| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
13,373 |
11,915 |
$602K |
| E0601 |
Cont airway pressure device |
6,719 |
6,269 |
$339K |
| T4528 |
Adult size pull-on xl |
2,380 |
2,179 |
$261K |
| T4527 |
Adult size pull-on lg |
1,758 |
1,633 |
$178K |
| E0470 |
Rad w/o backup non-inv intfc |
1,819 |
1,630 |
$173K |
| E0562 |
Humidifier heated used w pap |
3,384 |
2,980 |
$164K |
| T4535 |
Disposable liner/shield/pad |
2,871 |
2,605 |
$147K |
| T4526 |
Adult size pull-on med |
1,503 |
1,396 |
$144K |
| E0431 |
Portable gaseous 02 |
9,387 |
8,218 |
$141K |
| A7030 |
Cpap full face mask |
2,117 |
1,921 |
$130K |
| E0570 |
Nebulizer with compression |
6,031 |
5,348 |
$122K |
| T4541 |
Large disposable underpad |
3,031 |
2,842 |
$116K |
| E0260 |
Hosp bed semi-electr w/ matt |
3,666 |
3,180 |
$109K |
| E0603 |
Electric breast pump |
505 |
489 |
$94K |
| E0466 |
Home vent non-invasive inter |
226 |
204 |
$67K |
| K0001 |
Standard wheelchair |
3,631 |
3,154 |
$57K |
| A7035 |
Pos airway press headgear |
2,789 |
2,560 |
$55K |
| E0143 |
Walker folding wheeled w/o s |
1,405 |
1,272 |
$42K |
| L3908 |
Who cock-up nonmolde pre ots |
1,028 |
874 |
$42K |
| A7037 |
Pos airway pressure tubing |
1,685 |
1,598 |
$38K |
| T4525 |
Adult size pull-on sm |
458 |
415 |
$38K |
| E0730 |
Tens four lead |
844 |
790 |
$28K |
| A7034 |
Nasal application device |
599 |
566 |
$24K |
| L4386 |
Non-pneum walk boot pre cst |
255 |
242 |
$20K |
| A4927 |
Non-sterile gloves |
1,054 |
854 |
$12K |
| L4350 |
Ankle control ortho pre ots |
185 |
174 |
$10K |
| A7038 |
Pos airway pressure filter |
4,065 |
3,701 |
$10K |
| E0114 |
Crutch underarm pair no wood |
391 |
367 |
$8K |
| A4670 |
Automatic bp monitor, dial |
186 |
175 |
$8K |
| A4604 |
Tubing with heating element |
901 |
735 |
$8K |
| A7003 |
Nebulizer administration set |
2,012 |
1,848 |
$4K |
| A7031 |
Replacement facemask interfa |
291 |
225 |
$4K |
| L1810 |
Ko elastic with joints |
52 |
50 |
$3K |
| E0245 |
Tub stool or bench |
39 |
38 |
$1K |
| A6530 |
Compression stocking bk18-30 |
70 |
38 |
$1K |
| A4520 |
Incontinence garment anytype |
12 |
12 |
$1K |
| A7015 |
Aerosol mask used w nebulize |
781 |
705 |
$909.56 |
| E0156 |
Walker seat attachment |
116 |
95 |
$650.68 |
| K1005 |
Disp col sto bag breast milk |
40 |
37 |
$552.93 |
| E0627 |
Seat lift mech, electric any |
18 |
12 |
$519.56 |
| A4595 |
Tens suppl 2 lead per month |
30 |
29 |
$163.50 |
| A7000 |
Disposable canister for pump |
16 |
14 |
$162.95 |
| A4357 |
Bedside drainage bag |
14 |
12 |
$36.84 |
| A7046 |
Repl water chamber, pap dev |
50 |
30 |
$0.00 |