| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E0603 |
Electric breast pump |
3,400 |
3,397 |
$513K |
| E0601 |
Cont airway pressure device |
14,255 |
14,214 |
$490K |
| E1390 |
Oxygen concentrator |
3,300 |
3,286 |
$166K |
| A4239 |
Non-adju cgm supply allow |
1,170 |
1,151 |
$146K |
| E0562 |
Humidifier heated used w pap |
3,182 |
3,161 |
$135K |
| T4523 |
Adult size brief/diaper lg |
2,046 |
2,012 |
$107K |
| A7030 |
Cpap full face mask |
1,708 |
1,703 |
$97K |
| E0470 |
Rad w/o backup non-inv intfc |
938 |
936 |
$94K |
| A4554 |
Disposable underpads |
1,905 |
1,890 |
$86K |
| T4522 |
Adult size brief/diaper med |
2,020 |
1,964 |
$77K |
| A7034 |
Nasal application device |
2,782 |
2,768 |
$74K |
| K0001 |
Standard wheelchair |
4,405 |
4,357 |
$53K |
| T4524 |
Adult size brief/diaper xl |
760 |
738 |
$51K |
| E0630 |
Patient lift hydraulic |
1,015 |
1,006 |
$33K |
| E0260 |
Hosp bed semi-electr w/ matt |
2,013 |
1,984 |
$31K |
| A7035 |
Pos airway press headgear |
3,032 |
3,015 |
$30K |
| E0266 |
Hosp bed total elec w/o matt |
296 |
295 |
$30K |
| K0553 |
Ther cgm supply allowance |
273 |
270 |
$28K |
| E0143 |
Walker folding wheeled w/o s |
726 |
718 |
$28K |
| E0570 |
Nebulizer with compression |
671 |
671 |
$25K |
| A7032 |
Replacement nasal cushion |
876 |
858 |
$25K |
| A7031 |
Replacement facemask interfa |
946 |
938 |
$24K |
| A7037 |
Pos airway pressure tubing |
2,006 |
1,996 |
$21K |
| T4537 |
Reusable underpad bed size |
1,167 |
1,134 |
$18K |
| E0431 |
Portable gaseous 02 |
1,523 |
1,509 |
$17K |
| T4535 |
Disposable liner/shield/pad |
1,020 |
1,006 |
$15K |
| A7038 |
Pos airway pressure filter |
4,674 |
4,652 |
$14K |
| K0195 |
Elevating whlchair leg rests |
2,932 |
2,899 |
$13K |
| E0561 |
Humidifier nonheated w pap |
235 |
235 |
$12K |
| E1399 |
Durable medical equipment mi |
179 |
163 |
$11K |
| E1392 |
Portable oxygen concentrator |
507 |
506 |
$10K |
| E0261 |
Hosp bed semi-electr w/o mat |
268 |
268 |
$9K |
| E2103 |
Non-adju cgm receiver/mon |
51 |
50 |
$7K |
| A4604 |
Tubing with heating element |
1,480 |
1,474 |
$6K |
| E1038 |
Transport chair pt wt<=300lb |
453 |
450 |
$5K |
| E0165 |
Commode chair with detacharm |
207 |
207 |
$4K |
| E0240 |
Bath/shower chair |
107 |
107 |
$4K |
| A4927 |
Non-sterile gloves |
1,104 |
1,101 |
$3K |
| E0149 |
Heavy duty wheeled walker |
217 |
202 |
$3K |
| E0971 |
Wheelchair anti-tipping devi |
998 |
666 |
$2K |
| A7005 |
Nondisposable nebulizer set |
128 |
128 |
$2K |
| A7046 |
Repl water chamber, pap dev |
469 |
466 |
$2K |
| E0156 |
Walker seat attachment |
135 |
133 |
$2K |
| K0738 |
Portable gas oxygen system |
219 |
219 |
$1K |
| A7039 |
Filter, non disposable w pap |
527 |
526 |
$1K |
| B4152 |
Ef calorie dense>/=1.5kcal |
80 |
70 |
$1K |
| E0163 |
Commode chair with fixed arm |
52 |
51 |
$988.64 |
| K0003 |
Lightweight wheelchair |
130 |
129 |
$974.02 |
| E0100 |
Cane adjust/fixed with tip |
25 |
25 |
$295.48 |
| E0978 |
W/c acc,saf belt pelv strap |
25 |
25 |
$140.80 |
| A7015 |
Aerosol mask used w nebulize |
86 |
86 |
$81.66 |