| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
9,185 |
8,026 |
$415K |
| E0570 |
Nebulizer with compression |
24,203 |
21,633 |
$265K |
| A7030 |
Cpap full face mask |
2,687 |
2,314 |
$140K |
| E0601 |
Cont airway pressure device |
4,867 |
4,336 |
$136K |
| E0255 |
Hospital bed var ht w/ mattr |
3,306 |
2,836 |
$99K |
| A4253 |
Blood glucose/reagent strips |
4,962 |
4,369 |
$95K |
| E0431 |
Portable gaseous 02 |
7,082 |
6,207 |
$65K |
| A7034 |
Nasal application device |
1,477 |
1,287 |
$47K |
| T4522 |
Adult size brief/diaper med |
496 |
366 |
$41K |
| B4035 |
Enteral feed supp pump per d |
751 |
580 |
$40K |
| A7031 |
Replacement facemask interfa |
2,251 |
1,907 |
$39K |
| E0630 |
Patient lift hydraulic |
1,268 |
1,116 |
$35K |
| K0823 |
Pwc gp 2 std cap chair |
672 |
617 |
$33K |
| K0001 |
Standard wheelchair |
3,658 |
3,293 |
$29K |
| E0562 |
Humidifier heated used w pap |
628 |
511 |
$28K |
| A4239 |
Non-adju cgm supply allow |
275 |
247 |
$27K |
| A7037 |
Pos airway pressure tubing |
1,763 |
1,557 |
$25K |
| T4523 |
Adult size brief/diaper lg |
184 |
164 |
$24K |
| A7035 |
Pos airway press headgear |
2,646 |
2,278 |
$23K |
| A4604 |
Tubing with heating element |
2,294 |
1,965 |
$22K |
| A7038 |
Pos airway pressure filter |
4,309 |
3,695 |
$20K |
| T4527 |
Adult size pull-on lg |
156 |
132 |
$19K |
| T4526 |
Adult size pull-on med |
128 |
107 |
$14K |
| E0470 |
Rad w/o backup non-inv intfc |
316 |
256 |
$13K |
| A4259 |
Lancets per box |
4,172 |
3,680 |
$13K |
| E0443 |
Portable 02 contents, gas |
372 |
320 |
$12K |
| T4530 |
Ped size brief/diaper lg |
124 |
113 |
$12K |
| E0260 |
Hosp bed semi-electr w/ matt |
149 |
149 |
$10K |
| A4554 |
Disposable underpads |
287 |
232 |
$8K |
| A7046 |
Repl water chamber, pap dev |
1,473 |
1,257 |
$7K |
| E0143 |
Walker folding wheeled w/o s |
332 |
270 |
$7K |
| T4528 |
Adult size pull-on xl |
45 |
41 |
$7K |
| B9002 |
Enter nutr inf pump any type |
107 |
107 |
$5K |
| A4927 |
Non-sterile gloves |
728 |
422 |
$5K |
| A4335 |
Incontinence supply |
717 |
418 |
$4K |
| A7032 |
Replacement nasal cushion |
138 |
114 |
$3K |
| K0553 |
Ther cgm supply allowance |
19 |
13 |
$2K |
| B4034 |
Enter feed supkit syr by day |
56 |
52 |
$2K |
| T4525 |
Adult size pull-on sm |
17 |
12 |
$2K |
| T4524 |
Adult size brief/diaper xl |
23 |
12 |
$2K |
| A4245 |
Alcohol wipes per box |
710 |
625 |
$1K |
| E0156 |
Walker seat attachment |
174 |
151 |
$995.60 |
| A5500 |
Diab shoe for density insert |
14 |
12 |
$759.20 |
| S8490 |
100 insulin syringes |
27 |
25 |
$479.70 |
| E1392 |
Portable oxygen concentrator |
12 |
12 |
$132.39 |
| A5512 |
Multi den insert direct form |
13 |
12 |
$35.03 |
| A4256 |
Calibrator solution/chips |
26 |
22 |
$17.64 |