| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A7030 |
Cpap full face mask |
6,612 |
5,646 |
$543K |
| E0601 |
Cont airway pressure device |
8,770 |
7,156 |
$422K |
| A7031 |
Replacement facemask interfa |
6,740 |
5,693 |
$373K |
| A4604 |
Tubing with heating element |
8,575 |
7,349 |
$269K |
| E1390 |
Oxygen concentrator |
2,658 |
2,306 |
$169K |
| A7034 |
Nasal application device |
3,112 |
2,598 |
$157K |
| E0562 |
Humidifier heated used w pap |
6,125 |
4,485 |
$129K |
| A7038 |
Pos airway pressure filter |
11,038 |
9,317 |
$127K |
| A7035 |
Pos airway press headgear |
5,920 |
5,031 |
$116K |
| A7032 |
Replacement nasal cushion |
1,710 |
1,477 |
$115K |
| E0470 |
Rad w/o backup non-inv intfc |
869 |
776 |
$96K |
| A7046 |
Repl water chamber, pap dev |
4,088 |
3,448 |
$48K |
| A4351 |
Straight tip urine catheter |
286 |
236 |
$37K |
| A6530 |
Compression stocking bk18-30 |
1,027 |
414 |
$35K |
| E1392 |
Portable oxygen concentrator |
1,309 |
1,173 |
$30K |
| E0570 |
Nebulizer with compression |
3,954 |
3,184 |
$30K |
| A7033 |
Replacement nasal pillows |
1,091 |
890 |
$29K |
| T4522 |
Adult size brief/diaper med |
193 |
164 |
$26K |
| T4523 |
Adult size brief/diaper lg |
217 |
177 |
$26K |
| A4554 |
Disposable underpads |
633 |
512 |
$24K |
| E0260 |
Hosp bed semi-electr w/ matt |
734 |
667 |
$19K |
| K0738 |
Portable gas oxygen system |
825 |
718 |
$19K |
| A7037 |
Pos airway pressure tubing |
1,230 |
954 |
$18K |
| T4535 |
Disposable liner/shield/pad |
331 |
247 |
$17K |
| K0108 |
W/c component-accessory nos |
232 |
113 |
$16K |
| A4927 |
Non-sterile gloves |
1,601 |
1,272 |
$13K |
| K0739 |
Repair/svc dme non-oxygen eq |
237 |
184 |
$7K |
| E1028 |
W/c manual swingaway |
237 |
137 |
$5K |
| T4526 |
Adult size pull-on med |
34 |
29 |
$4K |
| E0955 |
Cushioned headrest |
91 |
74 |
$3K |
| K0001 |
Standard wheelchair |
365 |
348 |
$3K |
| E0143 |
Walker folding wheeled w/o s |
45 |
40 |
$2K |
| E0431 |
Portable gaseous 02 |
68 |
65 |
$1K |
| A4670 |
Automatic bp monitor, dial |
14 |
13 |
$727.68 |
| A7039 |
Filter, non disposable w pap |
54 |
52 |
$512.98 |
| A7003 |
Nebulizer administration set |
156 |
124 |
$414.38 |
| E0271 |
Mattress innerspring |
12 |
12 |
$214.15 |
| E0156 |
Walker seat attachment |
14 |
13 |
$135.06 |
| E0305 |
Rails bed side half length |
36 |
35 |
$107.66 |
| A7000 |
Disposable canister for pump |
17 |
13 |
$64.61 |