| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
12,060 |
10,021 |
$614K |
| A7030 |
Cpap full face mask |
2,853 |
2,507 |
$244K |
| E0601 |
Cont airway pressure device |
4,333 |
3,929 |
$219K |
| A4604 |
Tubing with heating element |
4,283 |
3,762 |
$126K |
| T4527 |
Adult size pull-on lg |
1,492 |
1,320 |
$121K |
| A7031 |
Replacement facemask interfa |
3,103 |
2,722 |
$102K |
| A7034 |
Nasal application device |
1,812 |
1,608 |
$100K |
| E0470 |
Rad w/o backup non-inv intfc |
1,089 |
955 |
$96K |
| E0570 |
Nebulizer with compression |
8,074 |
7,128 |
$80K |
| E0431 |
Portable gaseous 02 |
6,606 |
5,461 |
$56K |
| T4535 |
Disposable liner/shield/pad |
1,031 |
924 |
$52K |
| A7035 |
Pos airway press headgear |
2,969 |
2,596 |
$52K |
| A4239 |
Non-adju cgm supply allow |
354 |
329 |
$51K |
| T4528 |
Adult size pull-on xl |
544 |
509 |
$50K |
| A7032 |
Replacement nasal cushion |
1,156 |
1,015 |
$39K |
| E0562 |
Humidifier heated used w pap |
265 |
255 |
$38K |
| A7038 |
Pos airway pressure filter |
7,105 |
6,228 |
$35K |
| K0001 |
Standard wheelchair |
2,328 |
1,800 |
$32K |
| T4541 |
Large disposable underpad |
1,497 |
1,333 |
$28K |
| A4927 |
Non-sterile gloves |
2,290 |
1,632 |
$26K |
| E1392 |
Portable oxygen concentrator |
2,168 |
1,743 |
$25K |
| E0260 |
Hosp bed semi-electr w/ matt |
930 |
707 |
$19K |
| A7033 |
Replacement nasal pillows |
618 |
542 |
$14K |
| A7046 |
Repl water chamber, pap dev |
1,658 |
1,438 |
$14K |
| A7005 |
Nondisposable nebulizer set |
636 |
579 |
$11K |
| A7039 |
Filter, non disposable w pap |
1,424 |
1,214 |
$9K |
| T4526 |
Adult size pull-on med |
105 |
93 |
$8K |
| E0143 |
Walker folding wheeled w/o s |
148 |
129 |
$6K |
| A7015 |
Aerosol mask used w nebulize |
967 |
854 |
$941.33 |
| A7003 |
Nebulizer administration set |
434 |
407 |
$876.25 |
| A4456 |
Adhesive remover, wipes |
81 |
80 |
$592.27 |
| K0195 |
Elevating whlchair leg rests |
42 |
37 |
$330.33 |
| A4520 |
Incontinence garment anytype |
268 |
177 |
$0.00 |