| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
21,745 |
21,362 |
$2.24M |
| A7030 |
Cpap full face mask |
3,655 |
3,633 |
$376K |
| E0601 |
Cont airway pressure device |
6,012 |
5,974 |
$357K |
| E0570 |
Nebulizer with compression |
18,123 |
18,043 |
$347K |
| E0431 |
Portable gaseous 02 |
13,293 |
12,967 |
$248K |
| E0470 |
Rad w/o backup non-inv intfc |
1,837 |
1,834 |
$226K |
| A7031 |
Replacement facemask interfa |
3,827 |
3,797 |
$209K |
| B4035 |
Enteral feed supp pump per d |
1,040 |
875 |
$188K |
| A4604 |
Tubing with heating element |
3,044 |
3,029 |
$124K |
| T4522 |
Adult size brief/diaper med |
1,077 |
1,052 |
$118K |
| E0603 |
Electric breast pump |
907 |
905 |
$118K |
| T4541 |
Large disposable underpad |
1,052 |
1,030 |
$113K |
| T4527 |
Adult size pull-on lg |
722 |
712 |
$107K |
| E0562 |
Humidifier heated used w pap |
1,766 |
1,762 |
$101K |
| E0424 |
Stationary compressed gas 02 |
907 |
887 |
$101K |
| T4526 |
Adult size pull-on med |
681 |
676 |
$92K |
| T4523 |
Adult size brief/diaper lg |
608 |
593 |
$90K |
| K0001 |
Standard wheelchair |
3,469 |
3,426 |
$90K |
| E0260 |
Hosp bed semi-electr w/ matt |
1,579 |
1,560 |
$86K |
| A7038 |
Pos airway pressure filter |
7,368 |
7,289 |
$60K |
| A7035 |
Pos airway press headgear |
2,972 |
2,934 |
$59K |
| E1392 |
Portable oxygen concentrator |
1,632 |
1,626 |
$57K |
| K0003 |
Lightweight wheelchair |
1,021 |
1,001 |
$47K |
| T4524 |
Adult size brief/diaper xl |
282 |
270 |
$46K |
| A7034 |
Nasal application device |
644 |
634 |
$41K |
| E0202 |
Phototherapy light w/ photom |
802 |
192 |
$40K |
| A7032 |
Replacement nasal cushion |
666 |
660 |
$36K |
| E0143 |
Walker folding wheeled w/o s |
507 |
503 |
$26K |
| A7037 |
Pos airway pressure tubing |
1,355 |
1,344 |
$26K |
| A7046 |
Repl water chamber, pap dev |
2,072 |
2,050 |
$25K |
| T4528 |
Adult size pull-on xl |
145 |
144 |
$24K |
| E0445 |
Oximeter non-invasive |
144 |
131 |
$21K |
| B9998 |
Enteral supp not otherwise c |
180 |
147 |
$20K |
| E0118 |
Crutch substitute |
142 |
142 |
$19K |
| A4927 |
Non-sterile gloves |
1,689 |
1,598 |
$18K |
| E0471 |
Rad w/backup non inv intrfc |
66 |
66 |
$16K |
| A9901 |
Delivery/set up/dispensing |
2,373 |
2,178 |
$14K |
| A7039 |
Filter, non disposable w pap |
1,268 |
1,259 |
$8K |
| K0195 |
Elevating whlchair leg rests |
349 |
338 |
$4K |
| A7004 |
Disposable nebulizer sml vol |
2,371 |
2,347 |
$3K |
| E1399 |
Durable medical equipment mi |
40 |
38 |
$3K |
| B4160 |
Ef ped caloric dense>/=0.7kc |
12 |
12 |
$3K |
| B9002 |
Enter nutr inf pump any type |
40 |
39 |
$3K |
| A7015 |
Aerosol mask used w nebulize |
1,788 |
1,767 |
$3K |
| A7003 |
Nebulizer administration set |
1,238 |
1,230 |
$3K |
| E0600 |
Suction pump portab hom modl |
50 |
49 |
$2K |
| A6402 |
Sterile gauze <= 16 sq in |
165 |
143 |
$2K |
| A4670 |
Automatic bp monitor, dial |
12 |
12 |
$598.86 |
| A7526 |
Tracheostomy tube collar |
12 |
12 |
$577.13 |
| E0630 |
Patient lift hydraulic |
12 |
12 |
$538.91 |
| A4520 |
Incontinence garment anytype |
12 |
12 |
$294.00 |
| E0156 |
Walker seat attachment |
25 |
25 |
$228.47 |