| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E0603 |
Electric breast pump |
3,123 |
2,907 |
$451K |
| A7030 |
Cpap full face mask |
3,808 |
3,616 |
$431K |
| E0601 |
Cont airway pressure device |
3,184 |
2,900 |
$303K |
| E1390 |
Oxygen concentrator |
6,195 |
5,506 |
$299K |
| A7034 |
Nasal application device |
2,718 |
2,566 |
$186K |
| A7037 |
Pos airway pressure tubing |
5,804 |
5,510 |
$146K |
| E0562 |
Humidifier heated used w pap |
3,683 |
3,251 |
$144K |
| A7035 |
Pos airway press headgear |
5,614 |
5,328 |
$144K |
| A7031 |
Replacement facemask interfa |
2,528 |
2,361 |
$88K |
| E0431 |
Portable gaseous 02 |
3,096 |
2,692 |
$54K |
| E0570 |
Nebulizer with compression |
3,079 |
2,764 |
$44K |
| A7038 |
Pos airway pressure filter |
6,069 |
5,730 |
$34K |
| A7046 |
Repl water chamber, pap dev |
3,846 |
3,664 |
$32K |
| E1392 |
Portable oxygen concentrator |
1,632 |
1,473 |
$26K |
| A7039 |
Filter, non disposable w pap |
3,646 |
3,480 |
$25K |
| K0001 |
Standard wheelchair |
2,245 |
1,800 |
$20K |
| A7005 |
Nondisposable nebulizer set |
1,237 |
1,164 |
$16K |
| A7032 |
Replacement nasal cushion |
986 |
917 |
$13K |
| E0260 |
Hosp bed semi-electr w/ matt |
626 |
482 |
$8K |
| E0143 |
Walker folding wheeled w/o s |
191 |
171 |
$5K |
| A7033 |
Replacement nasal pillows |
256 |
231 |
$4K |
| A5120 |
Skin barrier, wipe or swab |
159 |
150 |
$814.35 |
| A4604 |
Tubing with heating element |
119 |
116 |
$776.43 |
| A4456 |
Adhesive remover, wipes |
130 |
120 |
$712.92 |
| A5063 |
Drain ostomy pouch w/flange |
30 |
24 |
$453.30 |
| A4385 |
Ost skn barrier sld ext wear |
25 |
24 |
$404.40 |
| K0739 |
Repair/svc dme non-oxygen eq |
16 |
15 |
$316.95 |
| K0195 |
Elevating whlchair leg rests |
544 |
427 |
$278.67 |
| A7015 |
Aerosol mask used w nebulize |
154 |
146 |
$176.04 |
| E0156 |
Walker seat attachment |
30 |
26 |
$115.38 |
| A7000 |
Disposable canister for pump |
13 |
12 |
$70.45 |
| A7002 |
Tubing used w suction pump |
13 |
12 |
$48.02 |
| E0604 |
Hosp grade elec breast pump |
17 |
12 |
$0.00 |