| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
32,130 |
27,905 |
$919K |
| A7030 |
Cpap full face mask |
7,294 |
6,387 |
$396K |
| E0431 |
Portable gaseous 02 |
15,090 |
13,078 |
$305K |
| A7031 |
Replacement facemask interfa |
10,700 |
8,260 |
$224K |
| K0738 |
Portable gas oxygen system |
7,535 |
6,616 |
$213K |
| L4361 |
Pneuma/vac walk boot pre ots |
2,284 |
2,096 |
$203K |
| E0601 |
Cont airway pressure device |
9,375 |
8,044 |
$183K |
| A7034 |
Nasal application device |
4,695 |
4,017 |
$149K |
| B4035 |
Enteral feed supp pump per d |
1,495 |
736 |
$142K |
| A7035 |
Pos airway press headgear |
6,855 |
6,048 |
$98K |
| A4604 |
Tubing with heating element |
7,302 |
6,241 |
$87K |
| A7038 |
Pos airway pressure filter |
19,280 |
14,745 |
$76K |
| A7037 |
Pos airway pressure tubing |
4,109 |
3,637 |
$64K |
| L3660 |
So 8 ab rstr can/web pre ots |
1,218 |
1,098 |
$61K |
| A7032 |
Replacement nasal cushion |
3,512 |
2,581 |
$53K |
| E0470 |
Rad w/o backup non-inv intfc |
1,654 |
1,416 |
$51K |
| E0562 |
Humidifier heated used w pap |
674 |
592 |
$50K |
| E0260 |
Hosp bed semi-electr w/ matt |
2,553 |
2,216 |
$48K |
| A7046 |
Repl water chamber, pap dev |
6,202 |
5,380 |
$45K |
| K0001 |
Standard wheelchair |
5,470 |
4,608 |
$44K |
| E0570 |
Nebulizer with compression |
6,786 |
6,375 |
$43K |
| A7033 |
Replacement nasal pillows |
3,212 |
2,309 |
$37K |
| E0114 |
Crutch underarm pair no wood |
834 |
826 |
$33K |
| L3908 |
Who cock-up nonmolde pre ots |
1,825 |
1,517 |
$31K |
| E0143 |
Walker folding wheeled w/o s |
1,415 |
1,245 |
$23K |
| B4152 |
Ef calorie dense>/=1.5kcal |
367 |
200 |
$22K |
| K0007 |
Extra heavy duty wheelchair |
670 |
518 |
$21K |
| L1820 |
Ko elas w/ condyle pads & jo |
297 |
263 |
$18K |
| L1902 |
Afo ankle gauntlet pre ots |
456 |
435 |
$18K |
| B4160 |
Ef ped caloric dense>/=0.7kc |
111 |
87 |
$14K |
| K0823 |
Pwc gp 2 std cap chair |
164 |
152 |
$14K |
| B4034 |
Enter feed supkit syr by day |
307 |
191 |
$10K |
| K0195 |
Elevating whlchair leg rests |
1,149 |
887 |
$9K |
| A7000 |
Disposable canister for pump |
1,010 |
728 |
$9K |
| A7039 |
Filter, non disposable w pap |
1,866 |
1,583 |
$9K |
| L3260 |
Ambulatory surgical boot eac |
404 |
337 |
$8K |
| E0630 |
Patient lift hydraulic |
239 |
215 |
$5K |
| L3984 |
Upper ext fx orthosis wrist |
44 |
44 |
$5K |
| K0006 |
Heavy duty wheelchair |
264 |
226 |
$4K |
| A7002 |
Tubing used w suction pump |
1,254 |
754 |
$4K |
| A7526 |
Tracheostomy tube collar |
121 |
99 |
$4K |
| A7520 |
Trach/laryn tube non-cuffed |
143 |
79 |
$3K |
| B4088 |
Gastro/jejuno tube, low-pro |
71 |
39 |
$3K |
| E1392 |
Portable oxygen concentrator |
556 |
527 |
$3K |
| A4628 |
Oropharyngeal suction cath |
1,433 |
931 |
$3K |
| A4213 |
20+ cc syringe only |
587 |
277 |
$2K |
| L3670 |
So acro/clav can web pre ots |
45 |
42 |
$2K |
| A7003 |
Nebulizer administration set |
1,410 |
1,155 |
$2K |
| A4606 |
Oxygen probe used w oximeter |
115 |
39 |
$2K |
| A7036 |
Pos airway press chinstrap |
207 |
144 |
$986.67 |
| A7507 |
Integrated filter & holder |
15 |
12 |
$805.80 |
| E0471 |
Rad w/backup non inv intrfc |
14 |
12 |
$567.80 |
| B9002 |
Enter nutr inf pump any type |
32 |
13 |
$541.24 |
| A6402 |
Sterile gauze <= 16 sq in |
337 |
152 |
$502.88 |
| B9998 |
Enteral supp not otherwise c |
94 |
41 |
$449.84 |
| E2601 |
Gen w/c cushion wdth < 22 in |
15 |
14 |
$270.34 |
| A4357 |
Bedside drainage bag |
73 |
50 |
$181.26 |
| A5120 |
Skin barrier, wipe or swab |
54 |
36 |
$158.10 |
| E0271 |
Mattress innerspring |
149 |
108 |
$102.87 |
| E0156 |
Walker seat attachment |
18 |
16 |
$63.01 |
| A7013 |
Disposable compressor filter |
149 |
138 |
$38.03 |
| E0305 |
Rails bed side half length |
107 |
77 |
$24.97 |
| A7015 |
Aerosol mask used w nebulize |
29 |
25 |
$3.62 |