| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
15,652 |
12,440 |
$1.01M |
| A7030 |
Cpap full face mask |
2,058 |
1,548 |
$118K |
| E0431 |
Portable gaseous 02 |
10,509 |
8,083 |
$99K |
| E0601 |
Cont airway pressure device |
2,432 |
1,990 |
$98K |
| T4527 |
Adult size pull-on lg |
879 |
789 |
$77K |
| E0260 |
Hosp bed semi-electr w/ matt |
2,081 |
1,375 |
$55K |
| E0470 |
Rad w/o backup non-inv intfc |
671 |
505 |
$51K |
| K0001 |
Standard wheelchair |
3,053 |
2,029 |
$46K |
| A4604 |
Tubing with heating element |
1,901 |
1,512 |
$43K |
| A4927 |
Non-sterile gloves |
3,296 |
2,236 |
$41K |
| T4541 |
Large disposable underpad |
2,213 |
1,869 |
$40K |
| A7031 |
Replacement facemask interfa |
1,728 |
1,278 |
$39K |
| E0562 |
Humidifier heated used w pap |
2,357 |
1,905 |
$38K |
| T4526 |
Adult size pull-on med |
468 |
399 |
$37K |
| T4535 |
Disposable liner/shield/pad |
457 |
426 |
$30K |
| T4528 |
Adult size pull-on xl |
294 |
261 |
$26K |
| A7035 |
Pos airway press headgear |
1,755 |
1,380 |
$24K |
| E0570 |
Nebulizer with compression |
3,529 |
2,454 |
$18K |
| A7038 |
Pos airway pressure filter |
3,596 |
2,834 |
$16K |
| A4351 |
Straight tip urine catheter |
132 |
108 |
$15K |
| A7034 |
Nasal application device |
287 |
222 |
$12K |
| T4522 |
Adult size brief/diaper med |
100 |
84 |
$9K |
| E0443 |
Portable 02 contents, gas |
619 |
468 |
$7K |
| A4670 |
Automatic bp monitor, dial |
123 |
114 |
$6K |
| A7039 |
Filter, non disposable w pap |
919 |
712 |
$5K |
| A7046 |
Repl water chamber, pap dev |
459 |
357 |
$3K |
| A7037 |
Pos airway pressure tubing |
91 |
65 |
$899.94 |
| A7005 |
Nondisposable nebulizer set |
29 |
29 |
$669.69 |
| E0143 |
Walker folding wheeled w/o s |
14 |
12 |
$606.36 |
| A7032 |
Replacement nasal cushion |
13 |
12 |
$327.78 |
| E2201 |
Man w/ch acc seat w>=20"<24" |
16 |
13 |
$236.86 |
| K0195 |
Elevating whlchair leg rests |
18 |
12 |
$132.61 |
| A7003 |
Nebulizer administration set |
30 |
30 |
$78.14 |
| A4520 |
Incontinence garment anytype |
1,306 |
738 |
$0.00 |