| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
7,374 |
7,269 |
$741K |
| E0570 |
Nebulizer with compression |
8,063 |
8,023 |
$130K |
| E0431 |
Portable gaseous 02 |
6,474 |
6,171 |
$123K |
| E0601 |
Cont airway pressure device |
1,414 |
1,414 |
$91K |
| A7030 |
Cpap full face mask |
707 |
704 |
$86K |
| T4541 |
Large disposable underpad |
469 |
457 |
$65K |
| A7031 |
Replacement facemask interfa |
854 |
847 |
$54K |
| B4035 |
Enteral feed supp pump per d |
224 |
172 |
$50K |
| K0001 |
Standard wheelchair |
1,120 |
1,113 |
$32K |
| A4604 |
Tubing with heating element |
600 |
600 |
$30K |
| T4527 |
Adult size pull-on lg |
181 |
179 |
$25K |
| T4526 |
Adult size pull-on med |
147 |
146 |
$21K |
| E1392 |
Portable oxygen concentrator |
450 |
450 |
$20K |
| A7038 |
Pos airway pressure filter |
2,064 |
2,047 |
$17K |
| E0562 |
Humidifier heated used w pap |
638 |
638 |
$17K |
| A7035 |
Pos airway press headgear |
458 |
456 |
$11K |
| E0603 |
Electric breast pump |
72 |
72 |
$9K |
| E0470 |
Rad w/o backup non-inv intfc |
53 |
53 |
$7K |
| A4927 |
Non-sterile gloves |
425 |
417 |
$7K |
| A9901 |
Delivery/set up/dispensing |
1,025 |
912 |
$5K |
| B9998 |
Enteral supp not otherwise c |
42 |
38 |
$5K |
| T4534 |
Youth size pull-on |
25 |
25 |
$3K |
| A7046 |
Repl water chamber, pap dev |
214 |
213 |
$3K |
| T4528 |
Adult size pull-on xl |
12 |
12 |
$2K |
| E0143 |
Walker folding wheeled w/o s |
25 |
25 |
$2K |
| A7004 |
Disposable nebulizer sml vol |
893 |
887 |
$1K |
| A7032 |
Replacement nasal cushion |
12 |
12 |
$1K |
| A7015 |
Aerosol mask used w nebulize |
442 |
441 |
$704.64 |
| A7037 |
Pos airway pressure tubing |
24 |
24 |
$551.76 |
| A7003 |
Nebulizer administration set |
64 |
63 |
$177.54 |
| A6402 |
Sterile gauze <= 16 sq in |
14 |
12 |
$105.30 |