| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
10,046 |
9,056 |
$294K |
| A4239 |
Non-adju cgm supply allow |
671 |
668 |
$163K |
| E0601 |
Cont airway pressure device |
4,713 |
4,361 |
$98K |
| B4150 |
Ef complet w/intact nutrient |
826 |
646 |
$82K |
| B4160 |
Ef ped caloric dense>/=0.7kc |
323 |
293 |
$41K |
| K0001 |
Standard wheelchair |
5,440 |
4,733 |
$41K |
| E0260 |
Hosp bed semi-electr w/ matt |
3,353 |
2,764 |
$37K |
| E0570 |
Nebulizer with compression |
14,664 |
13,638 |
$36K |
| E1392 |
Portable oxygen concentrator |
3,241 |
3,011 |
$23K |
| E0431 |
Portable gaseous 02 |
3,887 |
3,565 |
$22K |
| E0562 |
Humidifier heated used w pap |
1,642 |
1,486 |
$21K |
| E0143 |
Walker folding wheeled w/o s |
840 |
730 |
$14K |
| E0630 |
Patient lift hydraulic |
925 |
810 |
$13K |
| T4534 |
Youth size pull-on |
133 |
124 |
$13K |
| E0141 |
Rigid wheeled walker adj/fix |
860 |
762 |
$11K |
| K0823 |
Pwc gp 2 std cap chair |
104 |
84 |
$11K |
| L3660 |
So 8 ab rstr can/web pre ots |
458 |
413 |
$10K |
| A7037 |
Pos airway pressure tubing |
1,070 |
926 |
$9K |
| B4152 |
Ef calorie dense>/=1.5kcal |
57 |
52 |
$9K |
| E0470 |
Rad w/o backup non-inv intfc |
217 |
210 |
$9K |
| E0114 |
Crutch underarm pair no wood |
584 |
532 |
$7K |
| B4035 |
Enteral feed supp pump per d |
86 |
73 |
$7K |
| K0002 |
Stnd hemi (low seat) whlchr |
285 |
280 |
$5K |
| K0195 |
Elevating whlchair leg rests |
1,332 |
1,197 |
$5K |
| A7038 |
Pos airway pressure filter |
5,019 |
4,605 |
$5K |
| E0978 |
W/c acc,saf belt pelv strap |
249 |
214 |
$4K |
| E0565 |
Compressor air power source |
460 |
449 |
$4K |
| A4554 |
Disposable underpads |
54 |
49 |
$4K |
| K0003 |
Lightweight wheelchair |
436 |
378 |
$4K |
| A7033 |
Replacement nasal pillows |
837 |
751 |
$3K |
| E0250 |
Hosp bed fixed ht w/ mattres |
226 |
223 |
$3K |
| A7005 |
Nondisposable nebulizer set |
712 |
665 |
$2K |
| B4034 |
Enter feed supkit syr by day |
77 |
52 |
$2K |
| K0738 |
Portable gas oxygen system |
404 |
385 |
$2K |
| E0971 |
Wheelchair anti-tipping devi |
913 |
476 |
$2K |
| A7031 |
Replacement facemask interfa |
2,154 |
1,996 |
$2K |
| A7030 |
Cpap full face mask |
980 |
896 |
$2K |
| K0006 |
Heavy duty wheelchair |
65 |
51 |
$1K |
| E0156 |
Walker seat attachment |
797 |
643 |
$1K |
| A4927 |
Non-sterile gloves |
94 |
75 |
$1K |
| E0181 |
Press pad alternating w/ pum |
450 |
399 |
$1K |
| A7046 |
Repl water chamber, pap dev |
1,111 |
1,017 |
$1K |
| A7035 |
Pos airway press headgear |
891 |
806 |
$866.91 |
| E0163 |
Commode chair with fixed arm |
55 |
52 |
$806.11 |
| A4604 |
Tubing with heating element |
1,268 |
1,142 |
$792.02 |
| E0149 |
Heavy duty wheeled walker |
225 |
215 |
$713.23 |
| A7032 |
Replacement nasal cushion |
833 |
775 |
$670.65 |
| E0961 |
Wheelchair brake extension |
180 |
100 |
$602.35 |
| A7034 |
Nasal application device |
680 |
616 |
$465.36 |
| L4350 |
Ankle control ortho pre ots |
14 |
12 |
$433.02 |
| E0600 |
Suction pump portab hom modl |
12 |
12 |
$256.26 |
| L1830 |
Ko immob canvas long pre ots |
15 |
12 |
$213.22 |
| A4357 |
Bedside drainage bag |
63 |
48 |
$195.35 |
| K0739 |
Repair/svc dme non-oxygen eq |
17 |
13 |
$168.92 |
| L3908 |
Who cock-up nonmolde pre ots |
13 |
12 |
$166.58 |
| E1038 |
Transport chair pt wt<=300lb |
12 |
12 |
$91.63 |
| E2601 |
Gen w/c cushion wdth < 22 in |
12 |
12 |
$75.76 |
| A7039 |
Filter, non disposable w pap |
135 |
124 |
$62.84 |
| K0821 |
Pwc gp 2 std port cap chair |
27 |
24 |
$47.46 |
| A7013 |
Disposable compressor filter |
245 |
244 |
$17.49 |
| A7003 |
Nebulizer administration set |
92 |
87 |
$15.66 |
| A7015 |
Aerosol mask used w nebulize |
74 |
72 |
$11.03 |