| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
2,884 |
2,806 |
$263K |
| E0439 |
Stationary liquid 02 |
1,609 |
1,477 |
$124K |
| E0570 |
Nebulizer with compression |
2,549 |
2,464 |
$121K |
| E0601 |
Cont airway pressure device |
1,566 |
1,530 |
$111K |
| A7032 |
Replacement nasal cushion |
1,293 |
1,276 |
$94K |
| A7030 |
Cpap full face mask |
858 |
855 |
$92K |
| A7034 |
Nasal application device |
1,129 |
1,121 |
$87K |
| A7031 |
Replacement facemask interfa |
989 |
978 |
$70K |
| A7035 |
Pos airway press headgear |
1,972 |
1,959 |
$53K |
| A7038 |
Pos airway pressure filter |
3,182 |
3,093 |
$48K |
| A7037 |
Pos airway pressure tubing |
1,290 |
1,283 |
$30K |
| E0562 |
Humidifier heated used w pap |
772 |
738 |
$25K |
| A4604 |
Tubing with heating element |
552 |
550 |
$24K |
| E0434 |
Portable liquid 02 |
1,600 |
1,454 |
$19K |
| T4527 |
Adult size pull-on lg |
111 |
110 |
$19K |
| T4528 |
Adult size pull-on xl |
99 |
98 |
$15K |
| E0260 |
Hosp bed semi-electr w/ matt |
362 |
323 |
$15K |
| T4541 |
Large disposable underpad |
416 |
411 |
$15K |
| A4627 |
Spacer bag/reservoir |
928 |
904 |
$15K |
| A7039 |
Filter, non disposable w pap |
1,079 |
1,077 |
$13K |
| T4537 |
Reusable underpad bed size |
587 |
579 |
$13K |
| E0431 |
Portable gaseous 02 |
822 |
817 |
$10K |
| A7046 |
Repl water chamber, pap dev |
826 |
812 |
$10K |
| K0001 |
Standard wheelchair |
465 |
444 |
$10K |
| L4360 |
Pneumat walking boot pre cst |
50 |
49 |
$8K |
| A4927 |
Non-sterile gloves |
363 |
347 |
$5K |
| E0114 |
Crutch underarm pair no wood |
158 |
156 |
$5K |
| L4361 |
Pneuma/vac walk boot pre ots |
27 |
26 |
$5K |
| A7005 |
Nondisposable nebulizer set |
192 |
188 |
$4K |
| A7003 |
Nebulizer administration set |
569 |
553 |
$2K |
| A7033 |
Replacement nasal pillows |
63 |
63 |
$2K |
| K0195 |
Elevating whlchair leg rests |
263 |
240 |
$1K |
| A7015 |
Aerosol mask used w nebulize |
844 |
826 |
$1K |
| A7013 |
Disposable compressor filter |
639 |
621 |
$336.30 |