| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E0466 |
Home vent non-invasive inter |
861 |
510 |
$236K |
| E0601 |
Cont airway pressure device |
9,120 |
5,774 |
$222K |
| E1390 |
Oxygen concentrator |
5,484 |
4,144 |
$191K |
| A4554 |
Disposable underpads |
2,380 |
2,044 |
$115K |
| T4528 |
Adult size pull-on xl |
1,442 |
1,157 |
$105K |
| T4527 |
Adult size pull-on lg |
1,187 |
977 |
$100K |
| T4526 |
Adult size pull-on med |
1,247 |
942 |
$99K |
| T4535 |
Disposable liner/shield/pad |
810 |
633 |
$52K |
| E0260 |
Hosp bed semi-electr w/ matt |
1,416 |
1,182 |
$45K |
| A4927 |
Non-sterile gloves |
2,529 |
2,129 |
$39K |
| E0430 |
Oxygen system gas portable |
768 |
472 |
$28K |
| E0570 |
Nebulizer with compression |
1,790 |
1,500 |
$19K |
| E0470 |
Rad w/o backup non-inv intfc |
263 |
183 |
$18K |
| E0562 |
Humidifier heated used w pap |
130 |
82 |
$14K |
| K0003 |
Lightweight wheelchair |
1,522 |
1,390 |
$12K |
| E1392 |
Portable oxygen concentrator |
750 |
692 |
$11K |
| A7038 |
Pos airway pressure filter |
1,327 |
1,120 |
$10K |
| E0431 |
Portable gaseous 02 |
962 |
795 |
$9K |
| A7030 |
Cpap full face mask |
521 |
443 |
$9K |
| A7031 |
Replacement facemask interfa |
523 |
446 |
$7K |
| K0001 |
Standard wheelchair |
1,134 |
1,030 |
$6K |
| E0277 |
Powered pres-redu air mattrs |
56 |
48 |
$3K |
| A4604 |
Tubing with heating element |
402 |
330 |
$2K |
| E0630 |
Patient lift hydraulic |
207 |
193 |
$2K |
| A7035 |
Pos airway press headgear |
516 |
432 |
$943.68 |
| A4253 |
Blood glucose/reagent strips |
17 |
14 |
$700.76 |
| A7037 |
Pos airway pressure tubing |
173 |
137 |
$576.01 |
| A7034 |
Nasal application device |
47 |
39 |
$400.52 |
| E0143 |
Walker folding wheeled w/o s |
20 |
13 |
$362.75 |
| A7046 |
Repl water chamber, pap dev |
92 |
83 |
$295.58 |
| K0195 |
Elevating whlchair leg rests |
85 |
66 |
$137.64 |
| A7039 |
Filter, non disposable w pap |
38 |
33 |
$18.81 |