| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E0601 |
Cont airway pressure device |
13,702 |
11,783 |
$959K |
| E0470 |
Rad w/o backup non-inv intfc |
3,812 |
3,202 |
$578K |
| E0570 |
Nebulizer with compression |
13,226 |
12,358 |
$534K |
| A7031 |
Replacement facemask interfa |
10,626 |
9,643 |
$401K |
| T4534 |
Youth size pull-on |
2,723 |
2,243 |
$373K |
| A7030 |
Cpap full face mask |
3,940 |
3,658 |
$350K |
| E1390 |
Oxygen concentrator |
5,386 |
4,792 |
$302K |
| E0562 |
Humidifier heated used w pap |
15,169 |
14,014 |
$264K |
| A7037 |
Pos airway pressure tubing |
8,069 |
7,559 |
$172K |
| E0260 |
Hosp bed semi-electr w/ matt |
3,074 |
2,831 |
$127K |
| A7032 |
Replacement nasal cushion |
2,762 |
2,529 |
$124K |
| A7038 |
Pos airway pressure filter |
17,979 |
16,579 |
$118K |
| A7034 |
Nasal application device |
1,991 |
1,846 |
$118K |
| E0143 |
Walker folding wheeled w/o s |
2,823 |
2,642 |
$117K |
| A7035 |
Pos airway press headgear |
5,724 |
5,215 |
$110K |
| K0001 |
Standard wheelchair |
7,068 |
6,422 |
$107K |
| A7033 |
Replacement nasal pillows |
2,236 |
2,131 |
$84K |
| T4530 |
Ped size brief/diaper lg |
362 |
305 |
$33K |
| E0630 |
Patient lift hydraulic |
892 |
842 |
$27K |
| A7046 |
Repl water chamber, pap dev |
3,312 |
2,952 |
$26K |
| K0195 |
Elevating whlchair leg rests |
2,396 |
2,152 |
$24K |
| E0431 |
Portable gaseous 02 |
4,228 |
3,777 |
$18K |
| E0600 |
Suction pump portab hom modl |
906 |
808 |
$16K |
| E0163 |
Commode chair with fixed arm |
471 |
449 |
$10K |
| A5500 |
Diab shoe for density insert |
329 |
216 |
$10K |
| K0003 |
Lightweight wheelchair |
353 |
327 |
$9K |
| T4526 |
Adult size pull-on med |
73 |
64 |
$9K |
| K0007 |
Extra heavy duty wheelchair |
208 |
193 |
$8K |
| E0156 |
Walker seat attachment |
1,335 |
1,266 |
$7K |
| A7039 |
Filter, non disposable w pap |
1,187 |
1,073 |
$6K |
| E0443 |
Portable 02 contents, gas |
466 |
369 |
$6K |
| A4414 |
Ost sknbar w/o conv<=4 sq in |
79 |
76 |
$5K |
| A5063 |
Drain ostomy pouch w/flange |
156 |
154 |
$4K |
| A5512 |
Multi den insert direct form |
327 |
216 |
$4K |
| A7036 |
Pos airway press chinstrap |
412 |
388 |
$4K |
| E0971 |
Wheelchair anti-tipping devi |
1,365 |
663 |
$3K |
| E2201 |
Man w/ch acc seat w>=20"<24" |
221 |
201 |
$3K |
| K0006 |
Heavy duty wheelchair |
72 |
68 |
$2K |
| A4629 |
Tracheostomy care kit |
26 |
12 |
$1K |
| L8000 |
Mastectomy bra |
61 |
38 |
$950.14 |
| E0149 |
Heavy duty wheeled walker |
224 |
214 |
$634.53 |
| E2601 |
Gen w/c cushion wdth < 22 in |
13 |
13 |
$427.08 |
| L3908 |
Who cock-up nonmolde pre ots |
22 |
13 |
$402.27 |
| A4406 |
Pectin based ostomy paste |
51 |
50 |
$382.92 |