| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A7030 |
Cpap full face mask |
4,383 |
4,156 |
$424K |
| E0601 |
Cont airway pressure device |
9,409 |
8,360 |
$386K |
| E1390 |
Oxygen concentrator |
5,632 |
4,926 |
$317K |
| E0562 |
Humidifier heated used w pap |
9,953 |
8,832 |
$223K |
| A7034 |
Nasal application device |
1,986 |
1,882 |
$120K |
| A7035 |
Pos airway press headgear |
5,311 |
5,063 |
$118K |
| E0431 |
Portable gaseous 02 |
2,380 |
2,075 |
$113K |
| A7037 |
Pos airway pressure tubing |
4,848 |
4,632 |
$112K |
| E0570 |
Nebulizer with compression |
3,554 |
3,224 |
$58K |
| E0114 |
Crutch underarm pair no wood |
1,499 |
1,419 |
$51K |
| A7038 |
Pos airway pressure filter |
8,268 |
7,830 |
$39K |
| A7031 |
Replacement facemask interfa |
1,388 |
1,337 |
$36K |
| E0603 |
Electric breast pump |
217 |
201 |
$30K |
| A7046 |
Repl water chamber, pap dev |
3,754 |
3,575 |
$27K |
| A7005 |
Nondisposable nebulizer set |
1,652 |
1,566 |
$22K |
| E1392 |
Portable oxygen concentrator |
1,286 |
1,135 |
$17K |
| A4604 |
Tubing with heating element |
1,039 |
994 |
$7K |
| L4361 |
Pneuma/vac walk boot pre ots |
99 |
96 |
$7K |
| E0260 |
Hosp bed semi-electr w/ matt |
531 |
482 |
$6K |
| L3908 |
Who cock-up nonmolde pre ots |
277 |
240 |
$5K |
| E0143 |
Walker folding wheeled w/o s |
233 |
220 |
$5K |
| K0001 |
Standard wheelchair |
477 |
411 |
$5K |
| K0002 |
Stnd hemi (low seat) whlchr |
187 |
180 |
$2K |
| E0971 |
Wheelchair anti-tipping devi |
1,502 |
954 |
$2K |
| A6402 |
Sterile gauze <= 16 sq in |
291 |
211 |
$2K |
| A6443 |
Conform band n/s w>=3"<5"/yd |
208 |
126 |
$968.90 |
| A7033 |
Replacement nasal pillows |
59 |
54 |
$938.11 |
| A4450 |
Non-waterproof tape |
219 |
162 |
$920.86 |
| E0470 |
Rad w/o backup non-inv intfc |
12 |
12 |
$733.82 |
| L1812 |
Ko elastic w/joints pre ots |
13 |
12 |
$445.13 |
| A4409 |
Ost skn barr convex <=4 sq i |
13 |
12 |
$264.19 |
| A7032 |
Replacement nasal cushion |
26 |
24 |
$243.61 |
| K0738 |
Portable gas oxygen system |
25 |
24 |
$228.83 |
| A7015 |
Aerosol mask used w nebulize |
152 |
148 |
$186.39 |