| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E0466 |
Home vent non-invasive inter |
1,427 |
1,206 |
$618K |
| L4360 |
Pneumat walking boot pre cst |
4,050 |
3,921 |
$418K |
| L1832 |
Ko adj jnt pos r sup pre cst |
1,339 |
1,278 |
$394K |
| E1390 |
Oxygen concentrator |
8,306 |
7,651 |
$377K |
| E0601 |
Cont airway pressure device |
8,490 |
7,949 |
$288K |
| A7030 |
Cpap full face mask |
3,041 |
2,835 |
$130K |
| E0562 |
Humidifier heated used w pap |
2,746 |
2,579 |
$129K |
| E0470 |
Rad w/o backup non-inv intfc |
1,345 |
1,271 |
$122K |
| L3807 |
Whfo w/o joints pre cst |
1,015 |
956 |
$94K |
| L3908 |
Who cock-up nonmolde pre ots |
3,317 |
2,801 |
$90K |
| L1810 |
Ko elastic with joints |
1,853 |
1,639 |
$76K |
| E0431 |
Portable gaseous 02 |
3,870 |
3,583 |
$71K |
| L1852 |
Ko double upright prefab ots |
189 |
179 |
$70K |
| L2795 |
Knee control full kneecap |
1,831 |
1,617 |
$59K |
| L1902 |
Afo ankle gauntlet pre ots |
1,662 |
1,572 |
$49K |
| E1392 |
Portable oxygen concentrator |
2,094 |
1,940 |
$39K |
| A7035 |
Pos airway press headgear |
3,072 |
2,854 |
$39K |
| A7037 |
Pos airway pressure tubing |
3,765 |
3,504 |
$37K |
| E0114 |
Crutch underarm pair no wood |
2,149 |
2,138 |
$33K |
| L1820 |
Ko elas w/ condyle pads & jo |
579 |
541 |
$33K |
| A7034 |
Nasal application device |
1,226 |
1,143 |
$29K |
| K0001 |
Standard wheelchair |
900 |
825 |
$18K |
| E0570 |
Nebulizer with compression |
1,418 |
1,311 |
$17K |
| E0260 |
Hosp bed semi-electr w/ matt |
603 |
526 |
$16K |
| L3670 |
So acro/clav can web pre ots |
365 |
356 |
$15K |
| L3650 |
So 8 abd restraint pre ots |
549 |
538 |
$15K |
| L3984 |
Upper ext fx orthosis wrist |
101 |
99 |
$13K |
| L4350 |
Ankle control ortho pre ots |
169 |
165 |
$6K |
| E0730 |
Tens four lead |
50 |
45 |
$6K |
| A7038 |
Pos airway pressure filter |
4,407 |
4,019 |
$6K |
| A7031 |
Replacement facemask interfa |
471 |
389 |
$4K |
| L3982 |
Upper ext fx orthosis rad/ul |
25 |
25 |
$4K |
| A4595 |
Tens suppl 2 lead per month |
233 |
220 |
$3K |
| K0195 |
Elevating whlchair leg rests |
832 |
768 |
$3K |
| E0143 |
Walker folding wheeled w/o s |
103 |
85 |
$2K |
| A4604 |
Tubing with heating element |
207 |
196 |
$2K |
| A7046 |
Repl water chamber, pap dev |
677 |
630 |
$1K |
| A7039 |
Filter, non disposable w pap |
254 |
229 |
$873.09 |
| A7036 |
Pos airway press chinstrap |
13 |
12 |
$72.76 |
| A7003 |
Nebulizer administration set |
17 |
17 |
$19.61 |