| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
14,933 |
14,741 |
$1.17M |
| E0601 |
Cont airway pressure device |
10,158 |
10,039 |
$514K |
| L4361 |
Pneuma/vac walk boot pre ots |
1,549 |
1,542 |
$243K |
| B4150 |
Ef complet w/intact nutrient |
1,951 |
1,855 |
$217K |
| E0470 |
Rad w/o backup non-inv intfc |
1,956 |
1,916 |
$210K |
| E0431 |
Portable gaseous 02 |
12,296 |
12,120 |
$194K |
| A7030 |
Cpap full face mask |
2,563 |
2,478 |
$165K |
| E0114 |
Crutch underarm pair no wood |
5,702 |
5,639 |
$161K |
| E0570 |
Nebulizer with compression |
4,852 |
4,742 |
$146K |
| L3809 |
Whfo w/o joints pre ots |
1,003 |
991 |
$136K |
| E0562 |
Humidifier heated used w pap |
9,561 |
9,501 |
$121K |
| L4350 |
Ankle control ortho pre ots |
1,365 |
1,358 |
$88K |
| A7034 |
Nasal application device |
2,013 |
1,942 |
$82K |
| E0260 |
Hosp bed semi-electr w/ matt |
2,096 |
2,046 |
$75K |
| A7038 |
Pos airway pressure filter |
4,240 |
4,118 |
$75K |
| L3908 |
Who cock-up nonmolde pre ots |
1,720 |
1,583 |
$72K |
| E0143 |
Walker folding wheeled w/o s |
1,322 |
1,292 |
$71K |
| A7035 |
Pos airway press headgear |
3,654 |
3,539 |
$67K |
| A7037 |
Pos airway pressure tubing |
3,007 |
2,950 |
$62K |
| L1830 |
Ko immob canvas long pre ots |
1,102 |
1,097 |
$54K |
| K0001 |
Standard wheelchair |
3,093 |
3,016 |
$51K |
| L3660 |
So 8 ab rstr can/web pre ots |
841 |
840 |
$46K |
| L3260 |
Ambulatory surgical boot eac |
1,206 |
1,203 |
$36K |
| A7031 |
Replacement facemask interfa |
938 |
895 |
$28K |
| E0466 |
Home vent non-invasive inter |
25 |
25 |
$16K |
| K0553 |
Ther cgm supply allowance |
239 |
229 |
$14K |
| K0003 |
Lightweight wheelchair |
360 |
356 |
$11K |
| E0730 |
Tens four lead |
365 |
363 |
$11K |
| A7046 |
Repl water chamber, pap dev |
1,546 |
1,518 |
$9K |
| E0250 |
Hosp bed fixed ht w/ mattres |
255 |
241 |
$8K |
| B4152 |
Ef calorie dense>/=1.5kcal |
60 |
54 |
$6K |
| A4604 |
Tubing with heating element |
702 |
670 |
$5K |
| A4670 |
Automatic bp monitor, dial |
92 |
92 |
$5K |
| A7032 |
Replacement nasal cushion |
147 |
139 |
$5K |
| A6530 |
Compression stocking bk18-30 |
116 |
87 |
$5K |
| E0149 |
Heavy duty wheeled walker |
250 |
223 |
$4K |
| L4387 |
Non-pneum walk boot pre ots |
39 |
39 |
$3K |
| E0156 |
Walker seat attachment |
707 |
669 |
$3K |
| K0195 |
Elevating whlchair leg rests |
575 |
544 |
$3K |
| A7005 |
Nondisposable nebulizer set |
146 |
143 |
$2K |
| E0630 |
Patient lift hydraulic |
156 |
153 |
$2K |
| A4253 |
Blood glucose/reagent strips |
138 |
135 |
$2K |
| S5199 |
Personal care item nos each |
93 |
89 |
$840.34 |
| A7033 |
Replacement nasal pillows |
34 |
31 |
$814.61 |
| E0100 |
Cane adjust/fixed with tip |
37 |
37 |
$481.71 |
| B4034 |
Enter feed supkit syr by day |
15 |
14 |
$265.44 |
| A7003 |
Nebulizer administration set |
176 |
170 |
$199.56 |
| A4456 |
Adhesive remover, wipes |
25 |
25 |
$194.40 |
| E0971 |
Wheelchair anti-tipping devi |
67 |
37 |
$191.10 |
| A4259 |
Lancets per box |
67 |
66 |
$66.71 |
| E1392 |
Portable oxygen concentrator |
12 |
12 |
$59.66 |