| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
11,334 |
10,555 |
$888K |
| E0601 |
Cont airway pressure device |
6,033 |
5,732 |
$342K |
| A7030 |
Cpap full face mask |
2,171 |
2,053 |
$212K |
| E0603 |
Electric breast pump |
1,064 |
1,016 |
$171K |
| E0570 |
Nebulizer with compression |
5,730 |
5,381 |
$147K |
| T4526 |
Adult size pull-on med |
1,283 |
1,220 |
$127K |
| A4604 |
Tubing with heating element |
3,344 |
3,152 |
$118K |
| E0562 |
Humidifier heated used w pap |
842 |
800 |
$104K |
| A7034 |
Nasal application device |
1,498 |
1,413 |
$97K |
| E0143 |
Walker folding wheeled w/o s |
1,843 |
1,720 |
$90K |
| K0001 |
Standard wheelchair |
3,700 |
3,510 |
$88K |
| L4361 |
Pneuma/vac walk boot pre ots |
563 |
535 |
$84K |
| E0260 |
Hosp bed semi-electr w/ matt |
1,709 |
1,593 |
$82K |
| T4534 |
Youth size pull-on |
533 |
511 |
$79K |
| A7035 |
Pos airway press headgear |
3,222 |
3,071 |
$66K |
| A7031 |
Replacement facemask interfa |
1,710 |
1,632 |
$65K |
| T4527 |
Adult size pull-on lg |
627 |
521 |
$56K |
| E1392 |
Portable oxygen concentrator |
4,016 |
3,760 |
$54K |
| E0431 |
Portable gaseous 02 |
3,411 |
3,214 |
$49K |
| T4535 |
Disposable liner/shield/pad |
809 |
795 |
$47K |
| E0470 |
Rad w/o backup non-inv intfc |
472 |
458 |
$46K |
| A7032 |
Replacement nasal cushion |
1,034 |
981 |
$42K |
| E0114 |
Crutch underarm pair no wood |
1,510 |
1,436 |
$36K |
| A4927 |
Non-sterile gloves |
2,047 |
1,893 |
$34K |
| K0738 |
Portable gas oxygen system |
1,869 |
1,747 |
$33K |
| T4541 |
Large disposable underpad |
1,526 |
1,507 |
$32K |
| L3908 |
Who cock-up nonmolde pre ots |
886 |
722 |
$29K |
| T4528 |
Adult size pull-on xl |
210 |
210 |
$28K |
| A7038 |
Pos airway pressure filter |
4,439 |
4,210 |
$24K |
| T4540 |
Reusable underpad chair size |
593 |
586 |
$22K |
| A7046 |
Repl water chamber, pap dev |
2,151 |
2,030 |
$21K |
| E0445 |
Oximeter non-invasive |
484 |
478 |
$19K |
| A7005 |
Nondisposable nebulizer set |
1,086 |
1,031 |
$16K |
| T4525 |
Adult size pull-on sm |
108 |
108 |
$11K |
| L1902 |
Afo ankle gauntlet pre ots |
200 |
186 |
$9K |
| T4532 |
Ped size pull-on lg |
91 |
90 |
$8K |
| A4335 |
Incontinence supply |
626 |
542 |
$8K |
| A4245 |
Alcohol wipes per box |
124 |
113 |
$7K |
| L4350 |
Ankle control ortho pre ots |
188 |
175 |
$7K |
| L1820 |
Ko elas w/ condyle pads & jo |
138 |
125 |
$5K |
| A4606 |
Oxygen probe used w oximeter |
18 |
12 |
$4K |
| T4544 |
Adlt disp und/pull on abv xl |
26 |
25 |
$4K |
| T4530 |
Ped size brief/diaper lg |
27 |
25 |
$3K |
| E0240 |
Bath/shower chair |
82 |
73 |
$3K |
| E0163 |
Commode chair with fixed arm |
65 |
58 |
$2K |
| E0149 |
Heavy duty wheeled walker |
282 |
225 |
$2K |
| A4520 |
Incontinence garment anytype |
43 |
36 |
$2K |
| A4554 |
Disposable underpads |
133 |
118 |
$2K |
| E0630 |
Patient lift hydraulic |
70 |
52 |
$1K |
| L1830 |
Ko immob canvas long pre ots |
28 |
25 |
$1K |
| E0156 |
Walker seat attachment |
85 |
81 |
$817.88 |
| A7039 |
Filter, non disposable w pap |
86 |
75 |
$715.84 |
| A4627 |
Spacer bag/reservoir |
40 |
39 |
$497.09 |
| A7037 |
Pos airway pressure tubing |
15 |
15 |
$352.76 |
| E0971 |
Wheelchair anti-tipping devi |
18 |
13 |
$71.61 |
| A6453 |
Self-adher band w <3"/yd |
14 |
14 |
$5.27 |