| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
17,043 |
16,485 |
$873K |
| E0601 |
Cont airway pressure device |
16,528 |
16,251 |
$725K |
| E0570 |
Nebulizer with compression |
17,673 |
17,070 |
$413K |
| B4160 |
Ef ped caloric dense>/=0.7kc |
1,568 |
1,501 |
$287K |
| A7030 |
Cpap full face mask |
3,818 |
3,752 |
$272K |
| E0603 |
Electric breast pump |
1,923 |
1,875 |
$264K |
| E0562 |
Humidifier heated used w pap |
5,011 |
4,941 |
$231K |
| A4604 |
Tubing with heating element |
7,569 |
7,462 |
$180K |
| E0470 |
Rad w/o backup non-inv intfc |
1,843 |
1,824 |
$172K |
| A7031 |
Replacement facemask interfa |
5,130 |
5,062 |
$135K |
| E0431 |
Portable gaseous 02 |
13,601 |
13,212 |
$113K |
| E0260 |
Hosp bed semi-electr w/ matt |
3,182 |
3,099 |
$111K |
| K0001 |
Standard wheelchair |
6,827 |
6,634 |
$108K |
| E0143 |
Walker folding wheeled w/o s |
2,485 |
2,396 |
$87K |
| A7034 |
Nasal application device |
2,262 |
2,229 |
$85K |
| T4527 |
Adult size pull-on lg |
882 |
846 |
$77K |
| A7035 |
Pos airway press headgear |
6,015 |
5,921 |
$77K |
| T4526 |
Adult size pull-on med |
850 |
806 |
$61K |
| A6530 |
Compression stocking bk18-30 |
2,067 |
1,030 |
$54K |
| A7005 |
Nondisposable nebulizer set |
3,745 |
3,634 |
$53K |
| L3908 |
Who cock-up nonmolde pre ots |
1,750 |
1,112 |
$51K |
| L0621 |
Sio flex pelvic/sacr pre ots |
1,218 |
1,199 |
$46K |
| A7032 |
Replacement nasal cushion |
1,488 |
1,472 |
$40K |
| A7038 |
Pos airway pressure filter |
10,518 |
10,378 |
$37K |
| A4627 |
Spacer bag/reservoir |
2,982 |
2,855 |
$36K |
| A4409 |
Ost skn barr convex <=4 sq i |
334 |
323 |
$26K |
| E0250 |
Hosp bed fixed ht w/ mattres |
1,651 |
1,574 |
$26K |
| E0445 |
Oximeter non-invasive |
1,018 |
985 |
$25K |
| A7046 |
Repl water chamber, pap dev |
3,191 |
3,141 |
$22K |
| E0240 |
Bath/shower chair |
796 |
777 |
$19K |
| K0003 |
Lightweight wheelchair |
771 |
752 |
$18K |
| E0630 |
Patient lift hydraulic |
980 |
948 |
$17K |
| E0163 |
Commode chair with fixed arm |
571 |
551 |
$15K |
| K0195 |
Elevating whlchair leg rests |
3,716 |
3,616 |
$14K |
| A7033 |
Replacement nasal pillows |
711 |
692 |
$12K |
| E0303 |
Hosp bed hvy dty xtra wide |
125 |
121 |
$9K |
| E0156 |
Walker seat attachment |
1,121 |
1,087 |
$8K |
| T4540 |
Reusable underpad chair size |
306 |
294 |
$7K |
| E0149 |
Heavy duty wheeled walker |
548 |
527 |
$7K |
| K0007 |
Extra heavy duty wheelchair |
121 |
120 |
$5K |
| K0006 |
Heavy duty wheelchair |
130 |
127 |
$4K |
| A4385 |
Ost skn barrier sld ext wear |
78 |
76 |
$3K |
| A7039 |
Filter, non disposable w pap |
353 |
343 |
$2K |
| E0181 |
Press pad alternating w/ pum |
253 |
240 |
$2K |
| A4351 |
Straight tip urine catheter |
13 |
12 |
$2K |
| A7015 |
Aerosol mask used w nebulize |
2,082 |
2,038 |
$2K |
| E0971 |
Wheelchair anti-tipping devi |
503 |
320 |
$2K |
| L3809 |
Whfo w/o joints pre ots |
20 |
16 |
$1K |
| T4528 |
Adult size pull-on xl |
14 |
14 |
$1K |
| A7037 |
Pos airway pressure tubing |
83 |
79 |
$1K |
| A4927 |
Non-sterile gloves |
54 |
50 |
$1K |
| A4362 |
Solid skin barrier |
12 |
12 |
$1K |
| L1820 |
Ko elas w/ condyle pads & jo |
32 |
28 |
$927.50 |
| E0165 |
Commode chair with detacharm |
138 |
126 |
$894.22 |
| E0114 |
Crutch underarm pair no wood |
36 |
36 |
$891.99 |
| E0100 |
Cane adjust/fixed with tip |
114 |
112 |
$842.71 |
| A7003 |
Nebulizer administration set |
498 |
489 |
$812.01 |
| A6402 |
Sterile gauze <= 16 sq in |
197 |
185 |
$702.44 |
| A4456 |
Adhesive remover, wipes |
61 |
61 |
$492.27 |
| A6446 |
Conform band s w>=3" <5"/yd |
18 |
14 |
$456.81 |
| A5063 |
Drain ostomy pouch w/flange |
12 |
12 |
$305.24 |
| A5120 |
Skin barrier, wipe or swab |
98 |
94 |
$282.07 |
| A4450 |
Non-waterproof tape |
68 |
65 |
$207.06 |
| A4357 |
Bedside drainage bag |
27 |
25 |
$151.12 |
| A7013 |
Disposable compressor filter |
197 |
195 |
$66.22 |