| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E0601 |
Cont airway pressure device |
2,830 |
2,691 |
$101K |
| E1390 |
Oxygen concentrator |
1,762 |
1,635 |
$92K |
| T4535 |
Disposable liner/shield/pad |
1,185 |
1,152 |
$47K |
| T4527 |
Adult size pull-on lg |
463 |
460 |
$44K |
| T4528 |
Adult size pull-on xl |
433 |
422 |
$42K |
| T4537 |
Reusable underpad bed size |
1,088 |
1,058 |
$40K |
| E0562 |
Humidifier heated used w pap |
366 |
350 |
$36K |
| T4541 |
Large disposable underpad |
2,088 |
2,021 |
$34K |
| A7030 |
Cpap full face mask |
437 |
415 |
$30K |
| E0570 |
Nebulizer with compression |
1,024 |
919 |
$30K |
| T4526 |
Adult size pull-on med |
288 |
287 |
$26K |
| E0260 |
Hosp bed semi-electr w/ matt |
870 |
789 |
$20K |
| A4604 |
Tubing with heating element |
729 |
692 |
$18K |
| A4927 |
Non-sterile gloves |
1,715 |
1,632 |
$18K |
| K0001 |
Standard wheelchair |
888 |
817 |
$12K |
| E1392 |
Portable oxygen concentrator |
853 |
789 |
$10K |
| E0470 |
Rad w/o backup non-inv intfc |
110 |
105 |
$9K |
| A7035 |
Pos airway press headgear |
616 |
586 |
$9K |
| E0603 |
Electric breast pump |
50 |
50 |
$8K |
| E0143 |
Walker folding wheeled w/o s |
237 |
204 |
$7K |
| A7034 |
Nasal application device |
168 |
159 |
$6K |
| E0431 |
Portable gaseous 02 |
582 |
554 |
$5K |
| A7038 |
Pos airway pressure filter |
984 |
906 |
$4K |
| A7005 |
Nondisposable nebulizer set |
298 |
292 |
$4K |
| A4553 |
Nondisp underpads, all sizes |
90 |
89 |
$4K |
| L0621 |
Sio flex pelvic/sacr pre ots |
79 |
79 |
$4K |
| E0163 |
Commode chair with fixed arm |
142 |
135 |
$4K |
| K0195 |
Elevating whlchair leg rests |
637 |
581 |
$3K |
| T4523 |
Adult size brief/diaper lg |
37 |
37 |
$3K |
| A7031 |
Replacement facemask interfa |
110 |
107 |
$3K |
| A4554 |
Disposable underpads |
310 |
301 |
$3K |
| B4160 |
Ef ped caloric dense>/=0.7kc |
12 |
12 |
$3K |
| E0240 |
Bath/shower chair |
69 |
68 |
$2K |
| E0630 |
Patient lift hydraulic |
38 |
38 |
$745.55 |
| A4253 |
Blood glucose/reagent strips |
148 |
140 |
$737.27 |
| K0003 |
Lightweight wheelchair |
59 |
51 |
$679.06 |
| A7037 |
Pos airway pressure tubing |
43 |
41 |
$669.06 |
| A7046 |
Repl water chamber, pap dev |
32 |
32 |
$270.24 |
| A7039 |
Filter, non disposable w pap |
37 |
35 |
$236.93 |
| A7015 |
Aerosol mask used w nebulize |
333 |
326 |
$193.57 |
| A4627 |
Spacer bag/reservoir |
12 |
12 |
$129.60 |
| A7013 |
Disposable compressor filter |
360 |
351 |
$129.10 |