| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
7,540 |
7,163 |
$219K |
| T4541 |
Large disposable underpad |
1,177 |
1,118 |
$67K |
| A7030 |
Cpap full face mask |
1,598 |
1,506 |
$63K |
| K0738 |
Portable gas oxygen system |
3,293 |
3,179 |
$59K |
| A7031 |
Replacement facemask interfa |
1,846 |
1,739 |
$33K |
| T4535 |
Disposable liner/shield/pad |
584 |
569 |
$32K |
| E0601 |
Cont airway pressure device |
911 |
832 |
$25K |
| T4527 |
Adult size pull-on lg |
200 |
185 |
$25K |
| E0431 |
Portable gaseous 02 |
2,737 |
2,594 |
$19K |
| E0260 |
Hosp bed semi-electr w/ matt |
2,191 |
2,029 |
$16K |
| E0570 |
Nebulizer with compression |
2,268 |
2,132 |
$15K |
| A7038 |
Pos airway pressure filter |
3,457 |
3,261 |
$10K |
| A4604 |
Tubing with heating element |
505 |
474 |
$9K |
| A7035 |
Pos airway press headgear |
888 |
832 |
$8K |
| K0004 |
High strength ltwt whlchr |
2,021 |
1,905 |
$6K |
| A4927 |
Non-sterile gloves |
575 |
488 |
$6K |
| A7037 |
Pos airway pressure tubing |
955 |
884 |
$6K |
| T4526 |
Adult size pull-on med |
44 |
43 |
$5K |
| K0739 |
Repair/svc dme non-oxygen eq |
267 |
217 |
$4K |
| E0562 |
Humidifier heated used w pap |
156 |
123 |
$2K |
| E0971 |
Wheelchair anti-tipping devi |
3,437 |
1,725 |
$2K |
| T4528 |
Adult size pull-on xl |
12 |
12 |
$2K |
| A7034 |
Nasal application device |
43 |
39 |
$1K |
| E0143 |
Walker folding wheeled w/o s |
58 |
55 |
$781.19 |
| E0951 |
Loop heel |
2,538 |
1,285 |
$752.30 |
| K0195 |
Elevating whlchair leg rests |
109 |
108 |
$211.84 |
| E0630 |
Patient lift hydraulic |
13 |
12 |
$128.59 |