| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A4520 |
Incontinence garment anytype |
4,055 |
3,958 |
$529K |
| E1390 |
Oxygen concentrator |
2,034 |
1,828 |
$66K |
| E0601 |
Cont airway pressure device |
1,011 |
886 |
$60K |
| A4554 |
Disposable underpads |
765 |
748 |
$26K |
| E1392 |
Portable oxygen concentrator |
1,505 |
1,347 |
$20K |
| E1028 |
W/c manual swingaway |
328 |
276 |
$18K |
| E0562 |
Humidifier heated used w pap |
1,072 |
939 |
$14K |
| A7031 |
Replacement facemask interfa |
401 |
386 |
$12K |
| A7037 |
Pos airway pressure tubing |
923 |
848 |
$11K |
| E1161 |
Manual adult wc w tiltinspac |
50 |
37 |
$10K |
| K0108 |
W/c component-accessory nos |
55 |
40 |
$9K |
| A7030 |
Cpap full face mask |
93 |
87 |
$7K |
| A7035 |
Pos airway press headgear |
517 |
472 |
$7K |
| E0570 |
Nebulizer with compression |
439 |
404 |
$6K |
| E0971 |
Wheelchair anti-tipping devi |
604 |
273 |
$5K |
| A7038 |
Pos airway pressure filter |
1,620 |
1,510 |
$5K |
| K0739 |
Repair/svc dme non-oxygen eq |
374 |
264 |
$5K |
| E0973 |
W/ch access det adj armrest |
418 |
184 |
$3K |
| L4361 |
Pneuma/vac walk boot pre ots |
12 |
12 |
$3K |
| E0955 |
Cushioned headrest |
27 |
27 |
$2K |
| A7034 |
Nasal application device |
25 |
24 |
$2K |
| A7039 |
Filter, non disposable w pap |
188 |
178 |
$870.88 |
| A7003 |
Nebulizer administration set |
310 |
289 |
$759.34 |
| K0040 |
Adjustable angle footplate |
62 |
25 |
$686.67 |
| A7046 |
Repl water chamber, pap dev |
95 |
88 |
$554.33 |
| E0114 |
Crutch underarm pair no wood |
12 |
12 |
$530.30 |
| E0951 |
Loop heel |
93 |
38 |
$225.96 |
| A7013 |
Disposable compressor filter |
13 |
12 |
$2.29 |