| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E0470 |
Rad w/o backup non-inv intfc |
981 |
551 |
$377K |
| E1390 |
Oxygen concentrator |
3,649 |
2,354 |
$200K |
| E0601 |
Cont airway pressure device |
2,272 |
1,390 |
$184K |
| T4535 |
Disposable liner/shield/pad |
1,203 |
720 |
$74K |
| E0562 |
Humidifier heated used w pap |
2,029 |
1,618 |
$70K |
| E0570 |
Nebulizer with compression |
1,913 |
1,045 |
$46K |
| K0001 |
Standard wheelchair |
3,171 |
1,856 |
$39K |
| E0260 |
Hosp bed semi-electr w/ matt |
1,627 |
977 |
$34K |
| A4604 |
Tubing with heating element |
939 |
683 |
$26K |
| T4541 |
Large disposable underpad |
1,299 |
831 |
$26K |
| E0431 |
Portable gaseous 02 |
2,761 |
1,736 |
$24K |
| A4927 |
Non-sterile gloves |
1,307 |
843 |
$15K |
| A7035 |
Pos airway press headgear |
752 |
525 |
$12K |
| T4526 |
Adult size pull-on med |
157 |
115 |
$10K |
| A7038 |
Pos airway pressure filter |
1,606 |
1,124 |
$9K |
| A7034 |
Nasal application device |
152 |
133 |
$8K |
| E0118 |
Crutch substitute |
257 |
210 |
$7K |
| A7030 |
Cpap full face mask |
60 |
49 |
$5K |
| T4527 |
Adult size pull-on lg |
45 |
39 |
$4K |
| A7031 |
Replacement facemask interfa |
102 |
82 |
$3K |
| T4524 |
Adult size brief/diaper xl |
14 |
12 |
$1K |