| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E0570 |
Nebulizer with compression |
5,077 |
5,062 |
$738K |
| T4534 |
Youth size pull-on |
2,984 |
2,968 |
$713K |
| B4160 |
Ef ped caloric dense>/=0.7kc |
4,798 |
4,099 |
$621K |
| E1390 |
Oxygen concentrator |
4,222 |
4,169 |
$393K |
| K0001 |
Standard wheelchair |
4,919 |
4,899 |
$189K |
| T4522 |
Adult size brief/diaper med |
1,850 |
1,847 |
$182K |
| T4533 |
Youth size brief/diaper |
1,923 |
1,919 |
$168K |
| E0601 |
Cont airway pressure device |
2,719 |
2,705 |
$141K |
| T4541 |
Large disposable underpad |
2,546 |
2,528 |
$138K |
| E1236 |
Folding ped wc adjustable |
714 |
710 |
$124K |
| T4531 |
Ped size pull-on sm/med |
616 |
605 |
$113K |
| E0431 |
Portable gaseous 02 |
4,105 |
4,058 |
$103K |
| T4523 |
Adult size brief/diaper lg |
698 |
692 |
$94K |
| E0562 |
Humidifier heated used w pap |
3,471 |
3,451 |
$80K |
| K0003 |
Lightweight wheelchair |
1,067 |
1,064 |
$68K |
| T4530 |
Ped size brief/diaper lg |
518 |
517 |
$65K |
| E0143 |
Walker folding wheeled w/o s |
1,241 |
1,230 |
$64K |
| E0295 |
Hosp bed semi-elect w/o matt |
1,078 |
1,061 |
$64K |
| K0195 |
Elevating whlchair leg rests |
3,258 |
3,243 |
$58K |
| T4526 |
Adult size pull-on med |
541 |
531 |
$51K |
| E0277 |
Powered pres-redu air mattrs |
94 |
85 |
$34K |
| E0600 |
Suction pump portab hom modl |
663 |
661 |
$31K |
| A4670 |
Automatic bp monitor, dial |
611 |
608 |
$31K |
| A7000 |
Disposable canister for pump |
830 |
777 |
$23K |
| A7005 |
Nondisposable nebulizer set |
1,270 |
1,267 |
$18K |
| E0971 |
Wheelchair anti-tipping devi |
2,251 |
2,241 |
$17K |
| A4322 |
Irrigation syringe |
161 |
151 |
$14K |
| A6402 |
Sterile gauze <= 16 sq in |
642 |
607 |
$12K |
| E0305 |
Rails bed side half length |
1,218 |
1,203 |
$12K |
| E0147 |
Walker variable wheel resist |
50 |
50 |
$11K |
| E0272 |
Mattress foam rubber |
994 |
978 |
$11K |
| E0265 |
Hosp bed total electr w/ mat |
114 |
114 |
$11K |
| A4628 |
Oropharyngeal suction cath |
651 |
608 |
$10K |
| E0603 |
Electric breast pump |
92 |
92 |
$10K |
| A7015 |
Aerosol mask used w nebulize |
3,632 |
3,610 |
$10K |
| T4521 |
Adult size brief/diaper sm |
105 |
103 |
$9K |
| A7002 |
Tubing used w suction pump |
699 |
653 |
$9K |
| A7034 |
Nasal application device |
120 |
120 |
$8K |
| T4525 |
Adult size pull-on sm |
88 |
88 |
$8K |
| A7035 |
Pos airway press headgear |
250 |
250 |
$8K |
| E0978 |
W/c acc,saf belt pelv strap |
2,171 |
2,162 |
$7K |
| A7037 |
Pos airway pressure tubing |
215 |
215 |
$7K |
| A7526 |
Tracheostomy tube collar |
51 |
48 |
$5K |
| A7038 |
Pos airway pressure filter |
397 |
397 |
$4K |
| A4927 |
Non-sterile gloves |
92 |
87 |
$3K |
| E0114 |
Crutch underarm pair no wood |
105 |
105 |
$3K |
| E0240 |
Bath/shower chair |
50 |
50 |
$3K |
| A7003 |
Nebulizer administration set |
831 |
822 |
$2K |
| B4035 |
Enteral feed supp pump per d |
13 |
12 |
$2K |
| A4624 |
Tracheal suction tube |
13 |
13 |
$2K |
| A7039 |
Filter, non disposable w pap |
138 |
137 |
$2K |
| T4527 |
Adult size pull-on lg |
12 |
12 |
$1K |
| E0443 |
Portable 02 contents, gas |
12 |
12 |
$736.02 |
| E1038 |
Transport chair pt wt<=300lb |
12 |
12 |
$144.12 |