| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A4520 |
Incontinence garment anytype |
3,214 |
2,958 |
$343K |
| E1390 |
Oxygen concentrator |
4,932 |
4,622 |
$155K |
| L4387 |
Non-pneum walk boot pre ots |
718 |
625 |
$87K |
| E0601 |
Cont airway pressure device |
1,682 |
1,569 |
$81K |
| L3908 |
Who cock-up nonmolde pre ots |
1,319 |
1,082 |
$56K |
| A7030 |
Cpap full face mask |
496 |
468 |
$55K |
| B4035 |
Enteral feed supp pump per d |
167 |
137 |
$40K |
| E0603 |
Electric breast pump |
436 |
346 |
$40K |
| E1392 |
Portable oxygen concentrator |
3,276 |
3,083 |
$38K |
| A4604 |
Tubing with heating element |
1,149 |
1,061 |
$36K |
| E0562 |
Humidifier heated used w pap |
1,776 |
1,652 |
$33K |
| A7031 |
Replacement facemask interfa |
869 |
811 |
$29K |
| E0570 |
Nebulizer with compression |
343 |
310 |
$20K |
| E0114 |
Crutch underarm pair no wood |
443 |
384 |
$18K |
| A7035 |
Pos airway press headgear |
874 |
805 |
$14K |
| E0143 |
Walker folding wheeled w/o s |
291 |
269 |
$7K |
| A7038 |
Pos airway pressure filter |
1,736 |
1,569 |
$6K |
| K0001 |
Standard wheelchair |
207 |
197 |
$4K |
| A7046 |
Repl water chamber, pap dev |
318 |
287 |
$3K |
| A4565 |
Slings |
152 |
142 |
$1K |
| A4554 |
Disposable underpads |
37 |
36 |
$1K |
| A7003 |
Nebulizer administration set |
106 |
95 |
$359.87 |
| E0431 |
Portable gaseous 02 |
40 |
36 |
$95.23 |
| A6402 |
Sterile gauze <= 16 sq in |
21 |
12 |
$34.08 |
| A4615 |
Cannula nasal |
43 |
27 |
$5.12 |