| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E0601 |
Cont airway pressure device |
12,232 |
11,630 |
$602K |
| A7030 |
Cpap full face mask |
4,817 |
4,483 |
$450K |
| E1390 |
Oxygen concentrator |
9,459 |
8,815 |
$437K |
| E0562 |
Humidifier heated used w pap |
2,630 |
2,511 |
$399K |
| A7034 |
Nasal application device |
5,146 |
4,892 |
$342K |
| A4604 |
Tubing with heating element |
8,901 |
8,390 |
$329K |
| A7035 |
Pos airway press headgear |
8,215 |
7,800 |
$193K |
| A7031 |
Replacement facemask interfa |
3,415 |
3,114 |
$117K |
| E0294 |
Hosp bed semi-elect w/ mattr |
3,778 |
3,711 |
$98K |
| A7038 |
Pos airway pressure filter |
12,571 |
11,888 |
$89K |
| K0001 |
Standard wheelchair |
7,864 |
7,147 |
$89K |
| E0470 |
Rad w/o backup non-inv intfc |
953 |
882 |
$81K |
| T4527 |
Adult size pull-on lg |
871 |
833 |
$81K |
| K0738 |
Portable gas oxygen system |
4,322 |
4,002 |
$81K |
| E0570 |
Nebulizer with compression |
3,606 |
3,212 |
$74K |
| A7032 |
Replacement nasal cushion |
2,462 |
2,280 |
$73K |
| T4528 |
Adult size pull-on xl |
820 |
780 |
$73K |
| T4541 |
Large disposable underpad |
2,117 |
2,008 |
$72K |
| E0630 |
Patient lift hydraulic |
2,688 |
2,351 |
$56K |
| T4526 |
Adult size pull-on med |
758 |
710 |
$54K |
| A7046 |
Repl water chamber, pap dev |
4,529 |
4,294 |
$53K |
| T4535 |
Disposable liner/shield/pad |
1,256 |
1,148 |
$45K |
| A7039 |
Filter, non disposable w pap |
4,445 |
4,241 |
$40K |
| A4927 |
Non-sterile gloves |
3,316 |
2,819 |
$33K |
| E0471 |
Rad w/backup non inv intrfc |
213 |
195 |
$30K |
| E1161 |
Manual adult wc w tiltinspac |
307 |
285 |
$28K |
| E0431 |
Portable gaseous 02 |
2,380 |
2,244 |
$27K |
| E0143 |
Walker folding wheeled w/o s |
954 |
877 |
$26K |
| E1392 |
Portable oxygen concentrator |
1,593 |
1,478 |
$25K |
| A7005 |
Nondisposable nebulizer set |
982 |
955 |
$21K |
| A7033 |
Replacement nasal pillows |
955 |
893 |
$21K |
| E0600 |
Suction pump portab hom modl |
626 |
563 |
$20K |
| E0465 |
Home vent invasive interface |
58 |
38 |
$17K |
| E0260 |
Hosp bed semi-electr w/ matt |
1,644 |
1,622 |
$16K |
| E1028 |
W/c manual swingaway |
867 |
604 |
$16K |
| E2201 |
Man w/ch acc seat w>=20"<24" |
971 |
792 |
$14K |
| A7000 |
Disposable canister for pump |
742 |
693 |
$11K |
| T4537 |
Reusable underpad bed size |
237 |
231 |
$8K |
| A7002 |
Tubing used w suction pump |
920 |
704 |
$7K |
| K0195 |
Elevating whlchair leg rests |
882 |
788 |
$7K |
| E0181 |
Press pad alternating w/ pum |
1,234 |
1,065 |
$7K |
| T4523 |
Adult size brief/diaper lg |
86 |
81 |
$6K |
| E0156 |
Walker seat attachment |
514 |
473 |
$5K |
| E0973 |
W/ch access det adj armrest |
168 |
120 |
$4K |
| E0955 |
Cushioned headrest |
372 |
352 |
$4K |
| K0007 |
Extra heavy duty wheelchair |
43 |
38 |
$4K |
| A7036 |
Pos airway press chinstrap |
349 |
329 |
$4K |
| E0971 |
Wheelchair anti-tipping devi |
514 |
274 |
$3K |
| A7037 |
Pos airway pressure tubing |
69 |
67 |
$2K |
| A4217 |
Sterile water/saline, 500 ml |
32 |
24 |
$1K |
| K0006 |
Heavy duty wheelchair |
24 |
24 |
$1K |
| A4628 |
Oropharyngeal suction cath |
75 |
63 |
$342.13 |
| A7003 |
Nebulizer administration set |
351 |
331 |
$200.03 |
| E0961 |
Wheelchair brake extension |
22 |
12 |
$30.38 |