| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
9,828 |
9,343 |
$880K |
| E0601 |
Cont airway pressure device |
7,825 |
6,937 |
$337K |
| E0570 |
Nebulizer with compression |
2,452 |
2,342 |
$202K |
| A7030 |
Cpap full face mask |
2,332 |
2,245 |
$188K |
| E0431 |
Portable gaseous 02 |
10,303 |
9,814 |
$170K |
| A7034 |
Nasal application device |
1,985 |
1,875 |
$98K |
| A7031 |
Replacement facemask interfa |
2,832 |
2,655 |
$91K |
| E0562 |
Humidifier heated used w pap |
792 |
753 |
$76K |
| K0001 |
Standard wheelchair |
2,784 |
2,588 |
$52K |
| A7037 |
Pos airway pressure tubing |
4,326 |
4,053 |
$52K |
| A7032 |
Replacement nasal cushion |
1,905 |
1,613 |
$49K |
| A7035 |
Pos airway press headgear |
2,880 |
2,703 |
$47K |
| A7033 |
Replacement nasal pillows |
1,909 |
1,596 |
$42K |
| E0143 |
Walker folding wheeled w/o s |
964 |
917 |
$36K |
| A7038 |
Pos airway pressure filter |
9,227 |
8,327 |
$36K |
| T4534 |
Youth size pull-on |
309 |
294 |
$33K |
| B4160 |
Ef ped caloric dense>/=0.7kc |
768 |
593 |
$28K |
| T4530 |
Ped size brief/diaper lg |
617 |
576 |
$23K |
| E0470 |
Rad w/o backup non-inv intfc |
259 |
250 |
$22K |
| A7005 |
Nondisposable nebulizer set |
1,901 |
1,822 |
$21K |
| A4670 |
Automatic bp monitor, dial |
688 |
674 |
$20K |
| T4526 |
Adult size pull-on med |
467 |
445 |
$14K |
| E0260 |
Hosp bed semi-electr w/ matt |
455 |
426 |
$13K |
| T4533 |
Youth size brief/diaper |
429 |
395 |
$11K |
| T4523 |
Adult size brief/diaper lg |
577 |
569 |
$8K |
| K0195 |
Elevating whlchair leg rests |
736 |
662 |
$7K |
| A7039 |
Filter, non disposable w pap |
1,497 |
1,396 |
$7K |
| A7046 |
Repl water chamber, pap dev |
652 |
623 |
$7K |
| T4522 |
Adult size brief/diaper med |
680 |
652 |
$5K |
| T4524 |
Adult size brief/diaper xl |
140 |
137 |
$5K |
| A4604 |
Tubing with heating element |
73 |
73 |
$3K |
| E0990 |
Wheelchair elevating leg res |
163 |
163 |
$3K |
| B4035 |
Enteral feed supp pump per d |
660 |
642 |
$1K |
| A7015 |
Aerosol mask used w nebulize |
1,007 |
968 |
$1K |
| E0240 |
Bath/shower chair |
31 |
31 |
$973.33 |
| E0156 |
Walker seat attachment |
64 |
55 |
$864.32 |
| B4155 |
Ef incomplete/modular |
14 |
12 |
$346.89 |
| A4216 |
Sterile water/saline, 10 ml |
13 |
12 |
$292.31 |
| A5120 |
Skin barrier, wipe or swab |
13 |
13 |
$144.66 |
| E0600 |
Suction pump portab hom modl |
12 |
12 |
$138.89 |
| A4649 |
Surgical supplies |
17 |
12 |
$79.14 |
| K0003 |
Lightweight wheelchair |
12 |
12 |
$71.10 |
| A7002 |
Tubing used w suction pump |
33 |
24 |
$60.65 |
| A7000 |
Disposable canister for pump |
12 |
12 |
$28.91 |
| B9002 |
Enter nutr inf pump any type |
19 |
19 |
$0.00 |