| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A9276 |
Disposable sensor, cgm sys |
2,497 |
1,791 |
$586K |
| E1390 |
Oxygen concentrator |
9,502 |
8,112 |
$551K |
| A7030 |
Cpap full face mask |
4,387 |
4,113 |
$461K |
| E0601 |
Cont airway pressure device |
9,524 |
8,654 |
$414K |
| E0431 |
Portable gaseous 02 |
3,748 |
3,098 |
$276K |
| E0562 |
Humidifier heated used w pap |
8,251 |
7,548 |
$174K |
| E0466 |
Home vent non-invasive inter |
431 |
340 |
$150K |
| A7034 |
Nasal application device |
2,123 |
2,037 |
$150K |
| A7035 |
Pos airway press headgear |
6,467 |
6,099 |
$150K |
| E0603 |
Electric breast pump |
874 |
811 |
$125K |
| A7031 |
Replacement facemask interfa |
3,083 |
2,973 |
$84K |
| A9277 |
External transmitter, cgm |
159 |
154 |
$76K |
| A4230 |
Infus insulin pump non needl |
723 |
666 |
$75K |
| A7037 |
Pos airway pressure tubing |
5,083 |
4,801 |
$71K |
| B4160 |
Ef ped caloric dense>/=0.7kc |
532 |
469 |
$70K |
| E0471 |
Rad w/backup non inv intrfc |
355 |
285 |
$58K |
| E0570 |
Nebulizer with compression |
4,311 |
4,000 |
$57K |
| A4239 |
Non-adju cgm supply allow |
286 |
267 |
$50K |
| E0470 |
Rad w/o backup non-inv intfc |
1,113 |
1,027 |
$49K |
| A7038 |
Pos airway pressure filter |
9,931 |
9,432 |
$47K |
| A7046 |
Repl water chamber, pap dev |
4,975 |
4,658 |
$36K |
| L3908 |
Who cock-up nonmolde pre ots |
1,088 |
929 |
$35K |
| K0001 |
Standard wheelchair |
3,297 |
3,027 |
$30K |
| E0114 |
Crutch underarm pair no wood |
808 |
771 |
$30K |
| A4232 |
Syringe w/needle insulin 3cc |
766 |
704 |
$26K |
| K0738 |
Portable gas oxygen system |
3,501 |
3,360 |
$24K |
| E0143 |
Walker folding wheeled w/o s |
773 |
718 |
$21K |
| A4604 |
Tubing with heating element |
2,580 |
2,475 |
$21K |
| A4414 |
Ost sknbar w/o conv<=4 sq in |
417 |
374 |
$17K |
| L4387 |
Non-pneum walk boot pre ots |
191 |
183 |
$13K |
| A7005 |
Nondisposable nebulizer set |
690 |
656 |
$9K |
| T4527 |
Adult size pull-on lg |
309 |
225 |
$9K |
| E0149 |
Heavy duty wheeled walker |
610 |
588 |
$9K |
| B4035 |
Enteral feed supp pump per d |
61 |
53 |
$8K |
| E0260 |
Hosp bed semi-electr w/ matt |
718 |
392 |
$8K |
| L4350 |
Ankle control ortho pre ots |
141 |
139 |
$8K |
| L4361 |
Pneuma/vac walk boot pre ots |
76 |
71 |
$7K |
| E0255 |
Hospital bed var ht w/ mattr |
1,013 |
997 |
$6K |
| T4528 |
Adult size pull-on xl |
88 |
78 |
$5K |
| T4535 |
Disposable liner/shield/pad |
302 |
239 |
$4K |
| A4927 |
Non-sterile gloves |
388 |
276 |
$4K |
| A4425 |
Ost pch drain for barrier fl |
204 |
171 |
$4K |
| A4406 |
Pectin based ostomy paste |
433 |
378 |
$4K |
| B4088 |
Gastro/jejuno tube, low-pro |
70 |
36 |
$3K |
| A5120 |
Skin barrier, wipe or swab |
1,096 |
953 |
$3K |
| L3260 |
Ambulatory surgical boot eac |
180 |
170 |
$3K |
| A7032 |
Replacement nasal cushion |
263 |
198 |
$3K |
| E0730 |
Tens four lead |
64 |
56 |
$2K |
| E0118 |
Crutch substitute |
53 |
52 |
$2K |
| A4253 |
Blood glucose/reagent strips |
34 |
28 |
$2K |
| L3809 |
Whfo w/o joints pre ots |
40 |
38 |
$2K |
| A4351 |
Straight tip urine catheter |
30 |
25 |
$1K |
| A6212 |
Foam drg <=16 sq in w/border |
17 |
13 |
$1K |
| A7003 |
Nebulizer administration set |
662 |
641 |
$1K |
| A4385 |
Ost skn barrier sld ext wear |
44 |
37 |
$1K |
| K0195 |
Elevating whlchair leg rests |
645 |
618 |
$957.45 |
| T4544 |
Adlt disp und/pull on abv xl |
16 |
14 |
$933.34 |
| A4407 |
Ext wear ost skn barr <=4sq" |
41 |
36 |
$887.42 |
| A4456 |
Adhesive remover, wipes |
219 |
199 |
$811.41 |
| A6402 |
Sterile gauze <= 16 sq in |
174 |
137 |
$713.12 |
| E0156 |
Walker seat attachment |
88 |
82 |
$573.97 |
| T4526 |
Adult size pull-on med |
18 |
13 |
$553.20 |
| T4537 |
Reusable underpad bed size |
13 |
12 |
$526.88 |
| A7033 |
Replacement nasal pillows |
26 |
24 |
$347.93 |
| K0007 |
Extra heavy duty wheelchair |
12 |
12 |
$313.63 |
| A4357 |
Bedside drainage bag |
147 |
137 |
$158.53 |
| A4259 |
Lancets per box |
13 |
12 |
$79.95 |
| A7015 |
Aerosol mask used w nebulize |
24 |
24 |
$22.38 |