| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E0601 |
Cont airway pressure device |
491 |
469 |
$57K |
| A7030 |
Cpap full face mask |
570 |
544 |
$56K |
| A7031 |
Replacement facemask interfa |
557 |
535 |
$49K |
| A7032 |
Replacement nasal cushion |
344 |
330 |
$39K |
| A4604 |
Tubing with heating element |
1,046 |
1,006 |
$36K |
| E0470 |
Rad w/o backup non-inv intfc |
220 |
206 |
$34K |
| E0603 |
Electric breast pump |
171 |
171 |
$33K |
| E1390 |
Oxygen concentrator |
551 |
493 |
$31K |
| A7034 |
Nasal application device |
487 |
470 |
$30K |
| E0562 |
Humidifier heated used w pap |
657 |
619 |
$18K |
| A7038 |
Pos airway pressure filter |
1,197 |
1,143 |
$16K |
| T4527 |
Adult size pull-on lg |
133 |
129 |
$14K |
| A7035 |
Pos airway press headgear |
592 |
567 |
$13K |
| T4535 |
Disposable liner/shield/pad |
137 |
131 |
$11K |
| E0260 |
Hosp bed semi-electr w/ matt |
219 |
207 |
$10K |
| A7033 |
Replacement nasal pillows |
98 |
91 |
$6K |
| K0001 |
Standard wheelchair |
207 |
198 |
$5K |
| T4528 |
Adult size pull-on xl |
51 |
49 |
$5K |
| E0570 |
Nebulizer with compression |
180 |
173 |
$5K |
| A7046 |
Repl water chamber, pap dev |
471 |
456 |
$5K |
| T4541 |
Large disposable underpad |
157 |
156 |
$3K |
| A4927 |
Non-sterile gloves |
241 |
210 |
$3K |
| E0143 |
Walker folding wheeled w/o s |
73 |
68 |
$3K |
| E0431 |
Portable gaseous 02 |
226 |
200 |
$2K |
| E1392 |
Portable oxygen concentrator |
112 |
103 |
$2K |
| T4526 |
Adult size pull-on med |
13 |
13 |
$1K |
| A7036 |
Pos airway press chinstrap |
61 |
58 |
$617.14 |
| E0630 |
Patient lift hydraulic |
13 |
13 |
$610.63 |
| K0195 |
Elevating whlchair leg rests |
69 |
61 |
$590.07 |
| A7005 |
Nondisposable nebulizer set |
13 |
12 |
$206.97 |
| E2201 |
Man w/ch acc seat w>=20"<24" |
12 |
12 |
$164.68 |