| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| L4361 |
Pneuma/vac walk boot pre ots |
1,034 |
1,001 |
$260K |
| L1833 |
Ko adj jnt pos r sup pre ots |
391 |
379 |
$163K |
| L3809 |
Whfo w/o joints pre ots |
363 |
353 |
$76K |
| E0601 |
Cont airway pressure device |
1,496 |
1,469 |
$66K |
| E1390 |
Oxygen concentrator |
888 |
852 |
$57K |
| E0570 |
Nebulizer with compression |
1,714 |
1,658 |
$56K |
| L3908 |
Who cock-up nonmolde pre ots |
815 |
723 |
$53K |
| A7034 |
Nasal application device |
668 |
660 |
$42K |
| A4604 |
Tubing with heating element |
1,031 |
1,020 |
$41K |
| E0603 |
Electric breast pump |
200 |
192 |
$40K |
| T4534 |
Youth size pull-on |
264 |
258 |
$39K |
| E0114 |
Crutch underarm pair no wood |
709 |
702 |
$38K |
| T4528 |
Adult size pull-on xl |
305 |
296 |
$37K |
| A7030 |
Cpap full face mask |
407 |
404 |
$37K |
| L1902 |
Afo ankle gauntlet pre ots |
432 |
419 |
$32K |
| T4526 |
Adult size pull-on med |
280 |
267 |
$29K |
| E0562 |
Humidifier heated used w pap |
170 |
168 |
$25K |
| T4541 |
Large disposable underpad |
430 |
416 |
$22K |
| E0260 |
Hosp bed semi-electr w/ matt |
393 |
369 |
$21K |
| E0143 |
Walker folding wheeled w/o s |
383 |
374 |
$20K |
| T4527 |
Adult size pull-on lg |
222 |
215 |
$20K |
| T4535 |
Disposable liner/shield/pad |
323 |
309 |
$18K |
| A7035 |
Pos airway press headgear |
701 |
696 |
$14K |
| L3040 |
Ft arch suprt premold longit |
283 |
257 |
$12K |
| A7031 |
Replacement facemask interfa |
331 |
328 |
$12K |
| K0738 |
Portable gas oxygen system |
325 |
319 |
$11K |
| E1392 |
Portable oxygen concentrator |
331 |
317 |
$11K |
| K0001 |
Standard wheelchair |
439 |
418 |
$11K |
| A7032 |
Replacement nasal cushion |
316 |
307 |
$8K |
| T4522 |
Adult size brief/diaper med |
52 |
49 |
$8K |
| A4627 |
Spacer bag/reservoir |
253 |
250 |
$8K |
| E0118 |
Crutch substitute |
155 |
154 |
$7K |
| A7046 |
Repl water chamber, pap dev |
471 |
465 |
$6K |
| A7038 |
Pos airway pressure filter |
1,298 |
1,274 |
$6K |
| A7033 |
Replacement nasal pillows |
239 |
233 |
$5K |
| B4150 |
Ef complet w/intact nutrient |
48 |
39 |
$4K |
| A4927 |
Non-sterile gloves |
96 |
82 |
$3K |
| A7003 |
Nebulizer administration set |
710 |
687 |
$1K |
| A4385 |
Ost skn barrier sld ext wear |
12 |
12 |
$1K |
| K0739 |
Repair/svc dme non-oxygen eq |
27 |
24 |
$988.55 |
| L1830 |
Ko immob canvas long pre ots |
15 |
14 |
$892.43 |
| K0195 |
Elevating whlchair leg rests |
51 |
49 |
$770.24 |
| K0003 |
Lightweight wheelchair |
15 |
13 |
$650.62 |