| Code | Description | Claims | Beneficiaries | Total Paid |
| E0466 |
Home vent non-invasive inter |
4,524 |
4,400 |
$1.84M |
| E1390 |
Oxygen concentrator |
23,616 |
23,125 |
$1.51M |
| E0471 |
Rad w/backup non inv intrfc |
2,581 |
2,516 |
$850K |
| E0601 |
Cont airway pressure device |
6,348 |
6,143 |
$307K |
| T4541 |
Large disposable underpad |
6,071 |
6,037 |
$279K |
| T4527 |
Adult size pull-on lg |
3,796 |
3,755 |
$225K |
| E0470 |
Rad w/o backup non-inv intfc |
1,212 |
1,174 |
$159K |
| T4535 |
Disposable liner/shield/pad |
3,581 |
3,463 |
$153K |
| T4528 |
Adult size pull-on xl |
2,194 |
2,184 |
$143K |
| E0562 |
Humidifier heated used w pap |
9,672 |
9,532 |
$134K |
| T4526 |
Adult size pull-on med |
2,280 |
2,257 |
$121K |
| E0431 |
Portable gaseous 02 |
8,276 |
8,117 |
$106K |
| A4604 |
Tubing with heating element |
3,439 |
3,384 |
$84K |
| K0001 |
Standard wheelchair |
3,255 |
3,180 |
$74K |
| A7030 |
Cpap full face mask |
1,402 |
1,394 |
$71K |
| A7034 |
Nasal application device |
1,447 |
1,439 |
$65K |
| E0570 |
Nebulizer with compression |
5,724 |
5,490 |
$48K |
| K0738 |
Portable gas oxygen system |
1,462 |
1,438 |
$40K |
| E1392 |
Portable oxygen concentrator |
1,685 |
1,667 |
$35K |
| S9999 |
Sales tax |
10,566 |
10,264 |
$27K |
| A7032 |
Replacement nasal cushion |
1,138 |
1,132 |
$26K |
| A7031 |
Replacement facemask interfa |
1,004 |
998 |
$26K |
| E0143 |
Walker folding wheeled w/o s |
796 |
792 |
$25K |
| A7038 |
Pos airway pressure filter |
5,475 |
5,451 |
$21K |
| A7035 |
Pos airway press headgear |
1,891 |
1,882 |
$20K |
| A7046 |
Repl water chamber, pap dev |
1,948 |
1,916 |
$19K |
| A7033 |
Replacement nasal pillows |
477 |
473 |
$14K |
| A7039 |
Filter, non disposable w pap |
2,465 |
2,456 |
$8K |
| A7005 |
Nondisposable nebulizer set |
1,017 |
1,012 |
$7K |
| E0295 |
Hosp bed semi-elect w/o matt |
123 |
123 |
$4K |
| 99283 |
|
16 |
15 |
$2K |
| E0260 |
Hosp bed semi-electr w/ matt |
170 |
168 |
$1K |
| A7037 |
Pos airway pressure tubing |
152 |
152 |
$796.83 |
| A7036 |
Pos airway press chinstrap |
24 |
24 |
$174.82 |