| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
10,742 |
7,989 |
$515K |
| B4035 |
Enteral feed supp pump per d |
1,559 |
1,029 |
$276K |
| E0601 |
Cont airway pressure device |
5,731 |
4,382 |
$198K |
| A7030 |
Cpap full face mask |
3,312 |
2,695 |
$174K |
| E0466 |
Home vent non-invasive inter |
219 |
166 |
$117K |
| K0001 |
Standard wheelchair |
8,104 |
6,108 |
$112K |
| E0260 |
Hosp bed semi-electr w/ matt |
4,222 |
3,023 |
$108K |
| E0143 |
Walker folding wheeled w/o s |
2,606 |
2,155 |
$103K |
| A7031 |
Replacement facemask interfa |
4,581 |
3,225 |
$92K |
| A4623 |
Tracheostomy inner cannula |
976 |
567 |
$79K |
| B9002 |
Enter nutr inf pump any type |
804 |
667 |
$68K |
| E0431 |
Portable gaseous 02 |
7,205 |
5,395 |
$59K |
| E0470 |
Rad w/o backup non-inv intfc |
771 |
601 |
$57K |
| K0195 |
Elevating whlchair leg rests |
7,579 |
5,764 |
$56K |
| E0163 |
Commode chair with fixed arm |
1,406 |
1,138 |
$53K |
| K0003 |
Lightweight wheelchair |
2,357 |
1,744 |
$52K |
| A4624 |
Tracheal suction tube |
529 |
334 |
$47K |
| K0007 |
Extra heavy duty wheelchair |
641 |
498 |
$42K |
| E0445 |
Oximeter non-invasive |
460 |
330 |
$41K |
| A7035 |
Pos airway press headgear |
2,950 |
2,395 |
$37K |
| A4629 |
Tracheostomy care kit |
560 |
366 |
$36K |
| K0004 |
High strength ltwt whlchr |
1,047 |
739 |
$34K |
| E0247 |
Trans bench w/wo comm open |
513 |
420 |
$34K |
| E0562 |
Humidifier heated used w pap |
346 |
289 |
$33K |
| A7526 |
Tracheostomy tube collar |
1,222 |
789 |
$31K |
| E0630 |
Patient lift hydraulic |
1,091 |
800 |
$27K |
| E0465 |
Home vent invasive interface |
43 |
36 |
$26K |
| A7037 |
Pos airway pressure tubing |
1,591 |
1,246 |
$26K |
| A7034 |
Nasal application device |
813 |
668 |
$24K |
| A4604 |
Tubing with heating element |
2,355 |
2,022 |
$23K |
| E0600 |
Suction pump portab hom modl |
1,072 |
779 |
$23K |
| A7038 |
Pos airway pressure filter |
6,809 |
5,040 |
$20K |
| K0006 |
Heavy duty wheelchair |
543 |
414 |
$19K |
| A7520 |
Trach/laryn tube non-cuffed |
478 |
290 |
$19K |
| E0240 |
Bath/shower chair |
288 |
246 |
$15K |
| E1392 |
Portable oxygen concentrator |
1,509 |
1,079 |
$15K |
| E0971 |
Wheelchair anti-tipping devi |
651 |
412 |
$13K |
| A7000 |
Disposable canister for pump |
1,032 |
714 |
$13K |
| E0973 |
W/ch access det adj armrest |
1,416 |
1,017 |
$12K |
| E0570 |
Nebulizer with compression |
1,242 |
963 |
$11K |
| B9998 |
Enteral supp not otherwise c |
1,147 |
519 |
$9K |
| A4670 |
Automatic bp monitor, dial |
144 |
129 |
$8K |
| E0165 |
Commode chair with detacharm |
504 |
354 |
$8K |
| E2601 |
Gen w/c cushion wdth < 22 in |
283 |
219 |
$8K |
| E0776 |
Iv pole |
788 |
648 |
$8K |
| A7046 |
Repl water chamber, pap dev |
1,628 |
1,329 |
$8K |
| E2201 |
Man w/ch acc seat w>=20"<24" |
700 |
500 |
$8K |
| B4152 |
Ef calorie dense>/=1.5kcal |
72 |
52 |
$7K |
| K0738 |
Portable gas oxygen system |
531 |
367 |
$6K |
| A7032 |
Replacement nasal cushion |
369 |
277 |
$5K |
| A4554 |
Disposable underpads |
94 |
78 |
$4K |
| A7033 |
Replacement nasal pillows |
312 |
231 |
$4K |
| B4034 |
Enter feed supkit syr by day |
67 |
50 |
$4K |
| A4628 |
Oropharyngeal suction cath |
739 |
521 |
$3K |
| A7002 |
Tubing used w suction pump |
928 |
664 |
$3K |
| B4160 |
Ef ped caloric dense>/=0.7kc |
18 |
13 |
$3K |
| E0149 |
Heavy duty wheeled walker |
40 |
25 |
$3K |
| L8501 |
Tracheostomy speaking valve |
47 |
26 |
$2K |
| E0156 |
Walker seat attachment |
245 |
192 |
$2K |
| B4088 |
Gastro/jejuno tube, low-pro |
18 |
13 |
$1K |
| S8120 |
O2 contents gas cubic ft |
26 |
12 |
$443.29 |
| A4217 |
Sterile water/saline, 500 ml |
15 |
12 |
$430.83 |
| E1399 |
Durable medical equipment mi |
29 |
13 |
$355.20 |
| A7525 |
Tracheostomy mask |
129 |
92 |
$214.69 |
| A7012 |
Nebulizer water collec devic |
14 |
12 |
$68.13 |
| A7007 |
Lg vol nebulizer disposable |
17 |
12 |
$64.72 |
| W4211 |
|
47 |
39 |
$0.00 |