| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
12,347 |
9,314 |
$727K |
| T4527 |
Adult size pull-on lg |
3,614 |
2,841 |
$420K |
| A4554 |
Disposable underpads |
8,727 |
6,824 |
$419K |
| E0601 |
Cont airway pressure device |
7,767 |
6,119 |
$299K |
| T4526 |
Adult size pull-on med |
2,315 |
1,715 |
$235K |
| A7030 |
Cpap full face mask |
3,753 |
3,075 |
$223K |
| E0260 |
Hosp bed semi-electr w/ matt |
7,968 |
5,695 |
$197K |
| T4528 |
Adult size pull-on xl |
1,609 |
1,287 |
$181K |
| E0570 |
Nebulizer with compression |
9,096 |
6,705 |
$167K |
| K0001 |
Standard wheelchair |
13,590 |
9,785 |
$148K |
| E0562 |
Humidifier heated used w pap |
806 |
662 |
$92K |
| A7031 |
Replacement facemask interfa |
4,638 |
3,382 |
$90K |
| T4543 |
Adult disp brief/diap abv xl |
545 |
420 |
$86K |
| T4525 |
Adult size pull-on sm |
835 |
615 |
$84K |
| B4035 |
Enteral feed supp pump per d |
798 |
475 |
$80K |
| E0431 |
Portable gaseous 02 |
7,394 |
5,675 |
$77K |
| E0630 |
Patient lift hydraulic |
2,918 |
2,075 |
$70K |
| E0143 |
Walker folding wheeled w/o s |
2,493 |
1,919 |
$69K |
| E0163 |
Commode chair with fixed arm |
1,869 |
1,446 |
$57K |
| T4544 |
Adlt disp und/pull on abv xl |
343 |
283 |
$55K |
| T4524 |
Adult size brief/diaper xl |
584 |
404 |
$54K |
| E0470 |
Rad w/o backup non-inv intfc |
860 |
662 |
$53K |
| A7035 |
Pos airway press headgear |
3,448 |
2,826 |
$49K |
| K0007 |
Extra heavy duty wheelchair |
944 |
691 |
$48K |
| A7037 |
Pos airway pressure tubing |
2,405 |
1,919 |
$41K |
| B4160 |
Ef ped caloric dense>/=0.7kc |
571 |
391 |
$39K |
| E0240 |
Bath/shower chair |
795 |
622 |
$39K |
| A7034 |
Nasal application device |
1,107 |
920 |
$36K |
| A4670 |
Automatic bp monitor, dial |
524 |
440 |
$28K |
| A7005 |
Nondisposable nebulizer set |
1,850 |
1,487 |
$28K |
| A4604 |
Tubing with heating element |
2,338 |
2,039 |
$27K |
| B4158 |
Ef ped complete intact nut |
398 |
237 |
$27K |
| K0006 |
Heavy duty wheelchair |
1,021 |
790 |
$27K |
| A4927 |
Non-sterile gloves |
1,919 |
1,326 |
$26K |
| K0195 |
Elevating whlchair leg rests |
4,650 |
3,460 |
$22K |
| A7038 |
Pos airway pressure filter |
7,546 |
5,708 |
$19K |
| E1392 |
Portable oxygen concentrator |
1,622 |
1,215 |
$19K |
| K0003 |
Lightweight wheelchair |
949 |
701 |
$13K |
| T4534 |
Youth size pull-on |
96 |
80 |
$12K |
| T4523 |
Adult size brief/diaper lg |
99 |
77 |
$12K |
| E0600 |
Suction pump portab hom modl |
536 |
357 |
$11K |
| E0730 |
Tens four lead |
197 |
141 |
$11K |
| E0247 |
Trans bench w/wo comm open |
152 |
124 |
$10K |
| B9002 |
Enter nutr inf pump any type |
172 |
125 |
$10K |
| K0738 |
Portable gas oxygen system |
662 |
480 |
$10K |
| B4034 |
Enter feed supkit syr by day |
206 |
115 |
$9K |
| A7046 |
Repl water chamber, pap dev |
1,795 |
1,503 |
$9K |
| A7032 |
Replacement nasal cushion |
566 |
415 |
$8K |
| E0156 |
Walker seat attachment |
1,202 |
919 |
$8K |
| E2201 |
Man w/ch acc seat w>=20"<24" |
986 |
636 |
$7K |
| E2601 |
Gen w/c cushion wdth < 22 in |
268 |
212 |
$6K |
| A4217 |
Sterile water/saline, 500 ml |
108 |
61 |
$4K |
| A7033 |
Replacement nasal pillows |
333 |
257 |
$4K |
| E0149 |
Heavy duty wheeled walker |
120 |
76 |
$4K |
| E0165 |
Commode chair with detacharm |
348 |
235 |
$3K |
| A7526 |
Tracheostomy tube collar |
146 |
101 |
$3K |
| E0971 |
Wheelchair anti-tipping devi |
258 |
143 |
$3K |
| A7000 |
Disposable canister for pump |
244 |
187 |
$3K |
| A7015 |
Aerosol mask used w nebulize |
1,539 |
1,249 |
$2K |
| E0776 |
Iv pole |
395 |
263 |
$2K |
| E0181 |
Press pad alternating w/ pum |
265 |
190 |
$2K |
| E0303 |
Hosp bed hvy dty xtra wide |
17 |
12 |
$1K |
| A4624 |
Tracheal suction tube |
17 |
12 |
$1K |
| A4335 |
Incontinence supply |
162 |
130 |
$887.36 |
| A4627 |
Spacer bag/reservoir |
25 |
14 |
$874.32 |
| A4629 |
Tracheostomy care kit |
14 |
12 |
$834.07 |
| B4152 |
Ef calorie dense>/=1.5kcal |
17 |
12 |
$833.01 |
| E0990 |
Wheelchair elevating leg res |
35 |
28 |
$599.04 |
| E0265 |
Hosp bed total electr w/ mat |
75 |
46 |
$526.73 |
| A7002 |
Tubing used w suction pump |
214 |
146 |
$509.22 |
| A4628 |
Oropharyngeal suction cath |
126 |
90 |
$490.70 |
| E0978 |
W/c acc,saf belt pelv strap |
15 |
14 |
$418.17 |
| A7003 |
Nebulizer administration set |
52 |
44 |
$43.61 |