| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
12,349 |
11,792 |
$593K |
| A4239 |
Non-adju cgm supply allow |
728 |
689 |
$155K |
| A7030 |
Cpap full face mask |
1,360 |
1,335 |
$118K |
| E0601 |
Cont airway pressure device |
2,163 |
2,092 |
$85K |
| A4604 |
Tubing with heating element |
1,998 |
1,959 |
$57K |
| E0431 |
Portable gaseous 02 |
6,070 |
5,844 |
$55K |
| E0562 |
Humidifier heated used w pap |
327 |
320 |
$52K |
| A7031 |
Replacement facemask interfa |
1,605 |
1,560 |
$43K |
| E1392 |
Portable oxygen concentrator |
2,843 |
2,718 |
$39K |
| E0603 |
Electric breast pump |
286 |
286 |
$38K |
| A7034 |
Nasal application device |
556 |
547 |
$38K |
| E0600 |
Suction pump portab hom modl |
564 |
557 |
$29K |
| A7035 |
Pos airway press headgear |
1,392 |
1,359 |
$22K |
| E0570 |
Nebulizer with compression |
1,212 |
1,136 |
$20K |
| A7032 |
Replacement nasal cushion |
384 |
376 |
$19K |
| E0260 |
Hosp bed semi-electr w/ matt |
665 |
596 |
$18K |
| E0470 |
Rad w/o backup non-inv intfc |
168 |
160 |
$18K |
| K0001 |
Standard wheelchair |
1,317 |
1,279 |
$16K |
| T4527 |
Adult size pull-on lg |
159 |
142 |
$16K |
| E0424 |
Stationary compressed gas 02 |
169 |
169 |
$15K |
| T4541 |
Large disposable underpad |
599 |
574 |
$12K |
| E0143 |
Walker folding wheeled w/o s |
269 |
261 |
$12K |
| T4534 |
Youth size pull-on |
130 |
125 |
$11K |
| A7038 |
Pos airway pressure filter |
2,788 |
2,704 |
$11K |
| E0443 |
Portable 02 contents, gas |
288 |
281 |
$8K |
| E0434 |
Portable liquid 02 |
1,372 |
1,261 |
$8K |
| T4526 |
Adult size pull-on med |
81 |
75 |
$7K |
| A7046 |
Repl water chamber, pap dev |
637 |
629 |
$6K |
| T4522 |
Adult size brief/diaper med |
48 |
40 |
$4K |
| E0118 |
Crutch substitute |
260 |
260 |
$4K |
| A4927 |
Non-sterile gloves |
310 |
288 |
$4K |
| T4528 |
Adult size pull-on xl |
24 |
24 |
$3K |
| A7005 |
Nondisposable nebulizer set |
148 |
146 |
$3K |
| E1028 |
W/c manual swingaway |
36 |
25 |
$2K |
| E2103 |
Non-adju cgm receiver/mon |
12 |
12 |
$2K |
| K0739 |
Repair/svc dme non-oxygen eq |
21 |
13 |
$955.10 |
| T4535 |
Disposable liner/shield/pad |
12 |
12 |
$535.30 |
| B4150 |
Ef complet w/intact nutrient |
17 |
12 |
$438.76 |
| A7033 |
Replacement nasal pillows |
12 |
12 |
$422.06 |
| A4628 |
Oropharyngeal suction cath |
49 |
47 |
$302.25 |
| A7002 |
Tubing used w suction pump |
16 |
15 |
$88.67 |