| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
14,534 |
13,500 |
$774K |
| A7030 |
Cpap full face mask |
3,065 |
2,905 |
$229K |
| L4387 |
Non-pneum walk boot pre ots |
1,224 |
1,142 |
$167K |
| E0601 |
Cont airway pressure device |
4,229 |
3,923 |
$156K |
| A4604 |
Tubing with heating element |
4,733 |
4,500 |
$156K |
| E0470 |
Rad w/o backup non-inv intfc |
1,758 |
1,656 |
$134K |
| A7034 |
Nasal application device |
1,730 |
1,654 |
$97K |
| E0431 |
Portable gaseous 02 |
7,601 |
6,899 |
$86K |
| L3908 |
Who cock-up nonmolde pre ots |
1,573 |
1,342 |
$70K |
| A7031 |
Replacement facemask interfa |
2,120 |
2,016 |
$61K |
| L4386 |
Non-pneum walk boot pre cst |
386 |
360 |
$48K |
| A7035 |
Pos airway press headgear |
2,950 |
2,800 |
$48K |
| A7032 |
Replacement nasal cushion |
1,539 |
1,463 |
$41K |
| E0562 |
Humidifier heated used w pap |
302 |
288 |
$38K |
| E1392 |
Portable oxygen concentrator |
1,700 |
1,578 |
$34K |
| A4351 |
Straight tip urine catheter |
171 |
152 |
$30K |
| A7038 |
Pos airway pressure filter |
7,125 |
6,751 |
$28K |
| E1028 |
W/c manual swingaway |
717 |
540 |
$27K |
| E0114 |
Crutch underarm pair no wood |
563 |
534 |
$26K |
| E0471 |
Rad w/backup non inv intrfc |
141 |
136 |
$24K |
| A7046 |
Repl water chamber, pap dev |
2,215 |
2,096 |
$23K |
| E0570 |
Nebulizer with compression |
3,359 |
3,229 |
$22K |
| A6530 |
Compression stocking bk18-30 |
97 |
85 |
$7K |
| K0738 |
Portable gas oxygen system |
277 |
264 |
$6K |
| E0260 |
Hosp bed semi-electr w/ matt |
265 |
245 |
$6K |
| A4565 |
Slings |
756 |
731 |
$6K |
| K0003 |
Lightweight wheelchair |
291 |
242 |
$6K |
| K0739 |
Repair/svc dme non-oxygen eq |
285 |
195 |
$5K |
| K0108 |
W/c component-accessory nos |
192 |
52 |
$5K |
| E0261 |
Hosp bed semi-electr w/o mat |
116 |
100 |
$4K |
| A4409 |
Ost skn barr convex <=4 sq i |
40 |
37 |
$3K |
| E0143 |
Walker folding wheeled w/o s |
66 |
63 |
$2K |
| A4406 |
Pectin based ostomy paste |
189 |
179 |
$2K |
| A4419 |
Ost pch for bar w flange/flt |
53 |
49 |
$2K |
| A7005 |
Nondisposable nebulizer set |
86 |
83 |
$1K |
| A7033 |
Replacement nasal pillows |
12 |
12 |
$298.05 |
| A7015 |
Aerosol mask used w nebulize |
104 |
102 |
$109.86 |
| A7003 |
Nebulizer administration set |
45 |
43 |
$87.38 |
| A4357 |
Bedside drainage bag |
13 |
12 |
$67.56 |