| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
8,989 |
7,994 |
$343K |
| E0601 |
Cont airway pressure device |
3,761 |
3,526 |
$143K |
| E0570 |
Nebulizer with compression |
3,377 |
2,902 |
$115K |
| A7031 |
Replacement facemask interfa |
3,460 |
3,275 |
$95K |
| A7030 |
Cpap full face mask |
1,770 |
1,605 |
$88K |
| E0260 |
Hosp bed semi-electr w/ matt |
2,295 |
2,003 |
$48K |
| E0143 |
Walker folding wheeled w/o s |
1,707 |
1,543 |
$47K |
| E0431 |
Portable gaseous 02 |
5,162 |
4,618 |
$47K |
| E0562 |
Humidifier heated used w pap |
4,473 |
4,124 |
$47K |
| K0001 |
Standard wheelchair |
3,641 |
3,179 |
$38K |
| E0163 |
Commode chair with fixed arm |
1,057 |
945 |
$31K |
| A7037 |
Pos airway pressure tubing |
3,214 |
3,015 |
$30K |
| L4387 |
Non-pneum walk boot pre ots |
246 |
236 |
$28K |
| E0470 |
Rad w/o backup non-inv intfc |
438 |
380 |
$27K |
| A7035 |
Pos airway press headgear |
1,897 |
1,776 |
$25K |
| A7038 |
Pos airway pressure filter |
5,694 |
5,353 |
$18K |
| L3908 |
Who cock-up nonmolde pre ots |
407 |
295 |
$14K |
| E0603 |
Electric breast pump |
69 |
64 |
$13K |
| A6238 |
Hydrocolld drg >16<=48 w/bdr |
210 |
198 |
$12K |
| E1392 |
Portable oxygen concentrator |
872 |
702 |
$11K |
| A7046 |
Repl water chamber, pap dev |
1,052 |
974 |
$10K |
| A7039 |
Filter, non disposable w pap |
1,380 |
1,293 |
$6K |
| A4414 |
Ost sknbar w/o conv<=4 sq in |
106 |
99 |
$5K |
| A7003 |
Nebulizer administration set |
1,768 |
1,625 |
$4K |
| A4456 |
Adhesive remover, wipes |
443 |
407 |
$3K |
| A5063 |
Drain ostomy pouch w/flange |
105 |
92 |
$3K |
| E0118 |
Crutch substitute |
48 |
35 |
$1K |
| A6402 |
Sterile gauze <= 16 sq in |
154 |
125 |
$1K |
| E0114 |
Crutch underarm pair no wood |
12 |
12 |
$431.28 |
| A4604 |
Tubing with heating element |
14 |
14 |
$379.30 |
| K0195 |
Elevating whlchair leg rests |
46 |
38 |
$173.80 |
| A4450 |
Non-waterproof tape |
117 |
88 |
$138.08 |
| E0156 |
Walker seat attachment |
12 |
12 |
$96.91 |
| A7015 |
Aerosol mask used w nebulize |
26 |
26 |
$34.37 |