| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
13,609 |
13,536 |
$1.05M |
| E0601 |
Cont airway pressure device |
15,469 |
15,406 |
$1.04M |
| A7030 |
Cpap full face mask |
7,246 |
7,216 |
$572K |
| E0562 |
Humidifier heated used w pap |
4,982 |
4,970 |
$320K |
| A7031 |
Replacement facemask interfa |
6,098 |
6,056 |
$297K |
| E0570 |
Nebulizer with compression |
9,366 |
9,308 |
$271K |
| E0470 |
Rad w/o backup non-inv intfc |
1,885 |
1,877 |
$254K |
| L2116 |
Afo tibial fracture rigid |
932 |
929 |
$180K |
| L1930 |
Afo plastic |
996 |
990 |
$141K |
| A4604 |
Tubing with heating element |
6,013 |
5,973 |
$132K |
| A7034 |
Nasal application device |
3,277 |
3,261 |
$125K |
| E0431 |
Portable gaseous 02 |
7,988 |
7,956 |
$114K |
| L3908 |
Who cock-up nonmolde pre ots |
2,775 |
2,608 |
$102K |
| A7035 |
Pos airway press headgear |
7,493 |
7,455 |
$100K |
| E0471 |
Rad w/backup non inv intrfc |
890 |
887 |
$88K |
| E0114 |
Crutch underarm pair no wood |
4,137 |
4,121 |
$83K |
| A7032 |
Replacement nasal cushion |
1,438 |
1,421 |
$79K |
| A7038 |
Pos airway pressure filter |
10,416 |
10,350 |
$66K |
| L1820 |
Ko elas w/ condyle pads & jo |
785 |
775 |
$59K |
| E0143 |
Walker folding wheeled w/o s |
1,134 |
1,133 |
$52K |
| A7037 |
Pos airway pressure tubing |
4,456 |
4,445 |
$45K |
| A7033 |
Replacement nasal pillows |
787 |
783 |
$39K |
| K0001 |
Standard wheelchair |
2,216 |
2,204 |
$37K |
| A7005 |
Nondisposable nebulizer set |
2,783 |
2,780 |
$35K |
| A4239 |
Non-adju cgm supply allow |
181 |
179 |
$20K |
| L1902 |
Afo ankle gauntlet pre ots |
521 |
512 |
$19K |
| L3660 |
So 8 ab rstr can/web pre ots |
517 |
511 |
$19K |
| L1830 |
Ko immob canvas long pre ots |
382 |
379 |
$18K |
| E0260 |
Hosp bed semi-electr w/ matt |
980 |
965 |
$13K |
| L3807 |
Whfo w/o joints pre cst |
106 |
104 |
$12K |
| L1906 |
Afo multilig ank sup pre ots |
165 |
164 |
$9K |
| E1392 |
Portable oxygen concentrator |
213 |
211 |
$7K |
| A7046 |
Repl water chamber, pap dev |
386 |
384 |
$3K |
| A7013 |
Disposable compressor filter |
2,181 |
2,171 |
$2K |
| L1900 |
Afo sprng wir drsflx calf bd |
13 |
12 |
$1K |
| K0195 |
Elevating whlchair leg rests |
159 |
159 |
$963.54 |
| E0561 |
Humidifier nonheated w pap |
16 |
16 |
$432.16 |
| A7036 |
Pos airway press chinstrap |
13 |
13 |
$146.16 |
| E0156 |
Walker seat attachment |
12 |
12 |
$94.37 |