| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
2,889 |
2,730 |
$262K |
| E0601 |
Cont airway pressure device |
1,566 |
1,465 |
$100K |
| E0570 |
Nebulizer with compression |
2,074 |
2,054 |
$97K |
| A7030 |
Cpap full face mask |
470 |
470 |
$37K |
| E0562 |
Humidifier heated used w pap |
788 |
703 |
$32K |
| E0114 |
Crutch underarm pair no wood |
1,121 |
1,118 |
$30K |
| E0431 |
Portable gaseous 02 |
1,334 |
1,266 |
$27K |
| L3908 |
Who cock-up nonmolde pre ots |
432 |
409 |
$18K |
| E0603 |
Electric breast pump |
105 |
105 |
$18K |
| K0738 |
Portable gas oxygen system |
681 |
644 |
$12K |
| A7035 |
Pos airway press headgear |
728 |
726 |
$10K |
| K0001 |
Standard wheelchair |
544 |
511 |
$10K |
| A7034 |
Nasal application device |
230 |
228 |
$9K |
| A7037 |
Pos airway pressure tubing |
700 |
699 |
$8K |
| E1392 |
Portable oxygen concentrator |
109 |
103 |
$7K |
| E0260 |
Hosp bed semi-electr w/ matt |
452 |
440 |
$7K |
| L1820 |
Ko elas w/ condyle pads & jo |
66 |
65 |
$5K |
| E0143 |
Walker folding wheeled w/o s |
95 |
95 |
$5K |
| L1902 |
Afo ankle gauntlet pre ots |
76 |
76 |
$3K |
| A7038 |
Pos airway pressure filter |
935 |
930 |
$3K |
| L4361 |
Pneuma/vac walk boot pre ots |
15 |
15 |
$2K |
| A7039 |
Filter, non disposable w pap |
543 |
542 |
$2K |
| A7003 |
Nebulizer administration set |
717 |
714 |
$1K |
| A7031 |
Replacement facemask interfa |
25 |
25 |
$803.57 |
| A7015 |
Aerosol mask used w nebulize |
32 |
31 |
$33.56 |