
53 |
53 |
$777.60 |
| K0195 |
Elevating whlchair leg rests |
81 |
78 |
$494.39 |
| B9002 |
Enter nutr inf pump any type |
17 |
17 |
$133.73 |
| T4522 |
Adult size brief/diaper med |
208 |
205 |
$85.40 |
| A7003 |
Nebulizer administration set |
26 |
25 |
$36.97 |
| A7005 |
Nondisposable nebulizer set |
28 |
28 |
$19.26 |
| A7039 |
Filter, non disposable w pap |
34 |
34 |
$0.00 |
| E0445 |
Oximeter non-invasive |
13 |
13 |
$0.00 |
| K0003 |
Lightweight wheelchair |
15 |
15 |
$0.00 |
| A4615 |
Cannula nasal |
18 |
15 |
$0.00 |
| B4160 |
Ef ped caloric dense>/=0.7kc |
17 |
12 |
$0.00 |