| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
9,908 |
8,732 |
$607K |
| E0601 |
Cont airway pressure device |
3,224 |
2,796 |
$107K |
| E0570 |
Nebulizer with compression |
1,989 |
1,750 |
$59K |
| K0738 |
Portable gas oxygen system |
2,645 |
2,296 |
$57K |
| B4160 |
Ef ped caloric dense>/=0.7kc |
184 |
162 |
$41K |
| E0431 |
Portable gaseous 02 |
3,465 |
3,003 |
$40K |
| E0114 |
Crutch underarm pair no wood |
1,073 |
864 |
$40K |
| E0603 |
Electric breast pump |
371 |
323 |
$39K |
| K0001 |
Standard wheelchair |
2,604 |
2,181 |
$39K |
| A4604 |
Tubing with heating element |
1,525 |
1,257 |
$36K |
| E1392 |
Portable oxygen concentrator |
1,706 |
1,463 |
$34K |
| E0562 |
Humidifier heated used w pap |
1,983 |
1,660 |
$33K |
| L4387 |
Non-pneum walk boot pre ots |
262 |
221 |
$29K |
| E0143 |
Walker folding wheeled w/o s |
549 |
467 |
$22K |
| A7030 |
Cpap full face mask |
294 |
238 |
$17K |
| A7034 |
Nasal application device |
349 |
290 |
$13K |
| A7035 |
Pos airway press headgear |
779 |
630 |
$11K |
| A7038 |
Pos airway pressure filter |
1,636 |
1,348 |
$10K |
| B4035 |
Enteral feed supp pump per d |
33 |
25 |
$7K |
| E0445 |
Oximeter non-invasive |
228 |
177 |
$6K |
| L3908 |
Who cock-up nonmolde pre ots |
140 |
120 |
$6K |
| A7031 |
Replacement facemask interfa |
132 |
111 |
$5K |
| E0118 |
Crutch substitute |
144 |
117 |
$3K |
| A7046 |
Repl water chamber, pap dev |
350 |
277 |
$2K |
| A7003 |
Nebulizer administration set |
548 |
471 |
$2K |
| B9998 |
Enteral supp not otherwise c |
66 |
49 |
$2K |
| A4335 |
Incontinence supply |
152 |
125 |
$2K |
| L3809 |
Whfo w/o joints pre ots |
16 |
13 |
$1K |
| A5120 |
Skin barrier, wipe or swab |
137 |
96 |
$934.39 |
| E0990 |
Wheelchair elevating leg res |
79 |
55 |
$428.22 |
| A7032 |
Replacement nasal cushion |
14 |
13 |
$376.88 |
| E0776 |
Iv pole |
12 |
12 |
$79.68 |
| A6402 |
Sterile gauze <= 16 sq in |
12 |
12 |
$67.85 |