| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A4520 |
Incontinence garment anytype |
8,750 |
8,511 |
$1.02M |
| E1390 |
Oxygen concentrator |
10,130 |
9,721 |
$621K |
| A4554 |
Disposable underpads |
4,557 |
4,441 |
$106K |
| E0431 |
Portable gaseous 02 |
6,239 |
5,977 |
$95K |
| E0601 |
Cont airway pressure device |
1,561 |
1,394 |
$58K |
| E0570 |
Nebulizer with compression |
2,713 |
2,626 |
$55K |
| E0260 |
Hosp bed semi-electr w/ matt |
1,799 |
1,705 |
$51K |
| A7030 |
Cpap full face mask |
515 |
497 |
$37K |
| E0562 |
Humidifier heated used w pap |
1,303 |
1,188 |
$33K |
| K0001 |
Standard wheelchair |
2,031 |
1,933 |
$28K |
| A7035 |
Pos airway press headgear |
1,189 |
1,131 |
$23K |
| A7037 |
Pos airway pressure tubing |
1,375 |
1,313 |
$23K |
| A7038 |
Pos airway pressure filter |
2,429 |
2,338 |
$14K |
| A7034 |
Nasal application device |
131 |
126 |
$7K |
| A7039 |
Filter, non disposable w pap |
798 |
763 |
$6K |
| E0470 |
Rad w/o backup non-inv intfc |
101 |
88 |
$6K |
| E0143 |
Walker folding wheeled w/o s |
57 |
53 |
$2K |
| A7003 |
Nebulizer administration set |
733 |
700 |
$2K |
| A7046 |
Repl water chamber, pap dev |
27 |
27 |
$311.74 |