| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E0570 |
Nebulizer with compression |
11,673 |
11,495 |
$921K |
| E0601 |
Cont airway pressure device |
6,512 |
5,289 |
$258K |
| E1390 |
Oxygen concentrator |
3,364 |
3,303 |
$239K |
| E1235 |
Rigid ped wc adjustable |
1,006 |
857 |
$174K |
| A7005 |
Nondisposable nebulizer set |
11,058 |
10,879 |
$171K |
| S8101 |
Spacer with mask |
6,959 |
6,870 |
$142K |
| E1150 |
Wheelchair standard w/ leg r |
2,788 |
2,719 |
$138K |
| E0470 |
Rad w/o backup non-inv intfc |
966 |
961 |
$111K |
| A7030 |
Cpap full face mask |
1,630 |
1,597 |
$104K |
| E0260 |
Hosp bed semi-electr w/ matt |
2,975 |
2,918 |
$89K |
| A7031 |
Replacement facemask interfa |
2,698 |
2,616 |
$82K |
| A4627 |
Spacer bag/reservoir |
3,177 |
3,116 |
$81K |
| K0001 |
Standard wheelchair |
5,547 |
5,358 |
$77K |
| A4554 |
Disposable underpads |
2,250 |
2,182 |
$74K |
| B4035 |
Enteral feed supp pump per d |
286 |
269 |
$74K |
| E0562 |
Humidifier heated used w pap |
1,255 |
786 |
$61K |
| E0143 |
Walker folding wheeled w/o s |
1,950 |
1,846 |
$61K |
| K0007 |
Extra heavy duty wheelchair |
667 |
645 |
$59K |
| E1399 |
Durable medical equipment mi |
705 |
272 |
$47K |
| E0971 |
Wheelchair anti-tipping devi |
1,561 |
1,127 |
$43K |
| A7034 |
Nasal application device |
931 |
895 |
$42K |
| E0973 |
W/ch access det adj armrest |
1,187 |
768 |
$40K |
| E0431 |
Portable gaseous 02 |
2,645 |
2,574 |
$35K |
| E2611 |
Gen use back cush wdth <22in |
459 |
409 |
$35K |
| A7032 |
Replacement nasal cushion |
1,002 |
958 |
$33K |
| E0990 |
Wheelchair elevating leg res |
275 |
234 |
$32K |
| B9998 |
Enteral supp not otherwise c |
485 |
298 |
$31K |
| A7037 |
Pos airway pressure tubing |
1,769 |
1,638 |
$31K |
| E0630 |
Patient lift hydraulic |
951 |
943 |
$26K |
| A7035 |
Pos airway press headgear |
2,277 |
2,221 |
$26K |
| K0004 |
High strength ltwt whlchr |
921 |
906 |
$25K |
| A4606 |
Oxygen probe used w oximeter |
335 |
294 |
$23K |
| E0445 |
Oximeter non-invasive |
332 |
320 |
$23K |
| A7014 |
Compressor nondispos filter |
9,421 |
9,278 |
$22K |
| K0003 |
Lightweight wheelchair |
1,409 |
1,388 |
$22K |
| A7038 |
Pos airway pressure filter |
4,707 |
4,480 |
$18K |
| K0739 |
Repair/svc dme non-oxygen eq |
640 |
563 |
$16K |
| A7015 |
Aerosol mask used w nebulize |
13,087 |
12,845 |
$14K |
| E0978 |
W/c acc,saf belt pelv strap |
849 |
761 |
$13K |
| E0465 |
Home vent invasive interface |
22 |
12 |
$13K |
| A7000 |
Disposable canister for pump |
603 |
464 |
$13K |
| A4335 |
Incontinence supply |
2,543 |
2,472 |
$13K |
| T4526 |
Adult size pull-on med |
101 |
100 |
$12K |
| A9900 |
Supply/accessory/service |
956 |
271 |
$12K |
| E2601 |
Gen w/c cushion wdth < 22 in |
605 |
549 |
$11K |
| E0163 |
Commode chair with fixed arm |
538 |
527 |
$10K |
| K0821 |
Pwc gp 2 std port cap chair |
230 |
229 |
$9K |
| E1089 |
Wheelchair lightwt fixed arm |
70 |
68 |
$9K |
| S0215 |
Nonemerg transp mileage |
130 |
47 |
$8K |
| A7046 |
Repl water chamber, pap dev |
2,250 |
2,023 |
$8K |
| A4629 |
Tracheostomy care kit |
96 |
90 |
$7K |
| E0443 |
Portable 02 contents, gas |
355 |
238 |
$7K |
| K0015 |
Detach non-adj ht armrst rep |
159 |
115 |
$7K |
| A4253 |
Blood glucose/reagent strips |
213 |
181 |
$7K |
| K0195 |
Elevating whlchair leg rests |
1,816 |
1,778 |
$6K |
| A4483 |
Moisture exchanger |
109 |
74 |
$6K |
| A7526 |
Tracheostomy tube collar |
154 |
133 |
$5K |
| A4614 |
Hand-held pefr meter |
324 |
315 |
$5K |
| E0149 |
Heavy duty wheeled walker |
230 |
228 |
$5K |
| A7002 |
Tubing used w suction pump |
497 |
468 |
$5K |
| E0955 |
Cushioned headrest |
720 |
692 |
$4K |
| T4527 |
Adult size pull-on lg |
29 |
25 |
$4K |
| A4322 |
Irrigation syringe |
1,086 |
267 |
$3K |
| K0006 |
Heavy duty wheelchair |
111 |
108 |
$3K |
| A7003 |
Nebulizer administration set |
1,501 |
1,459 |
$3K |
| K0823 |
Pwc gp 2 std cap chair |
76 |
76 |
$3K |
| A4604 |
Tubing with heating element |
1,667 |
1,647 |
$3K |
| A4216 |
Sterile water/saline, 10 ml |
157 |
134 |
$3K |
| A9279 |
Monitoring feature/devicenoc |
67 |
56 |
$2K |
| E0951 |
Loop heel |
382 |
246 |
$2K |
| A4628 |
Oropharyngeal suction cath |
473 |
446 |
$2K |
| A0100 |
Nonemergency transport taxi |
131 |
47 |
$2K |
| E2201 |
Man w/ch acc seat w>=20"<24" |
14 |
13 |
$2K |
| A4927 |
Non-sterile gloves |
305 |
291 |
$2K |
| A4364 |
Adhesive, liquid or equal |
324 |
305 |
$2K |
| A7039 |
Filter, non disposable w pap |
365 |
342 |
$2K |
| A7521 |
Trach/laryn tube cuffed |
27 |
24 |
$1K |
| A6402 |
Sterile gauze <= 16 sq in |
254 |
210 |
$1K |
| E0165 |
Commode chair with detacharm |
192 |
188 |
$1K |
| A4259 |
Lancets per box |
149 |
147 |
$1K |
| S8186 |
Swivel adaptor |
914 |
878 |
$1K |
| T4535 |
Disposable liner/shield/pad |
28 |
24 |
$1K |
| E1295 |
Wheelchair heavy duty fixed |
12 |
12 |
$913.14 |
| A4618 |
Breathing circuits |
170 |
116 |
$875.81 |
| A4245 |
Alcohol wipes per box |
495 |
481 |
$724.60 |
| A4332 |
Lube sterile packet |
256 |
239 |
$628.41 |
| K0052 |
Swingaway detach ftrest repl |
14 |
13 |
$614.50 |
| E1028 |
W/c manual swingaway |
57 |
38 |
$607.74 |
| B4034 |
Enter feed supkit syr by day |
13 |
12 |
$519.38 |
| A7033 |
Replacement nasal pillows |
12 |
12 |
$259.83 |
| E0167 |
Commode chair pail or pan |
74 |
72 |
$98.88 |
| E0155 |
Walker wheel attachment,pair |
31 |
30 |
$32.48 |
| A4657 |
Syringe w/wo needle |
23 |
12 |
$30.10 |
| E0156 |
Walker seat attachment |
15 |
14 |
$0.00 |
| E0159 |
Brake for wheeled walker |
17 |
16 |
$0.00 |