| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
18,393 |
16,150 |
$746K |
| E0570 |
Nebulizer with compression |
39,354 |
35,040 |
$406K |
| E0601 |
Cont airway pressure device |
10,650 |
9,245 |
$253K |
| A7030 |
Cpap full face mask |
4,790 |
4,097 |
$227K |
| E0255 |
Hospital bed var ht w/ mattr |
4,780 |
4,205 |
$127K |
| E0431 |
Portable gaseous 02 |
13,801 |
12,083 |
$112K |
| A4253 |
Blood glucose/reagent strips |
4,061 |
3,604 |
$102K |
| E0562 |
Humidifier heated used w pap |
1,984 |
1,585 |
$94K |
| A7031 |
Replacement facemask interfa |
4,324 |
3,712 |
$84K |
| T4522 |
Adult size brief/diaper med |
907 |
666 |
$77K |
| A7034 |
Nasal application device |
2,971 |
2,430 |
$73K |
| E0443 |
Portable 02 contents, gas |
2,121 |
1,805 |
$65K |
| E0260 |
Hosp bed semi-electr w/ matt |
2,013 |
1,643 |
$62K |
| E0630 |
Patient lift hydraulic |
1,817 |
1,568 |
$49K |
| A7037 |
Pos airway pressure tubing |
3,157 |
2,740 |
$47K |
| K0001 |
Standard wheelchair |
6,695 |
5,887 |
$46K |
| A7035 |
Pos airway press headgear |
4,994 |
4,195 |
$43K |
| A4604 |
Tubing with heating element |
4,374 |
3,624 |
$42K |
| E0143 |
Walker folding wheeled w/o s |
1,850 |
1,576 |
$41K |
| A7038 |
Pos airway pressure filter |
7,978 |
6,611 |
$38K |
| T4530 |
Ped size brief/diaper lg |
436 |
359 |
$37K |
| E0470 |
Rad w/o backup non-inv intfc |
687 |
569 |
$33K |
| B4035 |
Enteral feed supp pump per d |
587 |
429 |
$33K |
| A9276 |
Disposable sensor, cgm sys |
53 |
39 |
$30K |
| A4239 |
Non-adju cgm supply allow |
347 |
307 |
$28K |
| T4523 |
Adult size brief/diaper lg |
196 |
156 |
$24K |
| A7032 |
Replacement nasal cushion |
1,303 |
1,072 |
$23K |
| K0823 |
Pwc gp 2 std cap chair |
506 |
406 |
$21K |
| A4259 |
Lancets per box |
3,456 |
3,077 |
$17K |
| A7046 |
Repl water chamber, pap dev |
2,951 |
2,449 |
$16K |
| T4525 |
Adult size pull-on sm |
128 |
114 |
$14K |
| B4034 |
Enter feed supkit syr by day |
337 |
237 |
$11K |
| A7033 |
Replacement nasal pillows |
636 |
505 |
$8K |
| E0163 |
Commode chair with fixed arm |
328 |
273 |
$8K |
| A4627 |
Spacer bag/reservoir |
247 |
222 |
$6K |
| E0149 |
Heavy duty wheeled walker |
589 |
516 |
$6K |
| E0156 |
Walker seat attachment |
820 |
683 |
$4K |
| B9998 |
Enteral supp not otherwise c |
219 |
90 |
$3K |
| T4527 |
Adult size pull-on lg |
26 |
24 |
$3K |
| K0195 |
Elevating whlchair leg rests |
1,063 |
931 |
$2K |
| S8490 |
100 insulin syringes |
112 |
92 |
$2K |
| A4554 |
Disposable underpads |
31 |
30 |
$2K |
| A4927 |
Non-sterile gloves |
213 |
135 |
$2K |
| A4245 |
Alcohol wipes per box |
900 |
782 |
$2K |
| A7039 |
Filter, non disposable w pap |
443 |
400 |
$1K |
| E1392 |
Portable oxygen concentrator |
344 |
316 |
$1K |
| A7000 |
Disposable canister for pump |
128 |
91 |
$1K |
| A4335 |
Incontinence supply |
222 |
140 |
$904.21 |
| K0006 |
Heavy duty wheelchair |
51 |
49 |
$727.73 |
| E0165 |
Commode chair with detacharm |
27 |
24 |
$566.76 |
| K0007 |
Extra heavy duty wheelchair |
13 |
12 |
$257.76 |
| A7036 |
Pos airway press chinstrap |
27 |
25 |
$123.01 |
| K0003 |
Lightweight wheelchair |
12 |
12 |
$108.02 |