| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
10,040 |
9,951 |
$710K |
| A4239 |
Non-adju cgm supply allow |
2,734 |
2,659 |
$476K |
| E0601 |
Cont airway pressure device |
7,390 |
7,342 |
$399K |
| K0553 |
Ther cgm supply allowance |
1,278 |
1,255 |
$199K |
| E0570 |
Nebulizer with compression |
4,935 |
4,863 |
$144K |
| E0470 |
Rad w/o backup non-inv intfc |
1,156 |
1,130 |
$133K |
| A7030 |
Cpap full face mask |
2,100 |
2,044 |
$124K |
| E0431 |
Portable gaseous 02 |
8,102 |
8,026 |
$116K |
| E0562 |
Humidifier heated used w pap |
6,811 |
6,762 |
$89K |
| A7034 |
Nasal application device |
2,015 |
1,985 |
$87K |
| A7038 |
Pos airway pressure filter |
4,080 |
4,004 |
$64K |
| A7035 |
Pos airway press headgear |
3,273 |
3,206 |
$61K |
| E0143 |
Walker folding wheeled w/o s |
1,130 |
1,095 |
$55K |
| A7037 |
Pos airway pressure tubing |
2,332 |
2,302 |
$53K |
| K0001 |
Standard wheelchair |
2,009 |
1,977 |
$40K |
| E0260 |
Hosp bed semi-electr w/ matt |
943 |
931 |
$36K |
| A7031 |
Replacement facemask interfa |
1,148 |
1,128 |
$30K |
| E0603 |
Electric breast pump |
195 |
193 |
$25K |
| A4253 |
Blood glucose/reagent strips |
1,172 |
1,146 |
$21K |
| E2103 |
Non-adju cgm receiver/mon |
101 |
96 |
$14K |
| B4152 |
Ef calorie dense>/=1.5kcal |
129 |
119 |
$14K |
| A6530 |
Compression stocking bk18-30 |
229 |
183 |
$14K |
| B4150 |
Ef complet w/intact nutrient |
141 |
120 |
$11K |
| A7005 |
Nondisposable nebulizer set |
652 |
645 |
$10K |
| A7032 |
Replacement nasal cushion |
363 |
358 |
$10K |
| A7046 |
Repl water chamber, pap dev |
1,503 |
1,479 |
$10K |
| A4604 |
Tubing with heating element |
829 |
819 |
$9K |
| B4034 |
Enter feed supkit syr by day |
235 |
215 |
$7K |
| E0149 |
Heavy duty wheeled walker |
367 |
360 |
$7K |
| L3908 |
Who cock-up nonmolde pre ots |
101 |
93 |
$6K |
| E0250 |
Hosp bed fixed ht w/ mattres |
197 |
195 |
$6K |
| A4230 |
Infus insulin pump non needl |
38 |
38 |
$5K |
| A7033 |
Replacement nasal pillows |
156 |
155 |
$5K |
| E0156 |
Walker seat attachment |
697 |
674 |
$3K |
| A4232 |
Syringe w/needle insulin 3cc |
49 |
49 |
$3K |
| E0114 |
Crutch underarm pair no wood |
85 |
85 |
$2K |
| K0554 |
Ther cgm receiver/monitor |
12 |
12 |
$2K |
| B4035 |
Enteral feed supp pump per d |
12 |
12 |
$1K |
| A4259 |
Lancets per box |
730 |
721 |
$1K |
| A4670 |
Automatic bp monitor, dial |
15 |
15 |
$872.20 |
| A4385 |
Ost skn barrier sld ext wear |
13 |
13 |
$745.97 |
| A4362 |
Solid skin barrier |
14 |
14 |
$639.10 |
| L4350 |
Ankle control ortho pre ots |
12 |
12 |
$595.60 |
| A5120 |
Skin barrier, wipe or swab |
120 |
116 |
$545.03 |
| A4456 |
Adhesive remover, wipes |
165 |
162 |
$524.19 |
| A7003 |
Nebulizer administration set |
354 |
346 |
$454.37 |
| A7036 |
Pos airway press chinstrap |
40 |
40 |
$350.94 |
| A5063 |
Drain ostomy pouch w/flange |
12 |
12 |
$195.41 |
| E0181 |
Press pad alternating w/ pum |
12 |
12 |
$41.18 |
| A7013 |
Disposable compressor filter |
60 |
59 |
$0.33 |