| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
4,385 |
2,751 |
$69K |
| L4387 |
Non-pneum walk boot pre ots |
931 |
492 |
$45K |
| L3908 |
Who cock-up nonmolde pre ots |
2,110 |
977 |
$31K |
| L4386 |
Non-pneum walk boot pre cst |
242 |
142 |
$17K |
| E0570 |
Nebulizer with compression |
1,671 |
1,067 |
$16K |
| E0114 |
Crutch underarm pair no wood |
904 |
422 |
$16K |
| E0601 |
Cont airway pressure device |
1,259 |
697 |
$16K |
| L3660 |
So 8 ab rstr can/web pre ots |
556 |
269 |
$14K |
| E0143 |
Walker folding wheeled w/o s |
397 |
224 |
$10K |
| K0003 |
Lightweight wheelchair |
1,394 |
1,006 |
$9K |
| E0431 |
Portable gaseous 02 |
2,515 |
1,622 |
$7K |
| L3807 |
Whfo w/o joints pre cst |
78 |
42 |
$6K |
| L3808 |
Whfo, rigid w/o joints |
31 |
25 |
$5K |
| E0260 |
Hosp bed semi-electr w/ matt |
325 |
180 |
$4K |
| L3809 |
Whfo w/o joints pre ots |
57 |
27 |
$4K |
| L1902 |
Afo ankle gauntlet pre ots |
93 |
60 |
$2K |
| L3650 |
So 8 abd restraint pre ots |
198 |
74 |
$2K |
| L1820 |
Ko elas w/ condyle pads & jo |
49 |
26 |
$2K |
| E1140 |
Wheelchair standard detach a |
99 |
84 |
$1K |
| A5500 |
Diab shoe for density insert |
46 |
12 |
$853.19 |
| E0430 |
Oxygen system gas portable |
139 |
107 |
$806.44 |
| E0156 |
Walker seat attachment |
137 |
80 |
$449.02 |
| E0149 |
Heavy duty wheeled walker |
26 |
12 |
$350.84 |
| A4927 |
Non-sterile gloves |
121 |
67 |
$312.01 |
| L3806 |
Whfo w/joint(s) custom fab |
93 |
56 |
$188.00 |
| L3260 |
Ambulatory surgical boot eac |
35 |
12 |
$67.29 |
| A7038 |
Pos airway pressure filter |
17 |
14 |
$0.00 |