| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
4,231 |
4,211 |
$214K |
| B4150 |
Ef complet w/intact nutrient |
2,402 |
2,203 |
$166K |
| E0261 |
Hosp bed semi-electr w/o mat |
3,334 |
3,317 |
$73K |
| K0003 |
Lightweight wheelchair |
3,089 |
3,051 |
$66K |
| E0601 |
Cont airway pressure device |
1,163 |
1,161 |
$45K |
| E0630 |
Patient lift hydraulic |
954 |
951 |
$26K |
| E0431 |
Portable gaseous 02 |
1,609 |
1,600 |
$24K |
| E0570 |
Nebulizer with compression |
1,411 |
1,403 |
$17K |
| B4035 |
Enteral feed supp pump per d |
262 |
242 |
$12K |
| A4253 |
Blood glucose/reagent strips |
508 |
497 |
$12K |
| A4595 |
Tens suppl 2 lead per month |
463 |
454 |
$10K |
| B4152 |
Ef calorie dense>/=1.5kcal |
129 |
120 |
$9K |
| E0562 |
Humidifier heated used w pap |
863 |
862 |
$7K |
| E0971 |
Wheelchair anti-tipping devi |
704 |
430 |
$7K |
| K0738 |
Portable gas oxygen system |
821 |
819 |
$6K |
| A7005 |
Nondisposable nebulizer set |
513 |
512 |
$5K |
| E0961 |
Wheelchair brake extension |
704 |
431 |
$5K |
| E0973 |
W/ch access det adj armrest |
419 |
257 |
$4K |
| E0143 |
Walker folding wheeled w/o s |
143 |
142 |
$4K |
| E2611 |
Gen use back cush wdth <22in |
89 |
79 |
$4K |
| A7030 |
Cpap full face mask |
81 |
80 |
$3K |
| S5199 |
Personal care item nos each |
226 |
215 |
$3K |
| E0730 |
Tens four lead |
92 |
92 |
$3K |
| E1392 |
Portable oxygen concentrator |
548 |
548 |
$3K |
| A7037 |
Pos airway pressure tubing |
205 |
204 |
$2K |
| E0951 |
Loop heel |
448 |
283 |
$2K |
| A7035 |
Pos airway press headgear |
165 |
163 |
$2K |
| E2601 |
Gen w/c cushion wdth < 22 in |
144 |
133 |
$2K |
| E0260 |
Hosp bed semi-electr w/ matt |
26 |
25 |
$2K |
| E0184 |
Dry pressure mattress |
59 |
59 |
$1K |
| A4259 |
Lancets per box |
410 |
403 |
$1K |
| A7038 |
Pos airway pressure filter |
347 |
344 |
$1K |
| E0156 |
Walker seat attachment |
127 |
126 |
$753.50 |
| E0163 |
Commode chair with fixed arm |
25 |
25 |
$490.52 |
| A7015 |
Aerosol mask used w nebulize |
449 |
448 |
$468.11 |
| A7000 |
Disposable canister for pump |
83 |
76 |
$352.30 |
| A4628 |
Oropharyngeal suction cath |
46 |
38 |
$306.34 |
| E0165 |
Commode chair with detacharm |
37 |
37 |
$263.56 |
| A7526 |
Tracheostomy tube collar |
15 |
12 |
$177.84 |
| E0561 |
Humidifier nonheated w pap |
24 |
24 |
$160.77 |
| A7002 |
Tubing used w suction pump |
68 |
63 |
$108.72 |