| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
58,943 |
48,336 |
$3.16M |
| L4361 |
Pneuma/vac walk boot pre ots |
12,253 |
10,139 |
$1.77M |
| E0601 |
Cont airway pressure device |
36,765 |
31,610 |
$1.77M |
| A7030 |
Cpap full face mask |
14,543 |
12,226 |
$1.02M |
| A7034 |
Nasal application device |
12,258 |
10,333 |
$650K |
| L3807 |
Whfo w/o joints pre cst |
5,558 |
4,628 |
$604K |
| E0562 |
Humidifier heated used w pap |
7,371 |
5,683 |
$535K |
| E0143 |
Walker folding wheeled w/o s |
11,214 |
8,862 |
$424K |
| A7037 |
Pos airway pressure tubing |
22,086 |
18,967 |
$415K |
| L1820 |
Ko elas w/ condyle pads & jo |
7,013 |
5,479 |
$408K |
| E0470 |
Rad w/o backup non-inv intfc |
4,143 |
3,403 |
$404K |
| E0570 |
Nebulizer with compression |
28,497 |
23,097 |
$357K |
| A7031 |
Replacement facemask interfa |
11,636 |
9,602 |
$339K |
| L3908 |
Who cock-up nonmolde pre ots |
13,132 |
9,750 |
$324K |
| L4360 |
Pneumat walking boot pre cst |
2,462 |
2,102 |
$314K |
| E0114 |
Crutch underarm pair no wood |
13,781 |
10,694 |
$299K |
| E0466 |
Home vent non-invasive inter |
905 |
797 |
$297K |
| E0431 |
Portable gaseous 02 |
38,170 |
31,284 |
$273K |
| A7035 |
Pos airway press headgear |
16,589 |
13,826 |
$267K |
| L3670 |
So acro/clav can web pre ots |
4,761 |
4,064 |
$258K |
| E0260 |
Hosp bed semi-electr w/ matt |
9,972 |
8,047 |
$258K |
| A7032 |
Replacement nasal cushion |
6,977 |
5,771 |
$256K |
| K0001 |
Standard wheelchair |
18,146 |
14,669 |
$200K |
| K0003 |
Lightweight wheelchair |
9,956 |
8,086 |
$175K |
| L3809 |
Whfo w/o joints pre ots |
1,314 |
1,050 |
$158K |
| A7038 |
Pos airway pressure filter |
31,337 |
24,249 |
$150K |
| L1902 |
Afo ankle gauntlet pre ots |
3,554 |
2,820 |
$148K |
| L4386 |
Non-pneum walk boot pre cst |
1,682 |
1,445 |
$138K |
| L1830 |
Ko immob canvas long pre ots |
3,220 |
2,639 |
$125K |
| E0163 |
Commode chair with fixed arm |
5,558 |
4,355 |
$119K |
| K0195 |
Elevating whlchair leg rests |
9,604 |
6,815 |
$102K |
| E1392 |
Portable oxygen concentrator |
15,148 |
11,877 |
$83K |
| A7046 |
Repl water chamber, pap dev |
9,820 |
8,318 |
$73K |
| L1832 |
Ko adj jnt pos r sup pre cst |
867 |
616 |
$70K |
| A7005 |
Nondisposable nebulizer set |
6,327 |
5,544 |
$70K |
| L1833 |
Ko adj jnt pos r sup pre ots |
276 |
216 |
$70K |
| L3650 |
So 8 abd restraint pre ots |
2,255 |
1,974 |
$67K |
| E0443 |
Portable 02 contents, gas |
7,373 |
4,611 |
$67K |
| K0007 |
Extra heavy duty wheelchair |
2,425 |
2,000 |
$65K |
| A7033 |
Replacement nasal pillows |
2,568 |
2,047 |
$61K |
| E0630 |
Patient lift hydraulic |
3,224 |
2,515 |
$58K |
| A7039 |
Filter, non disposable w pap |
9,301 |
8,003 |
$55K |
| E2601 |
Gen w/c cushion wdth < 22 in |
2,456 |
1,883 |
$51K |
| E0471 |
Rad w/backup non inv intrfc |
266 |
237 |
$45K |
| L3984 |
Upper ext fx orthosis wrist |
236 |
199 |
$37K |
| L4350 |
Ankle control ortho pre ots |
791 |
685 |
$35K |
| A7036 |
Pos airway press chinstrap |
3,900 |
3,266 |
$27K |
| E0971 |
Wheelchair anti-tipping devi |
4,102 |
2,986 |
$22K |
| L4387 |
Non-pneum walk boot pre ots |
313 |
271 |
$20K |
| E0149 |
Heavy duty wheeled walker |
2,532 |
1,946 |
$16K |
| E0978 |
W/c acc,saf belt pelv strap |
5,813 |
4,667 |
$16K |
| E0156 |
Walker seat attachment |
2,327 |
1,818 |
$13K |
| E1236 |
Folding ped wc adjustable |
270 |
243 |
$12K |
| L1843 |
Ko single upright pre cst |
36 |
28 |
$11K |
| K0006 |
Heavy duty wheelchair |
616 |
469 |
$11K |
| L2795 |
Knee control full kneecap |
234 |
185 |
$10K |
| E0165 |
Commode chair with detacharm |
1,116 |
855 |
$8K |
| E0168 |
Heavyduty/wide commode chair |
670 |
515 |
$7K |
| E0603 |
Electric breast pump |
99 |
97 |
$7K |
| E0720 |
Tens two lead |
367 |
285 |
$6K |
| L3924 |
Hfo without joints pre ots |
176 |
111 |
$6K |
| E0303 |
Hosp bed hvy dty xtra wide |
41 |
36 |
$6K |
| L3660 |
So 8 ab rstr can/web pre ots |
764 |
622 |
$5K |
| L3260 |
Ambulatory surgical boot eac |
130 |
95 |
$5K |
| E1038 |
Transport chair pt wt<=300lb |
1,171 |
957 |
$5K |
| E0430 |
Oxygen system gas portable |
448 |
265 |
$3K |
| A4253 |
Blood glucose/reagent strips |
834 |
666 |
$3K |
| L1810 |
Ko elastic with joints |
42 |
36 |
$2K |
| A4467 |
Belt strap sleev grmnt cover |
116 |
88 |
$2K |
| A7003 |
Nebulizer administration set |
1,133 |
1,059 |
$2K |
| E0100 |
Cane adjust/fixed with tip |
221 |
172 |
$1K |
| A4604 |
Tubing with heating element |
4,071 |
2,827 |
$1K |
| K0004 |
High strength ltwt whlchr |
39 |
36 |
$1K |
| E0607 |
Blood glucose monitor home |
208 |
162 |
$831.26 |
| E0135 |
Walker folding adjust/fixed |
30 |
25 |
$716.47 |
| E0600 |
Suction pump portab hom modl |
116 |
91 |
$690.12 |
| E0118 |
Crutch substitute |
59 |
49 |
$515.06 |
| A4259 |
Lancets per box |
667 |
540 |
$227.47 |
| A4565 |
Slings |
46 |
29 |
$205.50 |
| K0739 |
Repair/svc dme non-oxygen eq |
24 |
15 |
$78.46 |
| A4256 |
Calibrator solution/chips |
280 |
224 |
$74.29 |
| E0310 |
Rails bed side full length |
111 |
87 |
$9.12 |