| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
7,616 |
5,953 |
$275K |
| L4361 |
Pneuma/vac walk boot pre ots |
530 |
462 |
$109K |
| E0601 |
Cont airway pressure device |
2,824 |
2,328 |
$93K |
| A7030 |
Cpap full face mask |
1,794 |
1,478 |
$78K |
| E0114 |
Crutch underarm pair no wood |
1,844 |
1,680 |
$67K |
| A4604 |
Tubing with heating element |
2,923 |
2,469 |
$65K |
| L3809 |
Whfo w/o joints pre ots |
311 |
282 |
$53K |
| L3660 |
So 8 ab rstr can/web pre ots |
762 |
717 |
$42K |
| E0562 |
Humidifier heated used w pap |
1,154 |
1,015 |
$41K |
| E0260 |
Hosp bed semi-electr w/ matt |
2,354 |
1,719 |
$40K |
| E0431 |
Portable gaseous 02 |
4,446 |
3,787 |
$38K |
| L4350 |
Ankle control ortho pre ots |
537 |
485 |
$37K |
| A7031 |
Replacement facemask interfa |
2,119 |
1,632 |
$37K |
| A7034 |
Nasal application device |
1,024 |
885 |
$36K |
| E0570 |
Nebulizer with compression |
1,205 |
1,090 |
$28K |
| L3908 |
Who cock-up nonmolde pre ots |
550 |
494 |
$26K |
| A7035 |
Pos airway press headgear |
2,138 |
1,854 |
$24K |
| L1830 |
Ko immob canvas long pre ots |
393 |
352 |
$24K |
| K0001 |
Standard wheelchair |
1,963 |
1,513 |
$21K |
| E0470 |
Rad w/o backup non-inv intfc |
239 |
204 |
$18K |
| L3260 |
Ambulatory surgical boot eac |
541 |
487 |
$15K |
| A7032 |
Replacement nasal cushion |
877 |
658 |
$13K |
| E0143 |
Walker folding wheeled w/o s |
522 |
459 |
$13K |
| L1812 |
Ko elastic w/joints pre ots |
172 |
156 |
$12K |
| A7046 |
Repl water chamber, pap dev |
1,178 |
1,004 |
$8K |
| A7038 |
Pos airway pressure filter |
4,546 |
3,131 |
$6K |
| E1392 |
Portable oxygen concentrator |
496 |
362 |
$6K |
| K0738 |
Portable gas oxygen system |
594 |
467 |
$6K |
| E0630 |
Patient lift hydraulic |
228 |
162 |
$4K |
| K0195 |
Elevating whlchair leg rests |
624 |
489 |
$3K |
| A7033 |
Replacement nasal pillows |
191 |
167 |
$3K |
| K0003 |
Lightweight wheelchair |
187 |
163 |
$3K |
| A7037 |
Pos airway pressure tubing |
147 |
111 |
$969.24 |
| K0006 |
Heavy duty wheelchair |
33 |
25 |
$709.60 |
| E0135 |
Walker folding adjust/fixed |
14 |
14 |
$556.75 |
| A7005 |
Nondisposable nebulizer set |
27 |
26 |
$246.39 |
| E0971 |
Wheelchair anti-tipping devi |
22 |
13 |
$226.42 |
| A7039 |
Filter, non disposable w pap |
60 |
53 |
$222.34 |