| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
404 |
356 |
$36K |
| E0601 |
Cont airway pressure device |
259 |
215 |
$24K |
| B4035 |
Enteral feed supp pump per d |
142 |
131 |
$22K |
| T4535 |
Disposable liner/shield/pad |
221 |
196 |
$14K |
| T4527 |
Adult size pull-on lg |
165 |
149 |
$12K |
| E0570 |
Nebulizer with compression |
383 |
343 |
$10K |
| T4526 |
Adult size pull-on med |
137 |
131 |
$10K |
| A4927 |
Non-sterile gloves |
473 |
446 |
$8K |
| A7030 |
Cpap full face mask |
74 |
72 |
$8K |
| E0562 |
Humidifier heated used w pap |
274 |
230 |
$7K |
| T4528 |
Adult size pull-on xl |
88 |
82 |
$6K |
| E1392 |
Portable oxygen concentrator |
220 |
194 |
$6K |
| A7037 |
Pos airway pressure tubing |
198 |
194 |
$5K |
| K0001 |
Standard wheelchair |
268 |
223 |
$4K |
| A7031 |
Replacement facemask interfa |
100 |
97 |
$4K |
| L3908 |
Who cock-up nonmolde pre ots |
75 |
51 |
$4K |
| A7035 |
Pos airway press headgear |
160 |
155 |
$4K |
| B4150 |
Ef complet w/intact nutrient |
25 |
24 |
$3K |
| A7034 |
Nasal application device |
34 |
33 |
$2K |
| A7038 |
Pos airway pressure filter |
335 |
324 |
$2K |
| K0002 |
Stnd hemi (low seat) whlchr |
134 |
97 |
$2K |
| A7032 |
Replacement nasal cushion |
33 |
31 |
$1K |
| T4537 |
Reusable underpad bed size |
17 |
16 |
$899.16 |
| B9998 |
Enteral supp not otherwise c |
27 |
24 |
$870.27 |
| A7003 |
Nebulizer administration set |
232 |
206 |
$655.59 |
| A4670 |
Automatic bp monitor, dial |
12 |
12 |
$573.52 |
| K0739 |
Repair/svc dme non-oxygen eq |
16 |
12 |
$180.60 |
| A4456 |
Adhesive remover, wipes |
30 |
25 |
$105.83 |
| A5120 |
Skin barrier, wipe or swab |
37 |
37 |
$94.55 |
| A4628 |
Oropharyngeal suction cath |
24 |
24 |
$87.48 |
| A7000 |
Disposable canister for pump |
12 |
12 |
$59.29 |
| A7002 |
Tubing used w suction pump |
12 |
12 |
$40.80 |