| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
2,286 |
1,954 |
$99K |
| E0570 |
Nebulizer with compression |
1,664 |
1,341 |
$42K |
| A6021 |
Collagen dressing <=16 sq in |
253 |
177 |
$28K |
| E0431 |
Portable gaseous 02 |
2,492 |
2,109 |
$25K |
| A6212 |
Foam drg <=16 sq in w/border |
314 |
153 |
$22K |
| L4361 |
Pneuma/vac walk boot pre ots |
134 |
100 |
$19K |
| A6446 |
Conform band s w>=3" <5"/yd |
862 |
560 |
$19K |
| A6252 |
Absorpt drg >16 <=48 w/o bdr |
310 |
156 |
$17K |
| A6402 |
Sterile gauze <= 16 sq in |
1,149 |
730 |
$13K |
| E0143 |
Walker folding wheeled w/o s |
345 |
280 |
$11K |
| A4452 |
Waterproof tape |
565 |
339 |
$9K |
| E0114 |
Crutch underarm pair no wood |
260 |
241 |
$8K |
| E0603 |
Electric breast pump |
43 |
42 |
$4K |
| A7030 |
Cpap full face mask |
34 |
33 |
$2K |
| A7005 |
Nondisposable nebulizer set |
154 |
142 |
$2K |
| A4604 |
Tubing with heating element |
40 |
38 |
$1K |
| A6549 |
Grad com garm noc day use |
27 |
13 |
$929.99 |
| L0621 |
Sio flex pelvic/sacr pre ots |
12 |
12 |
$902.14 |
| A7034 |
Nasal application device |
13 |
13 |
$682.07 |
| A4649 |
Surgical supplies |
52 |
27 |
$560.23 |
| A7035 |
Pos airway press headgear |
30 |
30 |
$393.92 |
| A7038 |
Pos airway pressure filter |
78 |
75 |
$329.77 |
| A7039 |
Filter, non disposable w pap |
26 |
26 |
$124.66 |
| A7003 |
Nebulizer administration set |
68 |
54 |
$17.74 |