| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E0603 |
Electric breast pump |
6,732 |
5,526 |
$1.22M |
| T4527 |
Adult size pull-on lg |
10,085 |
9,464 |
$968K |
| T4526 |
Adult size pull-on med |
6,504 |
6,082 |
$601K |
| T4528 |
Adult size pull-on xl |
5,525 |
5,109 |
$523K |
| T4541 |
Large disposable underpad |
19,633 |
18,400 |
$522K |
| T4535 |
Disposable liner/shield/pad |
11,151 |
10,351 |
$468K |
| T4544 |
Adlt disp und/pull on abv xl |
1,607 |
1,487 |
$260K |
| E0601 |
Cont airway pressure device |
5,231 |
4,654 |
$235K |
| E1390 |
Oxygen concentrator |
3,286 |
2,634 |
$192K |
| A4927 |
Non-sterile gloves |
13,709 |
12,608 |
$168K |
| A7030 |
Cpap full face mask |
1,426 |
1,238 |
$98K |
| T4537 |
Reusable underpad bed size |
2,365 |
2,165 |
$92K |
| E0570 |
Nebulizer with compression |
2,673 |
2,443 |
$85K |
| A4670 |
Automatic bp monitor, dial |
1,509 |
1,237 |
$76K |
| A4604 |
Tubing with heating element |
2,595 |
2,257 |
$58K |
| A7031 |
Replacement facemask interfa |
2,320 |
1,978 |
$53K |
| T4523 |
Adult size brief/diaper lg |
479 |
412 |
$44K |
| A7034 |
Nasal application device |
952 |
804 |
$39K |
| E0260 |
Hosp bed semi-electr w/ matt |
772 |
663 |
$33K |
| A7035 |
Pos airway press headgear |
2,083 |
1,817 |
$29K |
| E0431 |
Portable gaseous 02 |
2,070 |
1,622 |
$27K |
| E0562 |
Humidifier heated used w pap |
187 |
170 |
$26K |
| K0001 |
Standard wheelchair |
1,106 |
919 |
$21K |
| A7038 |
Pos airway pressure filter |
5,149 |
4,437 |
$18K |
| T4525 |
Adult size pull-on sm |
210 |
210 |
$17K |
| A7032 |
Replacement nasal cushion |
1,029 |
826 |
$17K |
| T4524 |
Adult size brief/diaper xl |
125 |
124 |
$14K |
| E0143 |
Walker folding wheeled w/o s |
243 |
207 |
$13K |
| T4522 |
Adult size brief/diaper med |
103 |
94 |
$10K |
| A7033 |
Replacement nasal pillows |
555 |
469 |
$9K |
| T4543 |
Adult disp brief/diap abv xl |
40 |
25 |
$6K |
| A7046 |
Repl water chamber, pap dev |
814 |
708 |
$5K |
| A7039 |
Filter, non disposable w pap |
918 |
839 |
$5K |
| A4335 |
Incontinence supply |
239 |
225 |
$3K |
| E0163 |
Commode chair with fixed arm |
64 |
60 |
$3K |
| W0137 |
|
49 |
49 |
$2K |
| E0240 |
Bath/shower chair |
60 |
60 |
$2K |
| K0195 |
Elevating whlchair leg rests |
336 |
238 |
$2K |
| A7003 |
Nebulizer administration set |
543 |
474 |
$1K |
| E0470 |
Rad w/o backup non-inv intfc |
26 |
26 |
$589.58 |
| A7015 |
Aerosol mask used w nebulize |
27 |
26 |
$27.31 |