| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
10,643 |
9,341 |
$1.02M |
| E0601 |
Cont airway pressure device |
10,236 |
8,884 |
$743K |
| E0570 |
Nebulizer with compression |
5,251 |
4,917 |
$403K |
| A7032 |
Replacement nasal cushion |
6,229 |
5,620 |
$306K |
| B4035 |
Enteral feed supp pump per d |
1,725 |
1,350 |
$306K |
| A7034 |
Nasal application device |
5,878 |
5,401 |
$291K |
| E0562 |
Humidifier heated used w pap |
1,284 |
1,212 |
$249K |
| A7030 |
Cpap full face mask |
2,252 |
2,014 |
$233K |
| L4361 |
Pneuma/vac walk boot pre ots |
1,175 |
1,116 |
$227K |
| A7031 |
Replacement facemask interfa |
2,918 |
2,632 |
$213K |
| A7038 |
Pos airway pressure filter |
8,245 |
7,415 |
$142K |
| K0738 |
Portable gas oxygen system |
5,597 |
4,987 |
$142K |
| A7035 |
Pos airway press headgear |
5,246 |
4,799 |
$125K |
| B9998 |
Enteral supp not otherwise c |
1,809 |
1,012 |
$92K |
| A7005 |
Nondisposable nebulizer set |
2,903 |
2,806 |
$72K |
| A7033 |
Replacement nasal pillows |
971 |
890 |
$55K |
| E0431 |
Portable gaseous 02 |
1,945 |
1,822 |
$43K |
| L3908 |
Who cock-up nonmolde pre ots |
1,074 |
943 |
$41K |
| A7039 |
Filter, non disposable w pap |
4,136 |
3,779 |
$38K |
| E0114 |
Crutch underarm pair no wood |
999 |
960 |
$34K |
| A7046 |
Repl water chamber, pap dev |
2,356 |
2,136 |
$27K |
| A7037 |
Pos airway pressure tubing |
7,682 |
7,021 |
$25K |
| T4528 |
Adult size pull-on xl |
187 |
170 |
$22K |
| E0603 |
Electric breast pump |
76 |
74 |
$17K |
| K0001 |
Standard wheelchair |
733 |
625 |
$17K |
| T4534 |
Youth size pull-on |
139 |
119 |
$13K |
| A7000 |
Disposable canister for pump |
659 |
544 |
$12K |
| E0465 |
Home vent invasive interface |
21 |
12 |
$10K |
| E0470 |
Rad w/o backup non-inv intfc |
78 |
64 |
$10K |
| A7002 |
Tubing used w suction pump |
900 |
573 |
$9K |
| E1399 |
Durable medical equipment mi |
489 |
166 |
$9K |
| E0118 |
Crutch substitute |
87 |
64 |
$8K |
| A7526 |
Tracheostomy tube collar |
447 |
338 |
$5K |
| A4217 |
Sterile water/saline, 500 ml |
255 |
202 |
$4K |
| E0143 |
Walker folding wheeled w/o s |
85 |
82 |
$4K |
| B4088 |
Gastro/jejuno tube, low-pro |
31 |
28 |
$4K |
| A4606 |
Oxygen probe used w oximeter |
309 |
157 |
$4K |
| A6530 |
Compression stocking bk18-30 |
52 |
39 |
$3K |
| E0971 |
Wheelchair anti-tipping devi |
1,134 |
474 |
$2K |
| A4927 |
Non-sterile gloves |
120 |
92 |
$2K |
| T4530 |
Ped size brief/diaper lg |
12 |
12 |
$2K |
| A6402 |
Sterile gauze <= 16 sq in |
220 |
139 |
$1K |
| A4628 |
Oropharyngeal suction cath |
205 |
162 |
$966.03 |
| E0978 |
W/c acc,saf belt pelv strap |
590 |
474 |
$962.42 |
| A4604 |
Tubing with heating element |
414 |
369 |
$922.25 |
| L1902 |
Afo ankle gauntlet pre ots |
13 |
13 |
$847.34 |
| L0621 |
Sio flex pelvic/sacr pre ots |
12 |
12 |
$822.67 |
| A4213 |
20+ cc syringe only |
119 |
88 |
$683.30 |
| A4520 |
Incontinence garment anytype |
20 |
16 |
$497.40 |
| A4627 |
Spacer bag/reservoir |
16 |
12 |
$355.76 |
| A4216 |
Sterile water/saline, 10 ml |
30 |
24 |
$291.84 |
| A7015 |
Aerosol mask used w nebulize |
154 |
128 |
$263.12 |
| A7003 |
Nebulizer administration set |
233 |
193 |
$247.90 |