| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
10,868 |
10,375 |
$578K |
| E0601 |
Cont airway pressure device |
4,584 |
4,452 |
$229K |
| K0738 |
Portable gas oxygen system |
5,904 |
5,619 |
$190K |
| E0470 |
Rad w/o backup non-inv intfc |
1,498 |
1,452 |
$161K |
| E0730 |
Tens four lead |
1,652 |
1,495 |
$159K |
| A4595 |
Tens suppl 2 lead per month |
7,044 |
6,832 |
$118K |
| E0260 |
Hosp bed semi-electr w/ matt |
2,391 |
2,130 |
$109K |
| E0562 |
Humidifier heated used w pap |
1,215 |
1,140 |
$90K |
| K0001 |
Standard wheelchair |
2,784 |
2,602 |
$81K |
| E0570 |
Nebulizer with compression |
2,427 |
2,279 |
$79K |
| A7030 |
Cpap full face mask |
1,160 |
1,095 |
$73K |
| A7035 |
Pos airway press headgear |
1,691 |
1,592 |
$35K |
| A7031 |
Replacement facemask interfa |
1,152 |
1,090 |
$33K |
| K0003 |
Lightweight wheelchair |
580 |
556 |
$31K |
| E0431 |
Portable gaseous 02 |
1,151 |
1,103 |
$26K |
| A7034 |
Nasal application device |
615 |
589 |
$25K |
| A7037 |
Pos airway pressure tubing |
1,509 |
1,448 |
$24K |
| E0471 |
Rad w/backup non inv intrfc |
90 |
86 |
$22K |
| A7005 |
Nondisposable nebulizer set |
1,475 |
1,403 |
$18K |
| L3908 |
Who cock-up nonmolde pre ots |
472 |
321 |
$15K |
| A4351 |
Straight tip urine catheter |
298 |
255 |
$15K |
| A6530 |
Compression stocking bk18-30 |
375 |
314 |
$14K |
| E1392 |
Portable oxygen concentrator |
523 |
493 |
$14K |
| E0143 |
Walker folding wheeled w/o s |
296 |
270 |
$8K |
| E0202 |
Phototherapy light w/ photom |
44 |
37 |
$8K |
| A7039 |
Filter, non disposable w pap |
992 |
949 |
$7K |
| A7038 |
Pos airway pressure filter |
2,163 |
2,072 |
$5K |
| A7032 |
Replacement nasal cushion |
368 |
356 |
$5K |
| L8000 |
Mastectomy bra |
236 |
210 |
$4K |
| A7046 |
Repl water chamber, pap dev |
314 |
296 |
$2K |
| A7033 |
Replacement nasal pillows |
154 |
144 |
$2K |
| L8030 |
Breast prosthes w/o adhesive |
18 |
14 |
$2K |
| E0951 |
Loop heel |
1,073 |
558 |
$621.69 |
| E0245 |
Tub stool or bench |
14 |
12 |
$418.50 |
| A7003 |
Nebulizer administration set |
324 |
310 |
$262.64 |
| A7015 |
Aerosol mask used w nebulize |
201 |
198 |
$218.08 |
| K0195 |
Elevating whlchair leg rests |
33 |
25 |
$60.13 |
| A7013 |
Disposable compressor filter |
96 |
92 |
$1.96 |