| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E0466 |
Home vent non-invasive inter |
3,760 |
3,128 |
$855K |
| E1390 |
Oxygen concentrator |
20,670 |
14,840 |
$529K |
| E1392 |
Portable oxygen concentrator |
11,207 |
7,827 |
$132K |
| K0738 |
Portable gas oxygen system |
6,508 |
4,891 |
$119K |
| E0483 |
Hi freq chest wall oscil sys |
450 |
350 |
$100K |
| E0143 |
Walker folding wheeled w/o s |
3,821 |
2,796 |
$69K |
| E2611 |
Gen use back cush wdth <22in |
703 |
512 |
$65K |
| L4361 |
Pneuma/vac walk boot pre ots |
303 |
270 |
$48K |
| A7030 |
Cpap full face mask |
1,179 |
893 |
$46K |
| E0260 |
Hosp bed semi-electr w/ matt |
4,021 |
2,768 |
$41K |
| L3660 |
So 8 ab rstr can/web pre ots |
467 |
413 |
$30K |
| E0570 |
Nebulizer with compression |
5,271 |
3,502 |
$28K |
| E0601 |
Cont airway pressure device |
1,861 |
1,350 |
$28K |
| E0600 |
Suction pump portab hom modl |
1,022 |
823 |
$26K |
| K0001 |
Standard wheelchair |
4,975 |
3,444 |
$23K |
| E0114 |
Crutch underarm pair no wood |
904 |
695 |
$22K |
| A4604 |
Tubing with heating element |
1,336 |
992 |
$21K |
| E0971 |
Wheelchair anti-tipping devi |
1,286 |
577 |
$20K |
| E0163 |
Commode chair with fixed arm |
1,198 |
825 |
$18K |
| K0195 |
Elevating whlchair leg rests |
3,687 |
2,544 |
$17K |
| A7031 |
Replacement facemask interfa |
1,146 |
831 |
$17K |
| E0247 |
Trans bench w/wo comm open |
219 |
168 |
$16K |
| L3809 |
Whfo w/o joints pre ots |
137 |
120 |
$16K |
| E0185 |
Gel pressure mattress pad |
267 |
199 |
$14K |
| A7034 |
Nasal application device |
610 |
438 |
$14K |
| E2601 |
Gen w/c cushion wdth < 22 in |
757 |
548 |
$13K |
| L4350 |
Ankle control ortho pre ots |
222 |
201 |
$13K |
| E0562 |
Humidifier heated used w pap |
1,326 |
962 |
$12K |
| E0630 |
Patient lift hydraulic |
1,324 |
895 |
$11K |
| L1830 |
Ko immob canvas long pre ots |
201 |
179 |
$10K |
| L3908 |
Who cock-up nonmolde pre ots |
229 |
202 |
$9K |
| A7035 |
Pos airway press headgear |
1,051 |
792 |
$9K |
| E0240 |
Bath/shower chair |
116 |
98 |
$8K |
| L1812 |
Ko elastic w/joints pre ots |
73 |
67 |
$4K |
| E0156 |
Walker seat attachment |
624 |
413 |
$4K |
| E0565 |
Compressor air power source |
233 |
161 |
$4K |
| A7526 |
Tracheostomy tube collar |
136 |
88 |
$4K |
| A7032 |
Replacement nasal cushion |
344 |
225 |
$4K |
| A7000 |
Disposable canister for pump |
256 |
191 |
$4K |
| A7046 |
Repl water chamber, pap dev |
735 |
535 |
$4K |
| A7038 |
Pos airway pressure filter |
2,167 |
1,561 |
$4K |
| A7005 |
Nondisposable nebulizer set |
491 |
339 |
$3K |
| E0245 |
Tub stool or bench |
71 |
53 |
$3K |
| A4624 |
Tracheal suction tube |
34 |
26 |
$3K |
| K0003 |
Lightweight wheelchair |
269 |
168 |
$3K |
| E0149 |
Heavy duty wheeled walker |
167 |
118 |
$2K |
| E0978 |
W/c acc,saf belt pelv strap |
378 |
264 |
$2K |
| L3260 |
Ambulatory surgical boot eac |
206 |
182 |
$2K |
| K0006 |
Heavy duty wheelchair |
317 |
189 |
$2K |
| E1038 |
Transport chair pt wt<=300lb |
995 |
649 |
$2K |
| A7037 |
Pos airway pressure tubing |
312 |
229 |
$2K |
| A4629 |
Tracheostomy care kit |
38 |
27 |
$2K |
| E0100 |
Cane adjust/fixed with tip |
155 |
132 |
$1K |
| A4628 |
Oropharyngeal suction cath |
127 |
99 |
$1K |
| E0431 |
Portable gaseous 02 |
207 |
146 |
$1K |
| A7033 |
Replacement nasal pillows |
108 |
83 |
$875.68 |
| A4623 |
Tracheostomy inner cannula |
39 |
29 |
$769.28 |
| A7002 |
Tubing used w suction pump |
281 |
205 |
$709.76 |
| A4217 |
Sterile water/saline, 500 ml |
37 |
27 |
$535.38 |
| E0181 |
Press pad alternating w/ pum |
146 |
102 |
$462.21 |
| E0261 |
Hosp bed semi-electr w/o mat |
14 |
12 |
$398.45 |
| A7015 |
Aerosol mask used w nebulize |
530 |
366 |
$340.65 |
| A7003 |
Nebulizer administration set |
101 |
81 |
$218.90 |
| K0007 |
Extra heavy duty wheelchair |
104 |
100 |
$134.82 |
| A7039 |
Filter, non disposable w pap |
56 |
42 |
$123.95 |
| E0165 |
Commode chair with detacharm |
119 |
74 |
$111.38 |
| A6402 |
Sterile gauze <= 16 sq in |
15 |
14 |
$60.72 |
| A7525 |
Tracheostomy mask |
74 |
54 |
$59.98 |
| A7013 |
Disposable compressor filter |
28 |
15 |
$7.05 |