| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
15,594 |
15,499 |
$1.12M |
| E0603 |
Electric breast pump |
4,062 |
4,060 |
$741K |
| E1399 |
Durable medical equipment mi |
7,892 |
6,010 |
$296K |
| E0570 |
Nebulizer with compression |
4,073 |
4,061 |
$191K |
| E0431 |
Portable gaseous 02 |
8,540 |
8,513 |
$131K |
| K0001 |
Standard wheelchair |
3,719 |
3,664 |
$81K |
| E0261 |
Hosp bed semi-electr w/o mat |
1,307 |
1,301 |
$78K |
| E0265 |
Hosp bed total electr w/ mat |
963 |
959 |
$75K |
| E0143 |
Walker folding wheeled w/o s |
1,267 |
1,264 |
$73K |
| E1392 |
Portable oxygen concentrator |
3,734 |
3,709 |
$69K |
| E0260 |
Hosp bed semi-electr w/ matt |
1,944 |
1,929 |
$64K |
| E0601 |
Cont airway pressure device |
807 |
797 |
$46K |
| E0630 |
Patient lift hydraulic |
394 |
389 |
$21K |
| E0562 |
Humidifier heated used w pap |
813 |
796 |
$14K |
| E1038 |
Transport chair pt wt<=300lb |
1,199 |
1,186 |
$8K |
| B4152 |
Ef calorie dense>/=1.5kcal |
171 |
171 |
$8K |
| K0003 |
Lightweight wheelchair |
230 |
230 |
$7K |
| K0195 |
Elevating whlchair leg rests |
1,094 |
1,071 |
$6K |
| E0990 |
Wheelchair elevating leg res |
289 |
282 |
$4K |
| E0271 |
Mattress innerspring |
207 |
207 |
$4K |
| B4154 |
Ef spec metabolic noninherit |
98 |
98 |
$3K |
| E0163 |
Commode chair with fixed arm |
66 |
66 |
$3K |
| E0277 |
Powered pres-redu air mattrs |
13 |
13 |
$3K |
| E0181 |
Press pad alternating w/ pum |
291 |
291 |
$3K |
| E0978 |
W/c acc,saf belt pelv strap |
972 |
923 |
$3K |
| T4535 |
Disposable liner/shield/pad |
166 |
166 |
$2K |
| A4253 |
Blood glucose/reagent strips |
153 |
153 |
$2K |
| B4150 |
Ef complet w/intact nutrient |
61 |
61 |
$2K |
| K0002 |
Stnd hemi (low seat) whlchr |
69 |
68 |
$2K |
| E0971 |
Wheelchair anti-tipping devi |
480 |
379 |
$2K |
| A4520 |
Incontinence garment anytype |
68 |
68 |
$2K |
| T4541 |
Large disposable underpad |
63 |
63 |
$1K |
| E0470 |
Rad w/o backup non-inv intfc |
13 |
13 |
$1K |
| A4258 |
Lancet device each |
144 |
144 |
$777.50 |
| A7030 |
Cpap full face mask |
12 |
12 |
$774.46 |
| T4526 |
Adult size pull-on med |
50 |
50 |
$748.76 |
| A7035 |
Pos airway press headgear |
42 |
42 |
$662.00 |
| T4528 |
Adult size pull-on xl |
25 |
25 |
$613.84 |
| T4527 |
Adult size pull-on lg |
29 |
29 |
$432.13 |
| A4245 |
Alcohol wipes per box |
151 |
151 |
$185.03 |
| A7037 |
Pos airway pressure tubing |
13 |
13 |
$157.97 |
| A7038 |
Pos airway pressure filter |
25 |
25 |
$115.81 |