| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
14,341 |
14,053 |
$1.10M |
| A7030 |
Cpap full face mask |
2,705 |
2,656 |
$237K |
| E0601 |
Cont airway pressure device |
4,760 |
4,669 |
$215K |
| A7031 |
Replacement facemask interfa |
5,697 |
5,471 |
$197K |
| E0470 |
Rad w/o backup non-inv intfc |
998 |
978 |
$120K |
| E0431 |
Portable gaseous 02 |
8,273 |
8,132 |
$112K |
| E0562 |
Humidifier heated used w pap |
846 |
828 |
$104K |
| A7032 |
Replacement nasal cushion |
2,316 |
2,226 |
$94K |
| A7034 |
Nasal application device |
1,576 |
1,551 |
$85K |
| E0466 |
Home vent non-invasive inter |
103 |
98 |
$83K |
| A7037 |
Pos airway pressure tubing |
2,949 |
2,905 |
$56K |
| A7038 |
Pos airway pressure filter |
9,405 |
8,963 |
$43K |
| A7035 |
Pos airway press headgear |
2,488 |
2,449 |
$39K |
| L3660 |
So 8 ab rstr can/web pre ots |
969 |
965 |
$39K |
| E0114 |
Crutch underarm pair no wood |
1,180 |
1,171 |
$30K |
| A7033 |
Replacement nasal pillows |
1,088 |
1,042 |
$29K |
| K0738 |
Portable gas oxygen system |
888 |
872 |
$26K |
| L4361 |
Pneuma/vac walk boot pre ots |
500 |
496 |
$23K |
| E0570 |
Nebulizer with compression |
744 |
669 |
$16K |
| A7046 |
Repl water chamber, pap dev |
1,949 |
1,903 |
$12K |
| K0001 |
Standard wheelchair |
231 |
230 |
$7K |
| E0260 |
Hosp bed semi-electr w/ matt |
82 |
80 |
$7K |
| E0603 |
Electric breast pump |
50 |
49 |
$5K |
| L3908 |
Who cock-up nonmolde pre ots |
176 |
172 |
$4K |
| A7039 |
Filter, non disposable w pap |
686 |
675 |
$3K |
| A6402 |
Sterile gauze <= 16 sq in |
337 |
285 |
$2K |
| E1392 |
Portable oxygen concentrator |
1,098 |
1,060 |
$2K |
| A9279 |
Monitoring feature/devicenoc |
182 |
178 |
$1K |
| E0971 |
Wheelchair anti-tipping devi |
23 |
12 |
$523.69 |
| A4604 |
Tubing with heating element |
902 |
868 |
$508.44 |
| L1830 |
Ko immob canvas long pre ots |
13 |
13 |
$436.56 |
| A4335 |
Incontinence supply |
134 |
98 |
$397.45 |
| A4452 |
Waterproof tape |
14 |
12 |
$293.94 |
| L3260 |
Ambulatory surgical boot eac |
39 |
39 |
$141.17 |