| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
2,885 |
2,776 |
$303K |
| B4035 |
Enteral feed supp pump per d |
702 |
607 |
$91K |
| E0603 |
Electric breast pump |
663 |
653 |
$84K |
| E0570 |
Nebulizer with compression |
4,382 |
4,349 |
$67K |
| E0431 |
Portable gaseous 02 |
2,150 |
2,064 |
$53K |
| E0601 |
Cont airway pressure device |
690 |
679 |
$46K |
| B4152 |
Ef calorie dense>/=1.5kcal |
319 |
274 |
$41K |
| E0143 |
Walker folding wheeled w/o s |
374 |
373 |
$30K |
| E0114 |
Crutch underarm pair no wood |
787 |
784 |
$24K |
| K0001 |
Standard wheelchair |
507 |
496 |
$20K |
| A4385 |
Ost skn barrier sld ext wear |
409 |
379 |
$17K |
| E0424 |
Stationary compressed gas 02 |
106 |
100 |
$16K |
| L4350 |
Ankle control ortho pre ots |
236 |
236 |
$16K |
| B9002 |
Enter nutr inf pump any type |
348 |
311 |
$14K |
| L1830 |
Ko immob canvas long pre ots |
216 |
215 |
$12K |
| B4088 |
Gastro/jejuno tube, low-pro |
103 |
101 |
$11K |
| A7005 |
Nondisposable nebulizer set |
647 |
643 |
$8K |
| E0470 |
Rad w/o backup non-inv intfc |
42 |
39 |
$6K |
| E0562 |
Humidifier heated used w pap |
209 |
207 |
$6K |
| B4160 |
Ef ped caloric dense>/=0.7kc |
67 |
54 |
$5K |
| B4034 |
Enter feed supkit syr by day |
90 |
80 |
$4K |
| L3260 |
Ambulatory surgical boot eac |
77 |
76 |
$4K |
| K0738 |
Portable gas oxygen system |
583 |
576 |
$4K |
| E0445 |
Oximeter non-invasive |
35 |
25 |
$3K |
| L4360 |
Pneumat walking boot pre cst |
16 |
16 |
$3K |
| A4362 |
Solid skin barrier |
71 |
67 |
$2K |
| A5120 |
Skin barrier, wipe or swab |
351 |
343 |
$2K |
| L3908 |
Who cock-up nonmolde pre ots |
46 |
43 |
$2K |
| E0776 |
Iv pole |
400 |
398 |
$2K |
| E0971 |
Wheelchair anti-tipping devi |
421 |
253 |
$2K |
| E0600 |
Suction pump portab hom modl |
85 |
85 |
$1K |
| K0195 |
Elevating whlchair leg rests |
119 |
108 |
$1K |
| E0260 |
Hosp bed semi-electr w/ matt |
24 |
24 |
$1K |
| A4629 |
Tracheostomy care kit |
25 |
24 |
$1K |
| A4394 |
Ostomy pouch liq deodorant |
115 |
111 |
$1K |
| E0565 |
Compressor air power source |
38 |
36 |
$698.53 |
| A4406 |
Pectin based ostomy paste |
27 |
25 |
$641.48 |
| A4456 |
Adhesive remover, wipes |
197 |
190 |
$588.33 |
| A4452 |
Waterproof tape |
14 |
12 |
$346.49 |
| A4371 |
Skin barrier powder per oz |
179 |
177 |
$329.40 |
| E0978 |
W/c acc,saf belt pelv strap |
46 |
44 |
$136.33 |
| A7015 |
Aerosol mask used w nebulize |
91 |
91 |
$89.89 |
| A7002 |
Tubing used w suction pump |
24 |
24 |
$81.28 |
| A4367 |
Ostomy belt |
13 |
13 |
$66.24 |