| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
5,689 |
5,303 |
$499K |
| E0570 |
Nebulizer with compression |
4,283 |
4,064 |
$397K |
| E0601 |
Cont airway pressure device |
3,104 |
2,927 |
$193K |
| A7030 |
Cpap full face mask |
1,174 |
1,116 |
$127K |
| E0470 |
Rad w/o backup non-inv intfc |
797 |
771 |
$101K |
| L4361 |
Pneuma/vac walk boot pre ots |
520 |
463 |
$89K |
| L3908 |
Who cock-up nonmolde pre ots |
2,114 |
1,784 |
$78K |
| E0431 |
Portable gaseous 02 |
4,272 |
3,981 |
$72K |
| T4527 |
Adult size pull-on lg |
538 |
506 |
$67K |
| E0114 |
Crutch underarm pair no wood |
1,703 |
1,642 |
$59K |
| L3809 |
Whfo w/o joints pre ots |
303 |
285 |
$51K |
| L1902 |
Afo ankle gauntlet pre ots |
889 |
823 |
$46K |
| A7035 |
Pos airway press headgear |
1,977 |
1,886 |
$45K |
| L4360 |
Pneumat walking boot pre cst |
229 |
227 |
$44K |
| E0562 |
Humidifier heated used w pap |
544 |
508 |
$35K |
| A7034 |
Nasal application device |
459 |
444 |
$22K |
| T4528 |
Adult size pull-on xl |
129 |
124 |
$15K |
| E0603 |
Electric breast pump |
174 |
168 |
$13K |
| T4534 |
Youth size pull-on |
114 |
106 |
$12K |
| T4535 |
Disposable liner/shield/pad |
284 |
255 |
$12K |
| A7003 |
Nebulizer administration set |
2,706 |
2,604 |
$12K |
| T4526 |
Adult size pull-on med |
103 |
99 |
$10K |
| A7039 |
Filter, non disposable w pap |
1,108 |
1,066 |
$10K |
| A4627 |
Spacer bag/reservoir |
318 |
310 |
$9K |
| L4387 |
Non-pneum walk boot pre ots |
65 |
64 |
$8K |
| A7037 |
Pos airway pressure tubing |
2,077 |
1,984 |
$6K |
| K0001 |
Standard wheelchair |
230 |
214 |
$6K |
| A4554 |
Disposable underpads |
118 |
115 |
$5K |
| A4351 |
Straight tip urine catheter |
38 |
37 |
$4K |
| A5500 |
Diab shoe for density insert |
79 |
53 |
$3K |
| A6530 |
Compression stocking bk18-30 |
31 |
27 |
$2K |
| E0143 |
Walker folding wheeled w/o s |
42 |
38 |
$2K |
| S5170 |
Homedelivered prepared meal |
30 |
24 |
$2K |
| A7031 |
Replacement facemask interfa |
58 |
56 |
$2K |
| A5512 |
Multi den insert direct form |
78 |
52 |
$2K |
| E0260 |
Hosp bed semi-electr w/ matt |
14 |
14 |
$772.00 |
| A7038 |
Pos airway pressure filter |
104 |
99 |
$360.00 |
| L3260 |
Ambulatory surgical boot eac |
14 |
13 |
$240.17 |
| A4565 |
Slings |
39 |
39 |
$222.61 |