| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E0603 |
Electric breast pump |
2,149 |
1,792 |
$325K |
| E1390 |
Oxygen concentrator |
3,922 |
3,013 |
$115K |
| E0601 |
Cont airway pressure device |
1,367 |
1,115 |
$43K |
| K0738 |
Portable gas oxygen system |
2,154 |
1,571 |
$31K |
| E0143 |
Walker folding wheeled w/o s |
1,023 |
876 |
$26K |
| A7031 |
Replacement facemask interfa |
706 |
586 |
$17K |
| E0562 |
Humidifier heated used w pap |
851 |
692 |
$12K |
| E0114 |
Crutch underarm pair no wood |
311 |
294 |
$10K |
| A7032 |
Replacement nasal cushion |
367 |
264 |
$10K |
| L3660 |
So 8 ab rstr can/web pre ots |
180 |
162 |
$10K |
| E0163 |
Commode chair with fixed arm |
298 |
267 |
$9K |
| A7034 |
Nasal application device |
183 |
164 |
$7K |
| A7037 |
Pos airway pressure tubing |
712 |
594 |
$6K |
| K0001 |
Standard wheelchair |
658 |
531 |
$6K |
| A7038 |
Pos airway pressure filter |
1,787 |
1,350 |
$5K |
| A7035 |
Pos airway press headgear |
387 |
326 |
$4K |
| E0431 |
Portable gaseous 02 |
505 |
421 |
$4K |
| L4350 |
Ankle control ortho pre ots |
69 |
58 |
$4K |
| L1830 |
Ko immob canvas long pre ots |
41 |
37 |
$2K |
| A7046 |
Repl water chamber, pap dev |
300 |
247 |
$2K |
| L3809 |
Whfo w/o joints pre ots |
17 |
14 |
$2K |
| E0570 |
Nebulizer with compression |
187 |
155 |
$2K |
| A7039 |
Filter, non disposable w pap |
407 |
342 |
$2K |
| E0260 |
Hosp bed semi-electr w/ matt |
52 |
38 |
$2K |
| A7030 |
Cpap full face mask |
43 |
27 |
$890.66 |
| L3908 |
Who cock-up nonmolde pre ots |
23 |
21 |
$743.47 |
| E0250 |
Hosp bed fixed ht w/ mattres |
61 |
50 |
$710.89 |
| L3260 |
Ambulatory surgical boot eac |
39 |
31 |
$536.26 |
| K0195 |
Elevating whlchair leg rests |
126 |
89 |
$366.42 |
| K0003 |
Lightweight wheelchair |
33 |
26 |
$334.95 |