| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
13,780 |
7,763 |
$523K |
| E0601 |
Cont airway pressure device |
15,947 |
10,052 |
$488K |
| T4528 |
Adult size pull-on xl |
2,286 |
1,920 |
$327K |
| A7030 |
Cpap full face mask |
3,972 |
3,225 |
$326K |
| E0570 |
Nebulizer with compression |
9,819 |
6,172 |
$310K |
| A4554 |
Disposable underpads |
3,182 |
2,496 |
$156K |
| E0470 |
Rad w/o backup non-inv intfc |
2,561 |
1,505 |
$139K |
| E0562 |
Humidifier heated used w pap |
1,022 |
832 |
$137K |
| T4526 |
Adult size pull-on med |
966 |
590 |
$88K |
| E0260 |
Hosp bed semi-electr w/ matt |
5,333 |
2,939 |
$83K |
| A7037 |
Pos airway pressure tubing |
5,483 |
4,435 |
$82K |
| E0431 |
Portable gaseous 02 |
11,824 |
6,624 |
$69K |
| A7035 |
Pos airway press headgear |
4,194 |
3,418 |
$68K |
| A7031 |
Replacement facemask interfa |
2,627 |
2,111 |
$64K |
| A7034 |
Nasal application device |
1,732 |
1,349 |
$63K |
| A7005 |
Nondisposable nebulizer set |
2,967 |
2,452 |
$58K |
| A4627 |
Spacer bag/reservoir |
1,298 |
1,100 |
$57K |
| K0001 |
Standard wheelchair |
7,389 |
4,040 |
$45K |
| E0143 |
Walker folding wheeled w/o s |
1,361 |
1,081 |
$44K |
| A4670 |
Automatic bp monitor, dial |
833 |
525 |
$32K |
| B4160 |
Ef ped caloric dense>/=0.7kc |
709 |
365 |
$30K |
| T4527 |
Adult size pull-on lg |
260 |
201 |
$30K |
| A7038 |
Pos airway pressure filter |
6,578 |
5,331 |
$21K |
| T4544 |
Adlt disp und/pull on abv xl |
91 |
64 |
$13K |
| A7032 |
Replacement nasal cushion |
452 |
328 |
$9K |
| A7046 |
Repl water chamber, pap dev |
1,904 |
1,515 |
$8K |
| A7015 |
Aerosol mask used w nebulize |
3,057 |
2,564 |
$5K |
| Q0513 |
Disp fee inhal drugs/30 days |
668 |
655 |
$5K |
| E0630 |
Patient lift hydraulic |
245 |
135 |
$3K |
| E0156 |
Walker seat attachment |
348 |
273 |
$2K |
| A4604 |
Tubing with heating element |
90 |
72 |
$2K |
| A4253 |
Blood glucose/reagent strips |
521 |
351 |
$1K |
| A7033 |
Replacement nasal pillows |
63 |
58 |
$1K |
| A5500 |
Diab shoe for density insert |
88 |
61 |
$1K |
| E1038 |
Transport chair pt wt<=300lb |
135 |
83 |
$969.46 |
| A5512 |
Multi den insert direct form |
74 |
49 |
$760.48 |
| J7620 |
Albuterol ipratrop non-comp |
287 |
283 |
$580.20 |
| E0163 |
Commode chair with fixed arm |
17 |
12 |
$481.28 |
| A4259 |
Lancets per box |
200 |
150 |
$123.30 |
| A7003 |
Nebulizer administration set |
55 |
50 |
$113.95 |