| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
3,275 |
3,133 |
$296K |
| E0601 |
Cont airway pressure device |
3,198 |
2,934 |
$126K |
| A7030 |
Cpap full face mask |
865 |
851 |
$86K |
| A7031 |
Replacement facemask interfa |
1,510 |
1,438 |
$77K |
| A4604 |
Tubing with heating element |
2,001 |
1,878 |
$74K |
| T4527 |
Adult size pull-on lg |
503 |
492 |
$53K |
| E0562 |
Humidifier heated used w pap |
3,114 |
2,907 |
$44K |
| E1392 |
Portable oxygen concentrator |
1,258 |
1,204 |
$42K |
| T4528 |
Adult size pull-on xl |
292 |
284 |
$39K |
| A7032 |
Replacement nasal cushion |
727 |
694 |
$27K |
| A7035 |
Pos airway press headgear |
1,169 |
1,112 |
$25K |
| A7038 |
Pos airway pressure filter |
4,220 |
3,979 |
$25K |
| E0570 |
Nebulizer with compression |
768 |
749 |
$23K |
| E0260 |
Hosp bed semi-electr w/ matt |
325 |
315 |
$22K |
| A7034 |
Nasal application device |
336 |
320 |
$21K |
| T4535 |
Disposable liner/shield/pad |
283 |
276 |
$19K |
| T4526 |
Adult size pull-on med |
173 |
171 |
$16K |
| A7046 |
Repl water chamber, pap dev |
589 |
580 |
$8K |
| K0001 |
Standard wheelchair |
223 |
216 |
$6K |
| B4035 |
Enteral feed supp pump per d |
16 |
12 |
$3K |
| L4361 |
Pneuma/vac walk boot pre ots |
13 |
13 |
$3K |
| A7005 |
Nondisposable nebulizer set |
87 |
83 |
$2K |
| A6530 |
Compression stocking bk18-30 |
13 |
13 |
$815.63 |
| A7037 |
Pos airway pressure tubing |
38 |
38 |
$725.94 |
| A7033 |
Replacement nasal pillows |
26 |
24 |
$560.26 |
| E0118 |
Crutch substitute |
12 |
12 |
$323.90 |
| A4927 |
Non-sterile gloves |
15 |
12 |
$300.77 |
| A4335 |
Incontinence supply |
12 |
12 |
$40.80 |