| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
28,502 |
27,158 |
$2.02M |
| A7031 |
Replacement facemask interfa |
24,211 |
23,245 |
$1.14M |
| A7030 |
Cpap full face mask |
13,407 |
13,016 |
$1.05M |
| A4604 |
Tubing with heating element |
20,854 |
20,316 |
$726K |
| E0466 |
Home vent non-invasive inter |
1,066 |
1,027 |
$715K |
| A7032 |
Replacement nasal cushion |
13,081 |
12,611 |
$673K |
| A7034 |
Nasal application device |
10,773 |
10,510 |
$548K |
| E0601 |
Cont airway pressure device |
14,303 |
13,646 |
$547K |
| E0465 |
Home vent invasive interface |
616 |
448 |
$481K |
| E1392 |
Portable oxygen concentrator |
14,854 |
14,207 |
$461K |
| E0603 |
Electric breast pump |
1,370 |
1,317 |
$302K |
| A7035 |
Pos airway press headgear |
15,547 |
15,148 |
$282K |
| A7033 |
Replacement nasal pillows |
6,310 |
6,171 |
$265K |
| K0738 |
Portable gas oxygen system |
7,711 |
7,433 |
$254K |
| A7038 |
Pos airway pressure filter |
42,699 |
41,277 |
$250K |
| E0260 |
Hosp bed semi-electr w/ matt |
5,061 |
4,840 |
$245K |
| K0001 |
Standard wheelchair |
8,042 |
7,522 |
$157K |
| E0562 |
Humidifier heated used w pap |
1,259 |
1,230 |
$157K |
| A7046 |
Repl water chamber, pap dev |
12,854 |
12,497 |
$156K |
| E0470 |
Rad w/o backup non-inv intfc |
1,480 |
1,436 |
$146K |
| K0108 |
W/c component-accessory nos |
1,299 |
566 |
$143K |
| E0570 |
Nebulizer with compression |
5,827 |
5,688 |
$122K |
| E0118 |
Crutch substitute |
1,435 |
1,385 |
$61K |
| E0114 |
Crutch underarm pair no wood |
1,172 |
1,156 |
$58K |
| A7037 |
Pos airway pressure tubing |
4,073 |
4,002 |
$54K |
| K0739 |
Repair/svc dme non-oxygen eq |
1,778 |
1,453 |
$53K |
| E0630 |
Patient lift hydraulic |
898 |
854 |
$46K |
| E0973 |
W/ch access det adj armrest |
5,066 |
2,573 |
$41K |
| K0195 |
Elevating whlchair leg rests |
3,321 |
2,991 |
$33K |
| L4361 |
Pneuma/vac walk boot pre ots |
146 |
144 |
$33K |
| E0445 |
Oximeter non-invasive |
276 |
259 |
$32K |
| K0002 |
Stnd hemi (low seat) whlchr |
837 |
830 |
$32K |
| A4217 |
Sterile water/saline, 500 ml |
213 |
168 |
$29K |
| A7039 |
Filter, non disposable w pap |
4,387 |
4,317 |
$27K |
| E0265 |
Hosp bed total electr w/ mat |
276 |
267 |
$27K |
| E1028 |
W/c manual swingaway |
371 |
235 |
$24K |
| A7005 |
Nondisposable nebulizer set |
1,146 |
1,126 |
$24K |
| E0143 |
Walker folding wheeled w/o s |
428 |
420 |
$23K |
| A4670 |
Automatic bp monitor, dial |
223 |
223 |
$18K |
| E1226 |
Manual fully reclining back |
803 |
643 |
$16K |
| E0971 |
Wheelchair anti-tipping devi |
3,338 |
1,530 |
$16K |
| K0004 |
High strength ltwt whlchr |
212 |
206 |
$15K |
| L3908 |
Who cock-up nonmolde pre ots |
236 |
209 |
$14K |
| E0424 |
Stationary compressed gas 02 |
127 |
127 |
$13K |
| E0135 |
Walker folding adjust/fixed |
270 |
263 |
$13K |
| E0604 |
Hosp grade elec breast pump |
225 |
224 |
$11K |
| K0006 |
Heavy duty wheelchair |
156 |
151 |
$8K |
| E0978 |
W/c acc,saf belt pelv strap |
1,425 |
1,229 |
$7K |
| E0155 |
Walker wheel attachment,pair |
286 |
279 |
$6K |
| L3809 |
Whfo w/o joints pre ots |
30 |
25 |
$5K |
| A7036 |
Pos airway press chinstrap |
426 |
418 |
$4K |
| L1902 |
Afo ankle gauntlet pre ots |
56 |
52 |
$4K |
| B9002 |
Enter nutr inf pump any type |
42 |
42 |
$3K |
| K0007 |
Extra heavy duty wheelchair |
29 |
27 |
$3K |
| E0305 |
Rails bed side half length |
399 |
363 |
$2K |
| K0045 |
Ftrst compl assembly repl ea |
733 |
681 |
$2K |
| E0245 |
Tub stool or bench |
22 |
12 |
$1K |
| E2365 |
U1 sealed leadacid battery |
14 |
12 |
$927.79 |
| E0776 |
Iv pole |
105 |
90 |
$908.44 |
| A7520 |
Trach/laryn tube non-cuffed |
13 |
13 |
$636.57 |
| E0261 |
Hosp bed semi-electr w/o mat |
12 |
12 |
$592.79 |
| A7015 |
Aerosol mask used w nebulize |
325 |
323 |
$507.10 |
| E2601 |
Gen w/c cushion wdth < 22 in |
12 |
12 |
$369.73 |
| E0951 |
Loop heel |
40 |
24 |
$274.98 |
| E0431 |
Portable gaseous 02 |
14 |
14 |
$263.56 |
| E0961 |
Wheelchair brake extension |
22 |
12 |
$256.57 |
| L3260 |
Ambulatory surgical boot eac |
12 |
12 |
$114.37 |
| A7013 |
Disposable compressor filter |
34 |
33 |
$51.14 |
| A9279 |
Monitoring feature/devicenoc |
53 |
51 |
$0.00 |