| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
16,698 |
14,490 |
$1.21M |
| E0601 |
Cont airway pressure device |
14,997 |
14,086 |
$898K |
| A7030 |
Cpap full face mask |
5,730 |
5,140 |
$516K |
| A4604 |
Tubing with heating element |
9,201 |
8,228 |
$299K |
| E0562 |
Humidifier heated used w pap |
9,878 |
9,476 |
$283K |
| A7034 |
Nasal application device |
4,341 |
3,891 |
$259K |
| E0471 |
Rad w/backup non inv intrfc |
986 |
893 |
$245K |
| E0603 |
Electric breast pump |
1,251 |
1,179 |
$220K |
| A7031 |
Replacement facemask interfa |
5,287 |
4,674 |
$172K |
| A7035 |
Pos airway press headgear |
6,374 |
5,729 |
$124K |
| A7032 |
Replacement nasal cushion |
3,269 |
2,923 |
$115K |
| E0470 |
Rad w/o backup non-inv intfc |
1,128 |
1,021 |
$115K |
| T4527 |
Adult size pull-on lg |
1,319 |
1,211 |
$114K |
| E0431 |
Portable gaseous 02 |
8,424 |
7,167 |
$103K |
| K0001 |
Standard wheelchair |
5,021 |
4,270 |
$83K |
| E1392 |
Portable oxygen concentrator |
4,211 |
3,650 |
$67K |
| A7038 |
Pos airway pressure filter |
12,416 |
11,176 |
$67K |
| E0570 |
Nebulizer with compression |
3,913 |
3,329 |
$66K |
| T4526 |
Adult size pull-on med |
852 |
746 |
$65K |
| E0260 |
Hosp bed semi-electr w/ matt |
2,381 |
2,006 |
$54K |
| T4528 |
Adult size pull-on xl |
662 |
575 |
$51K |
| A4927 |
Non-sterile gloves |
3,337 |
2,585 |
$40K |
| T4541 |
Large disposable underpad |
2,250 |
1,916 |
$39K |
| A7046 |
Repl water chamber, pap dev |
3,945 |
3,499 |
$35K |
| T4535 |
Disposable liner/shield/pad |
624 |
571 |
$32K |
| A7033 |
Replacement nasal pillows |
1,025 |
904 |
$24K |
| E1028 |
W/c manual swingaway |
829 |
517 |
$16K |
| K0195 |
Elevating whlchair leg rests |
1,431 |
1,291 |
$14K |
| A7005 |
Nondisposable nebulizer set |
514 |
463 |
$9K |
| E0443 |
Portable 02 contents, gas |
311 |
249 |
$6K |
| E0143 |
Walker folding wheeled w/o s |
124 |
105 |
$4K |
| E2201 |
Man w/ch acc seat w>=20"<24" |
214 |
167 |
$3K |
| K0004 |
High strength ltwt whlchr |
25 |
24 |
$2K |
| K0739 |
Repair/svc dme non-oxygen eq |
27 |
21 |
$1K |
| E0630 |
Patient lift hydraulic |
63 |
54 |
$1K |
| T4534 |
Youth size pull-on |
19 |
12 |
$843.36 |
| E0156 |
Walker seat attachment |
15 |
14 |
$85.42 |
| A7015 |
Aerosol mask used w nebulize |
66 |
61 |
$61.77 |
| A4357 |
Bedside drainage bag |
14 |
12 |
$49.68 |
| A9279 |
Monitoring feature/devicenoc |
65 |
64 |
$0.00 |
| A4520 |
Incontinence garment anytype |
183 |
118 |
$0.00 |