| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T2029 |
Special med equip, noswaiver |
2,159 |
1,606 |
$1.39M |
| E1390 |
Oxygen concentrator |
2,355 |
2,096 |
$137K |
| E0601 |
Cont airway pressure device |
2,135 |
1,995 |
$85K |
| B4150 |
Ef complet w/intact nutrient |
739 |
678 |
$76K |
| T4541 |
Large disposable underpad |
1,929 |
1,816 |
$74K |
| T4528 |
Adult size pull-on xl |
290 |
278 |
$42K |
| T4527 |
Adult size pull-on lg |
331 |
294 |
$39K |
| K0001 |
Standard wheelchair |
1,439 |
1,311 |
$32K |
| E0260 |
Hosp bed semi-electr w/ matt |
902 |
815 |
$26K |
| E0470 |
Rad w/o backup non-inv intfc |
253 |
213 |
$25K |
| T4535 |
Disposable liner/shield/pad |
384 |
353 |
$22K |
| T4526 |
Adult size pull-on med |
211 |
176 |
$21K |
| E0431 |
Portable gaseous 02 |
702 |
584 |
$15K |
| E0562 |
Humidifier heated used w pap |
271 |
256 |
$14K |
| T4543 |
Adult disp brief/diap abv xl |
44 |
38 |
$11K |
| A4927 |
Non-sterile gloves |
542 |
506 |
$9K |
| A7038 |
Pos airway pressure filter |
3,142 |
2,987 |
$7K |
| A7035 |
Pos airway press headgear |
198 |
189 |
$4K |
| A7030 |
Cpap full face mask |
25 |
25 |
$2K |
| E0143 |
Walker folding wheeled w/o s |
31 |
27 |
$1K |
| E0570 |
Nebulizer with compression |
25 |
25 |
$997.42 |
| A7039 |
Filter, non disposable w pap |
105 |
101 |
$782.85 |
| A7031 |
Replacement facemask interfa |
26 |
26 |
$735.38 |
| A7003 |
Nebulizer administration set |
151 |
138 |
$417.40 |
| E0245 |
Tub stool or bench |
14 |
14 |
$369.00 |
| A7037 |
Pos airway pressure tubing |
12 |
12 |
$216.09 |
| E0156 |
Walker seat attachment |
13 |
12 |
$123.00 |
| E0159 |
Brake for wheeled walker |
15 |
13 |
$0.00 |