| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
24,818 |
24,470 |
$1.78M |
| E0600 |
Suction pump portab hom modl |
10,895 |
10,517 |
$390K |
| E0601 |
Cont airway pressure device |
10,261 |
10,126 |
$381K |
| E0445 |
Oximeter non-invasive |
6,963 |
1,918 |
$377K |
| E0431 |
Portable gaseous 02 |
17,846 |
17,509 |
$337K |
| E0603 |
Electric breast pump |
1,979 |
1,967 |
$273K |
| E0465 |
Home vent invasive interface |
315 |
309 |
$214K |
| E0471 |
Rad w/backup non inv intrfc |
1,015 |
998 |
$190K |
| E0470 |
Rad w/o backup non-inv intfc |
2,484 |
2,456 |
$185K |
| A7030 |
Cpap full face mask |
2,021 |
2,006 |
$163K |
| E0562 |
Humidifier heated used w pap |
13,419 |
13,236 |
$135K |
| E0443 |
Portable 02 contents, gas |
3,310 |
2,837 |
$88K |
| K0001 |
Standard wheelchair |
3,496 |
3,439 |
$71K |
| A4554 |
Disposable underpads |
1,760 |
1,672 |
$64K |
| K0004 |
High strength ltwt whlchr |
975 |
960 |
$56K |
| A7005 |
Nondisposable nebulizer set |
1,608 |
1,583 |
$52K |
| E0570 |
Nebulizer with compression |
6,555 |
6,461 |
$50K |
| T4534 |
Youth size pull-on |
372 |
339 |
$31K |
| A7034 |
Nasal application device |
552 |
548 |
$28K |
| A7031 |
Replacement facemask interfa |
1,633 |
1,563 |
$28K |
| A4927 |
Non-sterile gloves |
2,921 |
2,615 |
$27K |
| E0143 |
Walker folding wheeled w/o s |
1,490 |
1,466 |
$23K |
| A4628 |
Oropharyngeal suction cath |
1,394 |
1,355 |
$17K |
| E0424 |
Stationary compressed gas 02 |
427 |
411 |
$13K |
| E0202 |
Phototherapy light w/ photom |
181 |
51 |
$11K |
| A7035 |
Pos airway press headgear |
2,959 |
2,916 |
$11K |
| E0260 |
Hosp bed semi-electr w/ matt |
310 |
304 |
$11K |
| A4604 |
Tubing with heating element |
651 |
643 |
$10K |
| T4530 |
Ped size brief/diaper lg |
145 |
117 |
$8K |
| A7000 |
Disposable canister for pump |
1,874 |
1,816 |
$7K |
| T4535 |
Disposable liner/shield/pad |
248 |
196 |
$6K |
| A7037 |
Pos airway pressure tubing |
1,617 |
1,606 |
$6K |
| A4624 |
Tracheal suction tube |
213 |
202 |
$4K |
| A7038 |
Pos airway pressure filter |
3,012 |
2,954 |
$4K |
| T4526 |
Adult size pull-on med |
54 |
49 |
$4K |
| A4217 |
Sterile water/saline, 500 ml |
71 |
57 |
$4K |
| T4527 |
Adult size pull-on lg |
28 |
25 |
$3K |
| T4528 |
Adult size pull-on xl |
13 |
12 |
$1K |
| A4616 |
Tubing (oxygen) per foot |
252 |
245 |
$1K |
| A7526 |
Tracheostomy tube collar |
12 |
12 |
$849.07 |
| A7032 |
Replacement nasal cushion |
42 |
37 |
$408.28 |
| A6402 |
Sterile gauze <= 16 sq in |
60 |
52 |
$298.89 |
| E0990 |
Wheelchair elevating leg res |
12 |
12 |
$114.60 |
| A7002 |
Tubing used w suction pump |
41 |
40 |
$59.22 |
| A7046 |
Repl water chamber, pap dev |
15 |
15 |
$0.06 |