| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
15,620 |
15,535 |
$1.79M |
| K0001 |
Standard wheelchair |
2,212 |
2,198 |
$572K |
| L3000 |
Ft insert ucb berkeley shell |
3,119 |
1,559 |
$504K |
| E0431 |
Portable gaseous 02 |
20,440 |
14,990 |
$478K |
| E0570 |
Nebulizer with compression |
2,384 |
2,368 |
$228K |
| E0443 |
Portable 02 contents, gas |
2,684 |
1,834 |
$169K |
| K0195 |
Elevating whlchair leg rests |
1,344 |
1,327 |
$129K |
| E0143 |
Walker folding wheeled w/o s |
2,339 |
2,321 |
$120K |
| A5500 |
Diab shoe for density insert |
2,429 |
1,214 |
$114K |
| A5513 |
Multi den insert custom mold |
1,706 |
869 |
$111K |
| E0295 |
Hosp bed semi-elect w/o matt |
180 |
178 |
$79K |
| E0601 |
Cont airway pressure device |
258 |
255 |
$76K |
| E0144 |
Enclosed walker w rear seat |
369 |
366 |
$74K |
| E0277 |
Powered pres-redu air mattrs |
182 |
177 |
$60K |
| L4361 |
Pneuma/vac walk boot pre ots |
340 |
334 |
$54K |
| E0562 |
Humidifier heated used w pap |
442 |
435 |
$48K |
| K0823 |
Pwc gp 2 std cap chair |
14 |
13 |
$43K |
| E0603 |
Electric breast pump |
555 |
547 |
$40K |
| A7005 |
Nondisposable nebulizer set |
2,072 |
2,056 |
$30K |
| L1820 |
Ko elas w/ condyle pads & jo |
489 |
403 |
$27K |
| E0748 |
Elec osteogen stim spinal |
12 |
12 |
$26K |
| L0637 |
Lso sc r ant/pos pnl pre cst |
39 |
39 |
$25K |
| L3908 |
Who cock-up nonmolde pre ots |
643 |
461 |
$20K |
| K0003 |
Lightweight wheelchair |
50 |
50 |
$18K |
| E0163 |
Commode chair with fixed arm |
311 |
306 |
$16K |
| T4541 |
Large disposable underpad |
449 |
443 |
$12K |
| L0648 |
Lso sag r an/pos pnl pre ots |
13 |
13 |
$10K |
| A7030 |
Cpap full face mask |
110 |
107 |
$8K |
| A4604 |
Tubing with heating element |
192 |
183 |
$7K |
| A7035 |
Pos airway press headgear |
329 |
316 |
$7K |
| E0247 |
Trans bench w/wo comm open |
116 |
112 |
$7K |
| E2208 |
Cylinder tank carrier |
79 |
79 |
$7K |
| E0305 |
Rails bed side half length |
74 |
74 |
$6K |
| L3809 |
Whfo w/o joints pre ots |
42 |
30 |
$6K |
| L1833 |
Ko adj jnt pos r sup pre ots |
12 |
12 |
$6K |
| E0245 |
Tub stool or bench |
135 |
135 |
$5K |
| E0156 |
Walker seat attachment |
350 |
349 |
$4K |
| E0730 |
Tens four lead |
17 |
17 |
$4K |
| A7046 |
Repl water chamber, pap dev |
256 |
246 |
$3K |
| A7031 |
Replacement facemask interfa |
83 |
80 |
$3K |
| A5512 |
Multi den insert direct form |
54 |
27 |
$3K |
| A7037 |
Pos airway pressure tubing |
106 |
103 |
$3K |
| A7034 |
Nasal application device |
42 |
42 |
$2K |
| E0271 |
Mattress innerspring |
25 |
25 |
$2K |
| A7039 |
Filter, non disposable w pap |
291 |
280 |
$2K |
| T4523 |
Adult size brief/diaper lg |
12 |
12 |
$2K |
| E0114 |
Crutch underarm pair no wood |
64 |
63 |
$2K |
| E0100 |
Cane adjust/fixed with tip |
136 |
134 |
$1K |
| E0973 |
W/ch access det adj armrest |
14 |
13 |
$1K |
| A7015 |
Aerosol mask used w nebulize |
1,232 |
1,227 |
$1K |
| L0621 |
Sio flex pelvic/sacr pre ots |
15 |
15 |
$969.24 |
| A7032 |
Replacement nasal cushion |
41 |
41 |
$917.62 |
| T4535 |
Disposable liner/shield/pad |
12 |
12 |
$810.42 |
| A7038 |
Pos airway pressure filter |
247 |
238 |
$688.08 |
| A7045 |
Repl exhalation port for pap |
14 |
14 |
$192.59 |