| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
12,130 |
11,175 |
$872K |
| E0601 |
Cont airway pressure device |
3,886 |
3,610 |
$181K |
| T4541 |
Large disposable underpad |
2,561 |
2,366 |
$169K |
| K0738 |
Portable gas oxygen system |
4,905 |
4,511 |
$124K |
| T4526 |
Adult size pull-on med |
974 |
894 |
$122K |
| T4527 |
Adult size pull-on lg |
761 |
720 |
$119K |
| A7030 |
Cpap full face mask |
1,413 |
1,321 |
$110K |
| E0562 |
Humidifier heated used w pap |
4,337 |
3,971 |
$72K |
| T4535 |
Disposable liner/shield/pad |
1,501 |
1,391 |
$69K |
| T4528 |
Adult size pull-on xl |
408 |
403 |
$67K |
| E1392 |
Portable oxygen concentrator |
4,206 |
3,828 |
$64K |
| E0260 |
Hosp bed semi-electr w/ matt |
1,121 |
1,075 |
$42K |
| E0570 |
Nebulizer with compression |
869 |
830 |
$41K |
| A7035 |
Pos airway press headgear |
1,459 |
1,366 |
$26K |
| A7037 |
Pos airway pressure tubing |
1,106 |
1,032 |
$20K |
| A7031 |
Replacement facemask interfa |
781 |
735 |
$20K |
| A4927 |
Non-sterile gloves |
945 |
859 |
$13K |
| A7034 |
Nasal application device |
282 |
270 |
$13K |
| A7038 |
Pos airway pressure filter |
2,623 |
2,425 |
$12K |
| A4604 |
Tubing with heating element |
449 |
424 |
$10K |
| A7005 |
Nondisposable nebulizer set |
475 |
444 |
$8K |
| K0001 |
Standard wheelchair |
128 |
118 |
$6K |
| E0431 |
Portable gaseous 02 |
394 |
391 |
$6K |
| E0470 |
Rad w/o backup non-inv intfc |
38 |
36 |
$5K |
| A7046 |
Repl water chamber, pap dev |
484 |
453 |
$5K |
| K0003 |
Lightweight wheelchair |
92 |
92 |
$894.65 |
| A7032 |
Replacement nasal cushion |
14 |
14 |
$450.49 |
| E0973 |
W/ch access det adj armrest |
123 |
115 |
$173.74 |
| E0971 |
Wheelchair anti-tipping devi |
121 |
109 |
$94.63 |
| E0978 |
W/c acc,saf belt pelv strap |
107 |
107 |
$56.81 |