| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
10,042 |
9,312 |
$354K |
| A7030 |
Cpap full face mask |
4,651 |
4,318 |
$314K |
| E0601 |
Cont airway pressure device |
7,311 |
6,949 |
$293K |
| A4604 |
Tubing with heating element |
6,970 |
6,480 |
$181K |
| A7034 |
Nasal application device |
3,900 |
3,601 |
$176K |
| A7031 |
Replacement facemask interfa |
5,307 |
4,849 |
$170K |
| E0562 |
Humidifier heated used w pap |
4,387 |
4,164 |
$115K |
| E0260 |
Hosp bed semi-electr w/ matt |
2,214 |
2,097 |
$82K |
| A7032 |
Replacement nasal cushion |
2,129 |
1,925 |
$70K |
| A7035 |
Pos airway press headgear |
5,034 |
4,687 |
$64K |
| T4528 |
Adult size pull-on xl |
233 |
224 |
$62K |
| E0570 |
Nebulizer with compression |
4,936 |
4,783 |
$61K |
| A7033 |
Replacement nasal pillows |
1,951 |
1,763 |
$49K |
| T4527 |
Adult size pull-on lg |
196 |
188 |
$47K |
| E0431 |
Portable gaseous 02 |
5,916 |
5,424 |
$41K |
| A7038 |
Pos airway pressure filter |
8,875 |
8,208 |
$39K |
| S9999 |
Sales tax |
3,097 |
2,912 |
$38K |
| E0470 |
Rad w/o backup non-inv intfc |
470 |
445 |
$35K |
| T4526 |
Adult size pull-on med |
163 |
160 |
$34K |
| K0001 |
Standard wheelchair |
2,239 |
2,127 |
$34K |
| A7046 |
Repl water chamber, pap dev |
3,614 |
3,353 |
$28K |
| T4535 |
Disposable liner/shield/pad |
262 |
244 |
$23K |
| T4541 |
Large disposable underpad |
408 |
385 |
$19K |
| T4532 |
Ped size pull-on lg |
67 |
63 |
$17K |
| A4385 |
Ost skn barrier sld ext wear |
79 |
78 |
$14K |
| A7037 |
Pos airway pressure tubing |
940 |
880 |
$14K |
| E0143 |
Walker folding wheeled w/o s |
379 |
363 |
$10K |
| T4537 |
Reusable underpad bed size |
337 |
329 |
$9K |
| A4927 |
Non-sterile gloves |
335 |
293 |
$7K |
| A6530 |
Compression stocking bk18-30 |
144 |
136 |
$7K |
| E1392 |
Portable oxygen concentrator |
739 |
690 |
$6K |
| A4351 |
Straight tip urine catheter |
25 |
25 |
$6K |
| A7039 |
Filter, non disposable w pap |
1,398 |
1,300 |
$6K |
| T4522 |
Adult size brief/diaper med |
26 |
26 |
$5K |
| K0739 |
Repair/svc dme non-oxygen eq |
62 |
54 |
$4K |
| E0466 |
Home vent non-invasive inter |
13 |
12 |
$3K |
| K0108 |
W/c component-accessory nos |
41 |
28 |
$3K |
| E1028 |
W/c manual swingaway |
152 |
119 |
$3K |
| E0156 |
Walker seat attachment |
338 |
321 |
$2K |
| T4531 |
Ped size pull-on sm/med |
12 |
12 |
$2K |
| A5063 |
Drain ostomy pouch w/flange |
42 |
41 |
$2K |
| E0630 |
Patient lift hydraulic |
81 |
72 |
$1K |
| E0203 |
Therapeutic lightbox tabletp |
15 |
12 |
$981.97 |
| E0973 |
W/ch access det adj armrest |
47 |
27 |
$815.04 |
| E0149 |
Heavy duty wheeled walker |
68 |
64 |
$797.06 |
| A4414 |
Ost sknbar w/o conv<=4 sq in |
13 |
12 |
$603.93 |
| A7005 |
Nondisposable nebulizer set |
57 |
51 |
$594.89 |
| E0245 |
Tub stool or bench |
12 |
12 |
$552.30 |
| A7036 |
Pos airway press chinstrap |
34 |
30 |
$215.92 |
| A7003 |
Nebulizer administration set |
106 |
101 |
$203.58 |
| A4357 |
Bedside drainage bag |
13 |
12 |
$144.75 |
| A5120 |
Skin barrier, wipe or swab |
20 |
19 |
$76.65 |
| K0195 |
Elevating whlchair leg rests |
13 |
13 |
$61.59 |