| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
4,241 |
3,952 |
$156K |
| T4528 |
Adult size pull-on xl |
627 |
531 |
$85K |
| A7030 |
Cpap full face mask |
1,297 |
1,243 |
$83K |
| E0601 |
Cont airway pressure device |
3,220 |
3,004 |
$77K |
| T4527 |
Adult size pull-on lg |
582 |
519 |
$73K |
| A4604 |
Tubing with heating element |
1,452 |
1,381 |
$64K |
| A7031 |
Replacement facemask interfa |
2,075 |
1,913 |
$62K |
| E0570 |
Nebulizer with compression |
879 |
855 |
$50K |
| T4526 |
Adult size pull-on med |
402 |
337 |
$46K |
| A7032 |
Replacement nasal cushion |
735 |
684 |
$42K |
| T4535 |
Disposable liner/shield/pad |
1,022 |
898 |
$26K |
| T4541 |
Large disposable underpad |
399 |
359 |
$25K |
| A7005 |
Nondisposable nebulizer set |
756 |
748 |
$24K |
| A7034 |
Nasal application device |
582 |
543 |
$22K |
| E0431 |
Portable gaseous 02 |
2,084 |
1,946 |
$20K |
| A7035 |
Pos airway press headgear |
1,073 |
1,008 |
$15K |
| A4927 |
Non-sterile gloves |
516 |
454 |
$15K |
| A7038 |
Pos airway pressure filter |
3,279 |
3,074 |
$13K |
| E0562 |
Humidifier heated used w pap |
131 |
126 |
$12K |
| A7046 |
Repl water chamber, pap dev |
667 |
626 |
$8K |
| A7037 |
Pos airway pressure tubing |
368 |
358 |
$4K |
| B4150 |
Ef complet w/intact nutrient |
50 |
36 |
$4K |
| A4335 |
Incontinence supply |
1,040 |
942 |
$4K |
| E0260 |
Hosp bed semi-electr w/ matt |
159 |
141 |
$3K |
| E0603 |
Electric breast pump |
12 |
12 |
$1K |
| K0003 |
Lightweight wheelchair |
46 |
42 |
$1K |
| E0470 |
Rad w/o backup non-inv intfc |
12 |
12 |
$797.12 |
| E1392 |
Portable oxygen concentrator |
39 |
36 |
$519.05 |
| A7015 |
Aerosol mask used w nebulize |
164 |
162 |
$262.79 |
| E0143 |
Walker folding wheeled w/o s |
14 |
14 |
$172.71 |