| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E0601 |
Cont airway pressure device |
3,563 |
3,436 |
$231K |
| A7030 |
Cpap full face mask |
2,401 |
2,308 |
$218K |
| E1390 |
Oxygen concentrator |
2,681 |
2,406 |
$163K |
| E0570 |
Nebulizer with compression |
4,053 |
3,792 |
$100K |
| T4534 |
Youth size pull-on |
618 |
577 |
$95K |
| A7037 |
Pos airway pressure tubing |
3,210 |
3,096 |
$71K |
| A7031 |
Replacement facemask interfa |
1,771 |
1,700 |
$61K |
| E0260 |
Hosp bed semi-electr w/ matt |
1,600 |
1,447 |
$50K |
| E0562 |
Humidifier heated used w pap |
1,576 |
1,499 |
$45K |
| A7035 |
Pos airway press headgear |
1,927 |
1,844 |
$39K |
| K0001 |
Standard wheelchair |
2,034 |
1,874 |
$30K |
| A7005 |
Nondisposable nebulizer set |
1,838 |
1,770 |
$26K |
| A7034 |
Nasal application device |
412 |
393 |
$24K |
| A7038 |
Pos airway pressure filter |
3,138 |
3,002 |
$20K |
| E0143 |
Walker folding wheeled w/o s |
310 |
284 |
$14K |
| A7039 |
Filter, non disposable w pap |
1,516 |
1,456 |
$10K |
| E2201 |
Man w/ch acc seat w>=20"<24" |
688 |
631 |
$10K |
| A7046 |
Repl water chamber, pap dev |
849 |
811 |
$7K |
| E0431 |
Portable gaseous 02 |
586 |
534 |
$6K |
| E0443 |
Portable 02 contents, gas |
511 |
345 |
$5K |
| A9276 |
Disposable sensor, cgm sys |
12 |
12 |
$5K |
| K0195 |
Elevating whlchair leg rests |
255 |
208 |
$4K |
| E1392 |
Portable oxygen concentrator |
785 |
719 |
$4K |
| A4253 |
Blood glucose/reagent strips |
433 |
407 |
$3K |
| A7015 |
Aerosol mask used w nebulize |
1,792 |
1,728 |
$2K |
| K0003 |
Lightweight wheelchair |
115 |
104 |
$1K |
| A5500 |
Diab shoe for density insert |
38 |
25 |
$782.26 |
| A7032 |
Replacement nasal cushion |
14 |
14 |
$556.85 |
| A5512 |
Multi den insert direct form |
38 |
25 |
$438.10 |
| A4259 |
Lancets per box |
390 |
368 |
$200.38 |
| A7003 |
Nebulizer administration set |
44 |
41 |
$62.63 |
| A4258 |
Lancet device each |
14 |
12 |
$7.60 |