| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
5,749 |
5,593 |
$402K |
| E0601 |
Cont airway pressure device |
2,081 |
1,983 |
$144K |
| T4541 |
Large disposable underpad |
1,262 |
1,207 |
$81K |
| T4527 |
Adult size pull-on lg |
396 |
375 |
$55K |
| E0570 |
Nebulizer with compression |
2,482 |
2,385 |
$53K |
| T4535 |
Disposable liner/shield/pad |
986 |
950 |
$46K |
| E0431 |
Portable gaseous 02 |
3,298 |
3,174 |
$43K |
| K0001 |
Standard wheelchair |
1,089 |
1,061 |
$41K |
| A7030 |
Cpap full face mask |
431 |
420 |
$38K |
| T4528 |
Adult size pull-on xl |
213 |
209 |
$36K |
| E0260 |
Hosp bed semi-electr w/ matt |
1,284 |
1,261 |
$34K |
| E0562 |
Humidifier heated used w pap |
731 |
669 |
$33K |
| A7031 |
Replacement facemask interfa |
1,245 |
1,194 |
$28K |
| E0443 |
Portable 02 contents, gas |
812 |
784 |
$23K |
| A7035 |
Pos airway press headgear |
673 |
652 |
$12K |
| T4526 |
Adult size pull-on med |
53 |
51 |
$8K |
| A4604 |
Tubing with heating element |
290 |
278 |
$7K |
| A7038 |
Pos airway pressure filter |
1,669 |
1,608 |
$6K |
| E0143 |
Walker folding wheeled w/o s |
58 |
53 |
$4K |
| A7003 |
Nebulizer administration set |
1,355 |
1,246 |
$3K |
| B4152 |
Ef calorie dense>/=1.5kcal |
159 |
155 |
$3K |
| A4927 |
Non-sterile gloves |
160 |
148 |
$2K |
| K0006 |
Heavy duty wheelchair |
88 |
85 |
$2K |
| A7037 |
Pos airway pressure tubing |
66 |
64 |
$1K |
| A7046 |
Repl water chamber, pap dev |
36 |
36 |
$367.59 |
| A7013 |
Disposable compressor filter |
308 |
304 |
$214.86 |
| A7015 |
Aerosol mask used w nebulize |
210 |
195 |
$172.30 |
| E0156 |
Walker seat attachment |
14 |
14 |
$143.49 |
| B4035 |
Enteral feed supp pump per d |
138 |
138 |
$142.95 |
| E0181 |
Press pad alternating w/ pum |
12 |
12 |
$58.57 |
| B4087 |
Gastro/jejuno tube, std |
56 |
56 |
$0.00 |