| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
14,129 |
13,436 |
$604K |
| A7030 |
Cpap full face mask |
3,524 |
3,425 |
$229K |
| T4527 |
Adult size pull-on lg |
1,786 |
1,720 |
$178K |
| E0601 |
Cont airway pressure device |
3,649 |
3,456 |
$105K |
| T4528 |
Adult size pull-on xl |
1,005 |
943 |
$101K |
| T4526 |
Adult size pull-on med |
1,194 |
1,142 |
$95K |
| A4604 |
Tubing with heating element |
4,516 |
4,406 |
$94K |
| A7031 |
Replacement facemask interfa |
3,993 |
3,830 |
$92K |
| T4535 |
Disposable liner/shield/pad |
2,136 |
2,028 |
$83K |
| E0439 |
Stationary liquid 02 |
2,944 |
2,778 |
$74K |
| E0431 |
Portable gaseous 02 |
7,563 |
7,192 |
$56K |
| E0562 |
Humidifier heated used w pap |
910 |
863 |
$52K |
| A7034 |
Nasal application device |
1,091 |
1,075 |
$50K |
| E0603 |
Electric breast pump |
371 |
371 |
$50K |
| T4541 |
Large disposable underpad |
2,140 |
2,039 |
$36K |
| E0470 |
Rad w/o backup non-inv intfc |
675 |
645 |
$35K |
| E0570 |
Nebulizer with compression |
4,434 |
4,198 |
$35K |
| A7035 |
Pos airway press headgear |
2,982 |
2,922 |
$33K |
| B4150 |
Ef complet w/intact nutrient |
695 |
503 |
$33K |
| K0001 |
Standard wheelchair |
2,871 |
2,690 |
$32K |
| A4927 |
Non-sterile gloves |
3,097 |
2,911 |
$27K |
| E1028 |
W/c manual swingaway |
1,795 |
1,040 |
$27K |
| E1392 |
Portable oxygen concentrator |
2,672 |
2,529 |
$27K |
| A7032 |
Replacement nasal cushion |
706 |
688 |
$25K |
| E0260 |
Hosp bed semi-electr w/ matt |
1,232 |
1,160 |
$21K |
| E0143 |
Walker folding wheeled w/o s |
518 |
501 |
$17K |
| A7038 |
Pos airway pressure filter |
6,200 |
6,004 |
$17K |
| E0434 |
Portable liquid 02 |
2,585 |
2,468 |
$16K |
| A7046 |
Repl water chamber, pap dev |
2,019 |
1,972 |
$12K |
| T4537 |
Reusable underpad bed size |
700 |
673 |
$11K |
| A7005 |
Nondisposable nebulizer set |
589 |
570 |
$9K |
| S5161 |
Emer rspns sys serv permonth |
350 |
312 |
$9K |
| E0442 |
Stationary o2 contents, liq |
595 |
575 |
$8K |
| T4534 |
Youth size pull-on |
107 |
104 |
$8K |
| K0108 |
W/c component-accessory nos |
45 |
27 |
$7K |
| A7000 |
Disposable canister for pump |
378 |
360 |
$6K |
| A4409 |
Ost skn barr convex <=4 sq i |
69 |
66 |
$5K |
| E0118 |
Crutch substitute |
281 |
281 |
$5K |
| E0600 |
Suction pump portab hom modl |
163 |
150 |
$5K |
| E0444 |
Portable 02 contents, liquid |
227 |
217 |
$5K |
| K0739 |
Repair/svc dme non-oxygen eq |
265 |
165 |
$4K |
| T4544 |
Adlt disp und/pull on abv xl |
13 |
13 |
$4K |
| A7033 |
Replacement nasal pillows |
120 |
118 |
$4K |
| A4407 |
Ext wear ost skn barr <=4sq" |
25 |
25 |
$4K |
| K0195 |
Elevating whlchair leg rests |
367 |
354 |
$3K |
| A4385 |
Ost skn barrier sld ext wear |
46 |
45 |
$3K |
| E2201 |
Man w/ch acc seat w>=20"<24" |
175 |
148 |
$3K |
| A7002 |
Tubing used w suction pump |
345 |
325 |
$3K |
| A4217 |
Sterile water/saline, 500 ml |
18 |
14 |
$3K |
| A7039 |
Filter, non disposable w pap |
586 |
565 |
$2K |
| A4628 |
Oropharyngeal suction cath |
295 |
253 |
$2K |
| K0823 |
Pwc gp 2 std cap chair |
28 |
24 |
$2K |
| A4456 |
Adhesive remover, wipes |
235 |
216 |
$2K |
| E0973 |
W/ch access det adj armrest |
28 |
14 |
$1K |
| E0445 |
Oximeter non-invasive |
12 |
12 |
$1K |
| A5063 |
Drain ostomy pouch w/flange |
38 |
37 |
$1K |
| A7003 |
Nebulizer administration set |
770 |
743 |
$992.56 |
| A4425 |
Ost pch drain for barrier fl |
16 |
15 |
$835.94 |
| A4606 |
Oxygen probe used w oximeter |
79 |
38 |
$603.00 |
| E0443 |
Portable 02 contents, gas |
12 |
12 |
$387.81 |
| A5120 |
Skin barrier, wipe or swab |
64 |
55 |
$387.33 |
| E0156 |
Walker seat attachment |
45 |
39 |
$196.83 |
| A7015 |
Aerosol mask used w nebulize |
101 |
99 |
$129.79 |
| A7037 |
Pos airway pressure tubing |
12 |
12 |
$112.07 |
| A6402 |
Sterile gauze <= 16 sq in |
12 |
12 |
$98.36 |