| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
11,614 |
9,109 |
$724K |
| E0601 |
Cont airway pressure device |
8,935 |
7,235 |
$364K |
| E0562 |
Humidifier heated used w pap |
1,840 |
1,309 |
$206K |
| L4386 |
Non-pneum walk boot pre cst |
1,241 |
1,217 |
$183K |
| A7030 |
Cpap full face mask |
2,442 |
1,789 |
$176K |
| K0001 |
Standard wheelchair |
6,554 |
5,205 |
$164K |
| L3908 |
Who cock-up nonmolde pre ots |
3,194 |
2,987 |
$147K |
| E0431 |
Portable gaseous 02 |
9,679 |
7,974 |
$137K |
| E0260 |
Hosp bed semi-electr w/ matt |
3,673 |
2,371 |
$128K |
| E0114 |
Crutch underarm pair no wood |
2,728 |
2,671 |
$127K |
| A4604 |
Tubing with heating element |
5,488 |
4,188 |
$121K |
| L4361 |
Pneuma/vac walk boot pre ots |
603 |
589 |
$114K |
| E0143 |
Walker folding wheeled w/o s |
4,254 |
3,077 |
$108K |
| L1902 |
Afo ankle gauntlet pre ots |
1,330 |
1,287 |
$81K |
| K0003 |
Lightweight wheelchair |
1,951 |
1,496 |
$72K |
| A7034 |
Nasal application device |
1,543 |
1,178 |
$70K |
| E0570 |
Nebulizer with compression |
4,432 |
3,223 |
$69K |
| L1820 |
Ko elas w/ condyle pads & jo |
745 |
692 |
$68K |
| L4360 |
Pneumat walking boot pre cst |
262 |
258 |
$66K |
| A4627 |
Spacer bag/reservoir |
1,454 |
1,371 |
$63K |
| A7035 |
Pos airway press headgear |
3,901 |
2,951 |
$57K |
| A7031 |
Replacement facemask interfa |
2,749 |
2,129 |
$50K |
| E0470 |
Rad w/o backup non-inv intfc |
640 |
487 |
$50K |
| K0195 |
Elevating whlchair leg rests |
5,412 |
4,022 |
$47K |
| E0163 |
Commode chair with fixed arm |
1,776 |
1,282 |
$47K |
| K0007 |
Extra heavy duty wheelchair |
558 |
441 |
$33K |
| A7038 |
Pos airway pressure filter |
8,634 |
6,714 |
$27K |
| E0630 |
Patient lift hydraulic |
893 |
653 |
$26K |
| L3660 |
So 8 ab rstr can/web pre ots |
333 |
326 |
$26K |
| L3809 |
Whfo w/o joints pre ots |
118 |
111 |
$22K |
| A7526 |
Tracheostomy tube collar |
1,305 |
950 |
$21K |
| A4629 |
Tracheostomy care kit |
394 |
302 |
$21K |
| A7046 |
Repl water chamber, pap dev |
2,483 |
1,969 |
$19K |
| E1060 |
Wheelchair detachable arms |
284 |
212 |
$15K |
| L1830 |
Ko immob canvas long pre ots |
174 |
168 |
$15K |
| E0149 |
Heavy duty wheeled walker |
767 |
456 |
$13K |
| E0600 |
Suction pump portab hom modl |
687 |
533 |
$12K |
| A4624 |
Tracheal suction tube |
364 |
260 |
$10K |
| A7032 |
Replacement nasal cushion |
556 |
470 |
$9K |
| A4623 |
Tracheostomy inner cannula |
146 |
102 |
$6K |
| A7000 |
Disposable canister for pump |
713 |
513 |
$5K |
| A4565 |
Slings |
630 |
621 |
$5K |
| K0006 |
Heavy duty wheelchair |
59 |
52 |
$4K |
| E0971 |
Wheelchair anti-tipping devi |
1,760 |
938 |
$4K |
| E0445 |
Oximeter non-invasive |
70 |
43 |
$3K |
| A7003 |
Nebulizer administration set |
1,261 |
986 |
$3K |
| A6402 |
Sterile gauze <= 16 sq in |
354 |
236 |
$2K |
| A7002 |
Tubing used w suction pump |
805 |
595 |
$2K |
| L4350 |
Ankle control ortho pre ots |
16 |
16 |
$1K |
| A7033 |
Replacement nasal pillows |
110 |
94 |
$1K |
| E0165 |
Commode chair with detacharm |
19 |
12 |
$1K |
| L1812 |
Ko elastic w/joints pre ots |
12 |
12 |
$1K |
| E1392 |
Portable oxygen concentrator |
195 |
158 |
$1K |
| L3260 |
Ambulatory surgical boot eac |
31 |
29 |
$954.80 |
| E0910 |
Trapeze bar attached to bed |
77 |
62 |
$519.85 |
| A7015 |
Aerosol mask used w nebulize |
658 |
523 |
$510.82 |
| A4628 |
Oropharyngeal suction cath |
18 |
13 |
$318.17 |
| E0156 |
Walker seat attachment |
33 |
24 |
$106.66 |
| A4927 |
Non-sterile gloves |
26 |
12 |
$67.43 |