| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
15,465 |
15,261 |
$1.08M |
| E0445 |
Oximeter non-invasive |
7,029 |
2,123 |
$366K |
| E0601 |
Cont airway pressure device |
9,814 |
9,670 |
$344K |
| E0603 |
Electric breast pump |
2,044 |
2,030 |
$284K |
| E0431 |
Portable gaseous 02 |
11,088 |
10,889 |
$205K |
| A7030 |
Cpap full face mask |
1,757 |
1,744 |
$144K |
| E0562 |
Humidifier heated used w pap |
11,534 |
11,367 |
$115K |
| E0471 |
Rad w/backup non inv intrfc |
483 |
474 |
$98K |
| A4554 |
Disposable underpads |
1,834 |
1,730 |
$96K |
| E0470 |
Rad w/o backup non-inv intfc |
935 |
931 |
$74K |
| T4534 |
Youth size pull-on |
680 |
627 |
$60K |
| E0443 |
Portable 02 contents, gas |
2,158 |
1,907 |
$56K |
| K0001 |
Standard wheelchair |
2,839 |
2,774 |
$54K |
| E0465 |
Home vent invasive interface |
76 |
75 |
$50K |
| A7034 |
Nasal application device |
734 |
726 |
$38K |
| T4530 |
Ped size brief/diaper lg |
455 |
401 |
$36K |
| A4927 |
Non-sterile gloves |
2,989 |
2,727 |
$33K |
| A7005 |
Nondisposable nebulizer set |
516 |
508 |
$31K |
| E0570 |
Nebulizer with compression |
3,212 |
3,140 |
$25K |
| E0202 |
Phototherapy light w/ photom |
471 |
133 |
$23K |
| E0424 |
Stationary compressed gas 02 |
503 |
487 |
$18K |
| A7031 |
Replacement facemask interfa |
1,006 |
960 |
$17K |
| K0004 |
High strength ltwt whlchr |
387 |
383 |
$14K |
| E0260 |
Hosp bed semi-electr w/ matt |
464 |
445 |
$13K |
| A7035 |
Pos airway press headgear |
2,817 |
2,772 |
$12K |
| E0600 |
Suction pump portab hom modl |
282 |
275 |
$9K |
| A7037 |
Pos airway pressure tubing |
1,865 |
1,852 |
$8K |
| A4604 |
Tubing with heating element |
430 |
423 |
$7K |
| T4527 |
Adult size pull-on lg |
56 |
52 |
$6K |
| A7038 |
Pos airway pressure filter |
3,102 |
3,030 |
$4K |
| A4217 |
Sterile water/saline, 500 ml |
74 |
60 |
$3K |
| T4528 |
Adult size pull-on xl |
30 |
27 |
$3K |
| E0143 |
Walker folding wheeled w/o s |
257 |
252 |
$2K |
| T4535 |
Disposable liner/shield/pad |
41 |
40 |
$2K |
| T4522 |
Adult size brief/diaper med |
17 |
13 |
$1K |
| A7526 |
Tracheostomy tube collar |
12 |
12 |
$1K |
| A6530 |
Compression stocking bk18-30 |
12 |
12 |
$1K |
| A7032 |
Replacement nasal cushion |
12 |
12 |
$422.01 |
| A7000 |
Disposable canister for pump |
37 |
36 |
$312.28 |
| E0990 |
Wheelchair elevating leg res |
28 |
28 |
$215.85 |
| A7046 |
Repl water chamber, pap dev |
13 |
13 |
$0.00 |