| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
9,754 |
9,107 |
$788K |
| S5170 |
Homedelivered prepared meal |
7,137 |
6,503 |
$719K |
| E0601 |
Cont airway pressure device |
8,346 |
7,494 |
$576K |
| E0470 |
Rad w/o backup non-inv intfc |
2,439 |
2,172 |
$302K |
| A7030 |
Cpap full face mask |
2,453 |
2,389 |
$234K |
| E0570 |
Nebulizer with compression |
5,182 |
4,848 |
$224K |
| E0562 |
Humidifier heated used w pap |
7,751 |
7,011 |
$190K |
| T4528 |
Adult size pull-on xl |
1,118 |
1,037 |
$130K |
| A7034 |
Nasal application device |
2,241 |
2,166 |
$99K |
| T4526 |
Adult size pull-on med |
916 |
833 |
$80K |
| A7031 |
Replacement facemask interfa |
2,700 |
2,623 |
$79K |
| T4527 |
Adult size pull-on lg |
630 |
594 |
$78K |
| A7035 |
Pos airway press headgear |
3,736 |
3,623 |
$76K |
| E0431 |
Portable gaseous 02 |
4,741 |
4,427 |
$65K |
| K0738 |
Portable gas oxygen system |
1,888 |
1,784 |
$45K |
| K0823 |
Pwc gp 2 std cap chair |
465 |
407 |
$42K |
| A4554 |
Disposable underpads |
1,457 |
1,274 |
$39K |
| E0260 |
Hosp bed semi-electr w/ matt |
1,079 |
986 |
$37K |
| A7005 |
Nondisposable nebulizer set |
1,476 |
1,441 |
$33K |
| T4534 |
Youth size pull-on |
340 |
324 |
$33K |
| K0001 |
Standard wheelchair |
1,657 |
1,492 |
$31K |
| A7038 |
Pos airway pressure filter |
7,384 |
7,178 |
$25K |
| A7046 |
Repl water chamber, pap dev |
2,162 |
2,099 |
$22K |
| A7032 |
Replacement nasal cushion |
1,025 |
991 |
$17K |
| A7033 |
Replacement nasal pillows |
1,065 |
1,015 |
$14K |
| E0143 |
Walker folding wheeled w/o s |
288 |
265 |
$12K |
| A7037 |
Pos airway pressure tubing |
3,101 |
3,039 |
$11K |
| E0118 |
Crutch substitute |
26 |
26 |
$6K |
| A7039 |
Filter, non disposable w pap |
352 |
341 |
$3K |
| B4160 |
Ef ped caloric dense>/=0.7kc |
14 |
12 |
$2K |
| A6530 |
Compression stocking bk18-30 |
55 |
48 |
$2K |
| A4604 |
Tubing with heating element |
2,112 |
2,014 |
$2K |
| E0156 |
Walker seat attachment |
219 |
205 |
$2K |
| B4150 |
Ef complet w/intact nutrient |
14 |
12 |
$2K |
| A4357 |
Bedside drainage bag |
111 |
98 |
$732.98 |
| A4385 |
Ost skn barrier sld ext wear |
12 |
12 |
$726.00 |
| A4927 |
Non-sterile gloves |
57 |
52 |
$354.36 |
| A7015 |
Aerosol mask used w nebulize |
187 |
179 |
$300.83 |
| A6402 |
Sterile gauze <= 16 sq in |
20 |
14 |
$234.24 |
| K0739 |
Repair/svc dme non-oxygen eq |
12 |
12 |
$130.24 |
| A4520 |
Incontinence garment anytype |
17 |
14 |
$115.02 |
| A7003 |
Nebulizer administration set |
44 |
42 |
$59.81 |