| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
16,048 |
14,934 |
$662K |
| E0570 |
Nebulizer with compression |
4,901 |
4,552 |
$181K |
| L4361 |
Pneuma/vac walk boot pre ots |
873 |
799 |
$172K |
| E0601 |
Cont airway pressure device |
4,795 |
4,449 |
$166K |
| E0470 |
Rad w/o backup non-inv intfc |
2,318 |
2,103 |
$165K |
| E0431 |
Portable gaseous 02 |
10,452 |
9,750 |
$110K |
| A7031 |
Replacement facemask interfa |
3,794 |
3,607 |
$91K |
| A7030 |
Cpap full face mask |
1,923 |
1,794 |
$91K |
| E0562 |
Humidifier heated used w pap |
6,930 |
6,418 |
$70K |
| E0260 |
Hosp bed semi-electr w/ matt |
2,900 |
2,555 |
$67K |
| E1392 |
Portable oxygen concentrator |
3,293 |
3,054 |
$50K |
| K0001 |
Standard wheelchair |
2,894 |
2,639 |
$43K |
| L3984 |
Upper ext fx orthosis wrist |
137 |
129 |
$33K |
| A7037 |
Pos airway pressure tubing |
3,700 |
3,470 |
$31K |
| L3908 |
Who cock-up nonmolde pre ots |
771 |
559 |
$26K |
| A7035 |
Pos airway press headgear |
2,022 |
1,903 |
$24K |
| A7038 |
Pos airway pressure filter |
5,243 |
4,958 |
$14K |
| A7034 |
Nasal application device |
409 |
388 |
$14K |
| E0261 |
Hosp bed semi-electr w/o mat |
330 |
312 |
$13K |
| A4604 |
Tubing with heating element |
371 |
360 |
$12K |
| E0143 |
Walker folding wheeled w/o s |
478 |
428 |
$11K |
| A7039 |
Filter, non disposable w pap |
1,808 |
1,698 |
$7K |
| A5500 |
Diab shoe for density insert |
175 |
103 |
$7K |
| A7003 |
Nebulizer administration set |
3,206 |
2,863 |
$7K |
| E0630 |
Patient lift hydraulic |
178 |
151 |
$5K |
| A7032 |
Replacement nasal cushion |
192 |
177 |
$4K |
| A5512 |
Multi den insert direct form |
107 |
50 |
$4K |
| E0163 |
Commode chair with fixed arm |
100 |
91 |
$3K |
| A7046 |
Repl water chamber, pap dev |
405 |
381 |
$3K |
| L1820 |
Ko elas w/ condyle pads & jo |
28 |
25 |
$2K |
| L3995 |
Sock fracture or equal each |
93 |
89 |
$2K |
| K0007 |
Extra heavy duty wheelchair |
26 |
24 |
$2K |
| L1902 |
Afo ankle gauntlet pre ots |
30 |
26 |
$1K |
| L1812 |
Ko elastic w/joints pre ots |
13 |
12 |
$1K |
| A7013 |
Disposable compressor filter |
1,640 |
1,557 |
$719.33 |
| A7015 |
Aerosol mask used w nebulize |
454 |
426 |
$492.48 |
| A7005 |
Nondisposable nebulizer set |
50 |
48 |
$457.85 |
| E0156 |
Walker seat attachment |
46 |
38 |
$289.39 |
| A4456 |
Adhesive remover, wipes |
13 |
12 |
$121.31 |
| A4357 |
Bedside drainage bag |
13 |
12 |
$20.78 |