| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E0601 |
Cont airway pressure device |
4,995 |
3,246 |
$472K |
| E0470 |
Rad w/o backup non-inv intfc |
2,216 |
1,444 |
$420K |
| E1390 |
Oxygen concentrator |
4,472 |
3,120 |
$269K |
| T4526 |
Adult size pull-on med |
3,276 |
2,095 |
$257K |
| A7030 |
Cpap full face mask |
2,462 |
2,004 |
$211K |
| T4535 |
Disposable liner/shield/pad |
2,614 |
2,065 |
$196K |
| E0562 |
Humidifier heated used w pap |
5,370 |
3,692 |
$183K |
| A4604 |
Tubing with heating element |
4,872 |
3,661 |
$160K |
| A7031 |
Replacement facemask interfa |
3,257 |
2,461 |
$127K |
| A7034 |
Nasal application device |
2,158 |
1,628 |
$124K |
| T4524 |
Adult size brief/diaper xl |
1,116 |
867 |
$99K |
| T4527 |
Adult size pull-on lg |
1,158 |
934 |
$93K |
| A4927 |
Non-sterile gloves |
6,108 |
4,152 |
$88K |
| E0260 |
Hosp bed semi-electr w/ matt |
3,228 |
2,135 |
$73K |
| T4541 |
Large disposable underpad |
3,440 |
2,582 |
$70K |
| A7032 |
Replacement nasal cushion |
1,419 |
1,236 |
$69K |
| A7035 |
Pos airway press headgear |
3,573 |
2,754 |
$67K |
| A7038 |
Pos airway pressure filter |
7,225 |
5,667 |
$48K |
| K0001 |
Standard wheelchair |
3,606 |
2,410 |
$46K |
| E0570 |
Nebulizer with compression |
2,086 |
1,482 |
$45K |
| E0431 |
Portable gaseous 02 |
2,911 |
1,968 |
$36K |
| T4523 |
Adult size brief/diaper lg |
196 |
177 |
$18K |
| T4528 |
Adult size pull-on xl |
193 |
155 |
$14K |
| E0118 |
Crutch substitute |
499 |
419 |
$13K |
| T4534 |
Youth size pull-on |
223 |
172 |
$13K |
| T4537 |
Reusable underpad bed size |
105 |
100 |
$11K |
| E0603 |
Electric breast pump |
59 |
57 |
$10K |
| A7046 |
Repl water chamber, pap dev |
1,012 |
848 |
$9K |
| T4521 |
Adult size brief/diaper sm |
159 |
148 |
$9K |
| E0630 |
Patient lift hydraulic |
411 |
274 |
$8K |
| E0143 |
Walker folding wheeled w/o s |
178 |
141 |
$8K |
| T4522 |
Adult size brief/diaper med |
101 |
83 |
$7K |
| A7033 |
Replacement nasal pillows |
170 |
142 |
$7K |
| A4670 |
Automatic bp monitor, dial |
131 |
95 |
$5K |
| A7005 |
Nondisposable nebulizer set |
216 |
195 |
$4K |
| K0003 |
Lightweight wheelchair |
112 |
80 |
$2K |
| E0156 |
Walker seat attachment |
207 |
61 |
$1K |
| E0149 |
Heavy duty wheeled walker |
17 |
12 |
$692.51 |
| A7036 |
Pos airway press chinstrap |
44 |
38 |
$387.92 |