| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
25,126 |
24,554 |
$2.27M |
| E0601 |
Cont airway pressure device |
7,073 |
6,959 |
$376K |
| E0431 |
Portable gaseous 02 |
22,019 |
21,214 |
$363K |
| A7030 |
Cpap full face mask |
3,820 |
3,712 |
$362K |
| B4035 |
Enteral feed supp pump per d |
1,669 |
1,467 |
$284K |
| E0424 |
Stationary compressed gas 02 |
2,373 |
2,351 |
$258K |
| E0470 |
Rad w/o backup non-inv intfc |
1,964 |
1,902 |
$235K |
| A7031 |
Replacement facemask interfa |
3,762 |
3,651 |
$202K |
| E0603 |
Electric breast pump |
1,604 |
1,567 |
$199K |
| T4522 |
Adult size brief/diaper med |
1,988 |
1,876 |
$183K |
| T4526 |
Adult size pull-on med |
1,187 |
1,173 |
$151K |
| T4541 |
Large disposable underpad |
1,904 |
1,860 |
$142K |
| T4523 |
Adult size brief/diaper lg |
1,011 |
993 |
$132K |
| T4527 |
Adult size pull-on lg |
959 |
941 |
$128K |
| K0001 |
Standard wheelchair |
6,938 |
6,737 |
$127K |
| E0260 |
Hosp bed semi-electr w/ matt |
2,313 |
2,263 |
$105K |
| E0562 |
Humidifier heated used w pap |
1,755 |
1,711 |
$91K |
| E0570 |
Nebulizer with compression |
4,499 |
4,393 |
$85K |
| A7034 |
Nasal application device |
1,218 |
1,190 |
$75K |
| A7037 |
Pos airway pressure tubing |
4,031 |
3,921 |
$70K |
| A7038 |
Pos airway pressure filter |
7,069 |
6,854 |
$60K |
| A7035 |
Pos airway press headgear |
3,134 |
3,023 |
$58K |
| A7032 |
Replacement nasal cushion |
845 |
832 |
$53K |
| E1392 |
Portable oxygen concentrator |
1,544 |
1,537 |
$49K |
| E0445 |
Oximeter non-invasive |
372 |
344 |
$48K |
| T4528 |
Adult size pull-on xl |
291 |
289 |
$44K |
| E0143 |
Walker folding wheeled w/o s |
939 |
913 |
$42K |
| T4524 |
Adult size brief/diaper xl |
277 |
261 |
$39K |
| A4927 |
Non-sterile gloves |
3,116 |
2,961 |
$37K |
| B9998 |
Enteral supp not otherwise c |
272 |
240 |
$33K |
| A4604 |
Tubing with heating element |
712 |
706 |
$31K |
| E0202 |
Phototherapy light w/ photom |
629 |
124 |
$29K |
| K0003 |
Lightweight wheelchair |
845 |
832 |
$29K |
| A9901 |
Delivery/set up/dispensing |
4,591 |
4,312 |
$28K |
| T4534 |
Youth size pull-on |
219 |
217 |
$28K |
| A7046 |
Repl water chamber, pap dev |
2,232 |
2,190 |
$26K |
| E0118 |
Crutch substitute |
454 |
450 |
$11K |
| K0195 |
Elevating whlchair leg rests |
1,057 |
1,041 |
$10K |
| E0630 |
Patient lift hydraulic |
263 |
255 |
$10K |
| A4452 |
Waterproof tape |
284 |
252 |
$7K |
| A4520 |
Incontinence garment anytype |
140 |
138 |
$7K |
| B9002 |
Enter nutr inf pump any type |
65 |
64 |
$5K |
| A4554 |
Disposable underpads |
81 |
81 |
$5K |
| A6402 |
Sterile gauze <= 16 sq in |
535 |
463 |
$5K |
| E0600 |
Suction pump portab hom modl |
124 |
122 |
$4K |
| E0434 |
Portable liquid 02 |
182 |
176 |
$3K |
| E1399 |
Durable medical equipment mi |
14 |
14 |
$3K |
| T4521 |
Adult size brief/diaper sm |
28 |
25 |
$3K |
| E0471 |
Rad w/backup non inv intrfc |
12 |
12 |
$2K |
| A5120 |
Skin barrier, wipe or swab |
108 |
103 |
$954.47 |
| E0990 |
Wheelchair elevating leg res |
138 |
136 |
$945.89 |
| A7004 |
Disposable nebulizer sml vol |
718 |
698 |
$833.67 |
| A7015 |
Aerosol mask used w nebulize |
205 |
204 |
$303.55 |
| B4087 |
Gastro/jejuno tube, std |
14 |
13 |
$297.82 |
| A7003 |
Nebulizer administration set |
153 |
138 |
$289.11 |
| E0181 |
Press pad alternating w/ pum |
12 |
12 |
$158.65 |
| A4357 |
Bedside drainage bag |
29 |
25 |
$124.20 |