| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
20,590 |
20,046 |
$1.72M |
| E0424 |
Stationary compressed gas 02 |
3,140 |
3,027 |
$305K |
| B4035 |
Enteral feed supp pump per d |
1,546 |
1,364 |
$301K |
| E0431 |
Portable gaseous 02 |
17,760 |
17,090 |
$266K |
| A7030 |
Cpap full face mask |
2,538 |
2,460 |
$237K |
| E0601 |
Cont airway pressure device |
3,692 |
3,629 |
$185K |
| T4541 |
Large disposable underpad |
1,635 |
1,587 |
$161K |
| E0603 |
Electric breast pump |
1,088 |
1,050 |
$133K |
| A7031 |
Replacement facemask interfa |
2,614 |
2,519 |
$128K |
| E0470 |
Rad w/o backup non-inv intfc |
1,102 |
1,067 |
$125K |
| T4523 |
Adult size brief/diaper lg |
786 |
768 |
$104K |
| K0001 |
Standard wheelchair |
3,953 |
3,840 |
$76K |
| T4522 |
Adult size brief/diaper med |
763 |
737 |
$75K |
| T4526 |
Adult size pull-on med |
499 |
493 |
$64K |
| A4604 |
Tubing with heating element |
1,631 |
1,587 |
$62K |
| T4527 |
Adult size pull-on lg |
430 |
424 |
$61K |
| E0260 |
Hosp bed semi-electr w/ matt |
1,618 |
1,592 |
$61K |
| B9998 |
Enteral supp not otherwise c |
315 |
297 |
$47K |
| B4160 |
Ef ped caloric dense>/=0.7kc |
80 |
74 |
$35K |
| A7038 |
Pos airway pressure filter |
4,630 |
4,474 |
$34K |
| A4927 |
Non-sterile gloves |
3,164 |
3,046 |
$34K |
| A7035 |
Pos airway press headgear |
1,844 |
1,777 |
$34K |
| E0570 |
Nebulizer with compression |
2,016 |
1,970 |
$31K |
| T4524 |
Adult size brief/diaper xl |
179 |
177 |
$28K |
| E0562 |
Humidifier heated used w pap |
988 |
980 |
$21K |
| E1392 |
Portable oxygen concentrator |
594 |
591 |
$19K |
| A7037 |
Pos airway pressure tubing |
1,143 |
1,113 |
$19K |
| K0003 |
Lightweight wheelchair |
528 |
511 |
$18K |
| A9901 |
Delivery/set up/dispensing |
2,887 |
2,600 |
$17K |
| B9002 |
Enter nutr inf pump any type |
227 |
220 |
$17K |
| A7046 |
Repl water chamber, pap dev |
1,237 |
1,212 |
$14K |
| A4452 |
Waterproof tape |
278 |
264 |
$7K |
| A6402 |
Sterile gauze <= 16 sq in |
447 |
412 |
$5K |
| A7034 |
Nasal application device |
77 |
77 |
$5K |
| T4528 |
Adult size pull-on xl |
25 |
25 |
$4K |
| K0195 |
Elevating whlchair leg rests |
181 |
180 |
$2K |
| A7032 |
Replacement nasal cushion |
37 |
37 |
$2K |
| E0445 |
Oximeter non-invasive |
14 |
12 |
$2K |
| E0630 |
Patient lift hydraulic |
12 |
12 |
$609.98 |
| E0776 |
Iv pole |
66 |
65 |
$537.33 |
| A4322 |
Irrigation syringe |
24 |
24 |
$291.16 |
| A7004 |
Disposable nebulizer sml vol |
87 |
83 |
$108.10 |
| A7015 |
Aerosol mask used w nebulize |
12 |
12 |
$15.52 |
| A7003 |
Nebulizer administration set |
15 |
12 |
$11.84 |