| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| L4360 |
Pneumat walking boot pre cst |
6,566 |
6,363 |
$970K |
| E1390 |
Oxygen concentrator |
14,377 |
12,783 |
$594K |
| L3807 |
Whfo w/o joints pre cst |
3,961 |
3,826 |
$517K |
| L4350 |
Ankle control ortho pre ots |
7,766 |
7,508 |
$405K |
| E0114 |
Crutch underarm pair no wood |
17,837 |
17,269 |
$363K |
| L3650 |
So 8 abd restraint pre ots |
9,712 |
9,269 |
$357K |
| K0003 |
Lightweight wheelchair |
6,285 |
5,482 |
$218K |
| E0260 |
Hosp bed semi-electr w/ matt |
3,218 |
2,725 |
$190K |
| L1830 |
Ko immob canvas long pre ots |
4,352 |
4,158 |
$185K |
| L3908 |
Who cock-up nonmolde pre ots |
3,889 |
3,690 |
$143K |
| E0601 |
Cont airway pressure device |
2,952 |
2,569 |
$106K |
| E0570 |
Nebulizer with compression |
6,358 |
5,849 |
$105K |
| E0431 |
Portable gaseous 02 |
6,697 |
5,910 |
$103K |
| E0143 |
Walker folding wheeled w/o s |
2,419 |
2,244 |
$77K |
| L1820 |
Ko elas w/ condyle pads & jo |
907 |
875 |
$68K |
| E0630 |
Patient lift hydraulic |
1,738 |
1,478 |
$48K |
| E1392 |
Portable oxygen concentrator |
3,208 |
2,745 |
$42K |
| E0250 |
Hosp bed fixed ht w/ mattres |
4,246 |
3,741 |
$39K |
| K0001 |
Standard wheelchair |
1,812 |
1,612 |
$36K |
| E0562 |
Humidifier heated used w pap |
586 |
488 |
$24K |
| K0007 |
Extra heavy duty wheelchair |
285 |
237 |
$22K |
| E0470 |
Rad w/o backup non-inv intfc |
210 |
171 |
$19K |
| A7030 |
Cpap full face mask |
409 |
353 |
$19K |
| L4361 |
Pneuma/vac walk boot pre ots |
596 |
549 |
$14K |
| A7005 |
Nondisposable nebulizer set |
996 |
900 |
$13K |
| E0990 |
Wheelchair elevating leg res |
467 |
374 |
$13K |
| K0738 |
Portable gas oxygen system |
886 |
775 |
$13K |
| A7035 |
Pos airway press headgear |
833 |
710 |
$12K |
| T4541 |
Large disposable underpad |
360 |
318 |
$12K |
| E0135 |
Walker folding adjust/fixed |
387 |
363 |
$12K |
| E0181 |
Press pad alternating w/ pum |
1,292 |
1,136 |
$12K |
| T4535 |
Disposable liner/shield/pad |
269 |
242 |
$11K |
| L3660 |
So 8 ab rstr can/web pre ots |
1,034 |
970 |
$10K |
| E0303 |
Hosp bed hvy dty xtra wide |
82 |
78 |
$10K |
| A7037 |
Pos airway pressure tubing |
947 |
822 |
$10K |
| K0006 |
Heavy duty wheelchair |
127 |
108 |
$9K |
| T4527 |
Adult size pull-on lg |
108 |
102 |
$8K |
| K0195 |
Elevating whlchair leg rests |
2,878 |
2,513 |
$8K |
| L3809 |
Whfo w/o joints pre ots |
231 |
220 |
$8K |
| T4544 |
Adlt disp und/pull on abv xl |
41 |
39 |
$6K |
| E0149 |
Heavy duty wheeled walker |
215 |
188 |
$6K |
| A4570 |
Splint |
816 |
755 |
$6K |
| A4927 |
Non-sterile gloves |
400 |
359 |
$6K |
| L0174 |
Cerv sr 2pc thor ext pre ots |
41 |
39 |
$5K |
| A7031 |
Replacement facemask interfa |
172 |
144 |
$5K |
| T4528 |
Adult size pull-on xl |
69 |
63 |
$5K |
| A7034 |
Nasal application device |
168 |
135 |
$5K |
| L1832 |
Ko adj jnt pos r sup pre cst |
16 |
12 |
$5K |
| A7038 |
Pos airway pressure filter |
1,449 |
1,165 |
$4K |
| E1038 |
Transport chair pt wt<=300lb |
701 |
649 |
$4K |
| B4152 |
Ef calorie dense>/=1.5kcal |
66 |
47 |
$4K |
| A7039 |
Filter, non disposable w pap |
678 |
566 |
$4K |
| T4526 |
Adult size pull-on med |
53 |
49 |
$3K |
| T4537 |
Reusable underpad bed size |
34 |
32 |
$3K |
| T4543 |
Adult disp brief/diap abv xl |
14 |
14 |
$2K |
| E0627 |
Seat lift mech, electric any |
36 |
27 |
$2K |
| B4154 |
Ef spec metabolic noninherit |
22 |
16 |
$2K |
| A7003 |
Nebulizer administration set |
1,325 |
1,164 |
$2K |
| T4540 |
Reusable underpad chair size |
33 |
31 |
$2K |
| B4150 |
Ef complet w/intact nutrient |
20 |
16 |
$1K |
| E2601 |
Gen w/c cushion wdth < 22 in |
63 |
53 |
$1K |
| E0165 |
Commode chair with detacharm |
142 |
135 |
$784.09 |
| A7015 |
Aerosol mask used w nebulize |
460 |
362 |
$778.78 |
| A7032 |
Replacement nasal cushion |
20 |
12 |
$711.96 |
| E0100 |
Cane adjust/fixed with tip |
93 |
92 |
$678.20 |
| E0971 |
Wheelchair anti-tipping devi |
15 |
12 |
$664.31 |
| L0120 |
Cerv flex n/adj foam pre ots |
25 |
25 |
$363.47 |
| E0910 |
Trapeze bar attached to bed |
55 |
51 |
$293.54 |
| A7046 |
Repl water chamber, pap dev |
116 |
94 |
$263.67 |
| A4604 |
Tubing with heating element |
28 |
24 |
$258.52 |
| A7013 |
Disposable compressor filter |
25 |
15 |
$1.14 |