| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
17,186 |
17,074 |
$1.21M |
| E0601 |
Cont airway pressure device |
10,282 |
10,195 |
$442K |
| E0431 |
Portable gaseous 02 |
11,575 |
11,473 |
$167K |
| A7030 |
Cpap full face mask |
2,728 |
2,626 |
$167K |
| E0470 |
Rad w/o backup non-inv intfc |
1,933 |
1,877 |
$158K |
| E0570 |
Nebulizer with compression |
4,533 |
4,415 |
$136K |
| E0603 |
Electric breast pump |
816 |
810 |
$98K |
| E0562 |
Humidifier heated used w pap |
1,322 |
1,302 |
$96K |
| E0260 |
Hosp bed semi-electr w/ matt |
2,793 |
2,777 |
$92K |
| A4253 |
Blood glucose/reagent strips |
2,197 |
2,150 |
$72K |
| A7034 |
Nasal application device |
1,885 |
1,806 |
$72K |
| A7037 |
Pos airway pressure tubing |
3,476 |
3,376 |
$65K |
| A4239 |
Non-adju cgm supply allow |
340 |
335 |
$64K |
| A7031 |
Replacement facemask interfa |
2,251 |
1,961 |
$62K |
| A7035 |
Pos airway press headgear |
3,736 |
3,568 |
$59K |
| K0003 |
Lightweight wheelchair |
1,432 |
1,430 |
$40K |
| A6530 |
Compression stocking bk18-30 |
485 |
470 |
$26K |
| A7038 |
Pos airway pressure filter |
4,956 |
4,676 |
$26K |
| K0001 |
Standard wheelchair |
1,949 |
1,938 |
$25K |
| A7005 |
Nondisposable nebulizer set |
1,912 |
1,889 |
$25K |
| E0143 |
Walker folding wheeled w/o s |
564 |
561 |
$24K |
| K0004 |
High strength ltwt whlchr |
214 |
213 |
$14K |
| B4035 |
Enteral feed supp pump per d |
100 |
97 |
$13K |
| A7032 |
Replacement nasal cushion |
426 |
364 |
$12K |
| A7046 |
Repl water chamber, pap dev |
1,952 |
1,914 |
$11K |
| L3908 |
Who cock-up nonmolde pre ots |
149 |
148 |
$8K |
| A4670 |
Automatic bp monitor, dial |
151 |
151 |
$7K |
| A5500 |
Diab shoe for density insert |
108 |
94 |
$6K |
| T4534 |
Youth size pull-on |
39 |
39 |
$6K |
| A4259 |
Lancets per box |
1,374 |
1,352 |
$6K |
| A4604 |
Tubing with heating element |
409 |
408 |
$3K |
| E0156 |
Walker seat attachment |
375 |
374 |
$3K |
| A5513 |
Multi den insert custom mold |
25 |
25 |
$3K |
| E0630 |
Patient lift hydraulic |
51 |
51 |
$3K |
| E0149 |
Heavy duty wheeled walker |
153 |
151 |
$3K |
| A7003 |
Nebulizer administration set |
1,585 |
1,555 |
$2K |
| K0195 |
Elevating whlchair leg rests |
223 |
222 |
$1K |
| T4528 |
Adult size pull-on xl |
12 |
12 |
$1K |
| A4627 |
Spacer bag/reservoir |
96 |
95 |
$1K |
| B4087 |
Gastro/jejuno tube, std |
89 |
24 |
$1K |
| E0971 |
Wheelchair anti-tipping devi |
34 |
26 |
$1K |
| A5514 |
Mult den insert dir carv/cam |
16 |
12 |
$946.71 |
| A7013 |
Disposable compressor filter |
606 |
575 |
$782.74 |
| A7033 |
Replacement nasal pillows |
30 |
26 |
$778.83 |
| T4535 |
Disposable liner/shield/pad |
12 |
12 |
$767.37 |
| K0739 |
Repair/svc dme non-oxygen eq |
12 |
12 |
$703.45 |
| A7015 |
Aerosol mask used w nebulize |
646 |
633 |
$689.73 |
| A4595 |
Tens suppl 2 lead per month |
27 |
26 |
$379.82 |
| S5199 |
Personal care item nos each |
40 |
39 |
$295.20 |
| A4256 |
Calibrator solution/chips |
24 |
24 |
$83.57 |
| A4450 |
Non-waterproof tape |
13 |
13 |
$42.08 |