| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
8,043 |
5,439 |
$200K |
| E0570 |
Nebulizer with compression |
3,461 |
2,663 |
$189K |
| T4527 |
Adult size pull-on lg |
2,365 |
2,339 |
$178K |
| A7030 |
Cpap full face mask |
2,976 |
2,426 |
$173K |
| T4526 |
Adult size pull-on med |
2,214 |
2,192 |
$156K |
| T4528 |
Adult size pull-on xl |
1,751 |
1,744 |
$149K |
| A7031 |
Replacement facemask interfa |
4,960 |
4,162 |
$138K |
| T4535 |
Disposable liner/shield/pad |
4,539 |
4,501 |
$125K |
| T4541 |
Large disposable underpad |
5,223 |
5,116 |
$124K |
| T4534 |
Youth size pull-on |
1,018 |
983 |
$64K |
| E0601 |
Cont airway pressure device |
1,888 |
1,418 |
$58K |
| T4525 |
Adult size pull-on sm |
742 |
739 |
$54K |
| A7034 |
Nasal application device |
1,549 |
1,228 |
$53K |
| A4604 |
Tubing with heating element |
1,872 |
1,598 |
$51K |
| T4523 |
Adult size brief/diaper lg |
345 |
341 |
$40K |
| A7032 |
Replacement nasal cushion |
1,348 |
1,108 |
$38K |
| T4522 |
Adult size brief/diaper med |
387 |
385 |
$34K |
| A7035 |
Pos airway press headgear |
2,625 |
2,075 |
$29K |
| E0431 |
Portable gaseous 02 |
5,459 |
3,505 |
$26K |
| A7037 |
Pos airway pressure tubing |
2,532 |
1,988 |
$23K |
| A7038 |
Pos airway pressure filter |
6,540 |
5,425 |
$23K |
| E0562 |
Humidifier heated used w pap |
1,089 |
805 |
$21K |
| K0001 |
Standard wheelchair |
1,184 |
1,015 |
$18K |
| A7005 |
Nondisposable nebulizer set |
1,682 |
1,571 |
$14K |
| A7046 |
Repl water chamber, pap dev |
2,185 |
1,703 |
$14K |
| E0470 |
Rad w/o backup non-inv intfc |
202 |
166 |
$12K |
| A7033 |
Replacement nasal pillows |
379 |
329 |
$9K |
| A4409 |
Ost skn barr convex <=4 sq i |
77 |
62 |
$6K |
| L1830 |
Ko immob canvas long pre ots |
202 |
187 |
$5K |
| A7039 |
Filter, non disposable w pap |
1,304 |
964 |
$5K |
| T4530 |
Ped size brief/diaper lg |
88 |
86 |
$4K |
| E0443 |
Portable 02 contents, gas |
453 |
210 |
$4K |
| A4605 |
Trach suction cath close sys |
13 |
12 |
$3K |
| L3660 |
So 8 ab rstr can/web pre ots |
230 |
217 |
$2K |
| L3670 |
So acro/clav can web pre ots |
211 |
201 |
$2K |
| A4629 |
Tracheostomy care kit |
14 |
14 |
$2K |
| E0114 |
Crutch underarm pair no wood |
813 |
772 |
$2K |
| A7003 |
Nebulizer administration set |
1,228 |
1,192 |
$2K |
| A7526 |
Tracheostomy tube collar |
17 |
17 |
$2K |
| A4425 |
Ost pch drain for barrier fl |
28 |
24 |
$1K |
| E0143 |
Walker folding wheeled w/o s |
70 |
57 |
$1K |
| A7507 |
Integrated filter & holder |
19 |
17 |
$1K |
| L4350 |
Ankle control ortho pre ots |
74 |
70 |
$968.78 |
| L3908 |
Who cock-up nonmolde pre ots |
72 |
64 |
$634.60 |
| A7015 |
Aerosol mask used w nebulize |
629 |
592 |
$603.72 |
| A7000 |
Disposable canister for pump |
28 |
28 |
$317.59 |
| A7002 |
Tubing used w suction pump |
32 |
30 |
$245.80 |
| A4628 |
Oropharyngeal suction cath |
18 |
15 |
$205.53 |
| E0260 |
Hosp bed semi-electr w/ matt |
60 |
48 |
$92.90 |
| L3260 |
Ambulatory surgical boot eac |
28 |
27 |
$41.12 |
| A4615 |
Cannula nasal |
15 |
13 |
$1.92 |
| A7013 |
Disposable compressor filter |
16 |
12 |
$1.41 |