| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
22,109 |
19,547 |
$768K |
| E0431 |
Portable gaseous 02 |
9,790 |
8,868 |
$345K |
| A7030 |
Cpap full face mask |
3,440 |
2,997 |
$247K |
| E0601 |
Cont airway pressure device |
7,728 |
7,028 |
$187K |
| E0562 |
Humidifier heated used w pap |
1,626 |
1,364 |
$120K |
| A7031 |
Replacement facemask interfa |
4,574 |
3,610 |
$114K |
| A7034 |
Nasal application device |
1,864 |
1,602 |
$84K |
| B4035 |
Enteral feed supp pump per d |
266 |
260 |
$72K |
| A4604 |
Tubing with heating element |
3,977 |
3,418 |
$67K |
| L4361 |
Pneuma/vac walk boot pre ots |
515 |
508 |
$66K |
| A7035 |
Pos airway press headgear |
3,467 |
3,043 |
$65K |
| E0570 |
Nebulizer with compression |
4,505 |
4,050 |
$59K |
| E0470 |
Rad w/o backup non-inv intfc |
1,184 |
1,025 |
$59K |
| A7038 |
Pos airway pressure filter |
8,719 |
6,942 |
$38K |
| K0738 |
Portable gas oxygen system |
1,150 |
999 |
$33K |
| E0445 |
Oximeter non-invasive |
172 |
171 |
$30K |
| E0443 |
Portable 02 contents, gas |
744 |
595 |
$27K |
| K0001 |
Standard wheelchair |
2,000 |
1,800 |
$25K |
| A7032 |
Replacement nasal cushion |
1,220 |
993 |
$24K |
| A7046 |
Repl water chamber, pap dev |
2,526 |
2,205 |
$23K |
| E0114 |
Crutch underarm pair no wood |
426 |
426 |
$19K |
| E0143 |
Walker folding wheeled w/o s |
263 |
259 |
$17K |
| A7037 |
Pos airway pressure tubing |
570 |
497 |
$11K |
| A7033 |
Replacement nasal pillows |
689 |
555 |
$10K |
| B9002 |
Enter nutr inf pump any type |
90 |
86 |
$8K |
| E1392 |
Portable oxygen concentrator |
1,191 |
1,064 |
$7K |
| K0195 |
Elevating whlchair leg rests |
483 |
469 |
$7K |
| L3660 |
So 8 ab rstr can/web pre ots |
73 |
73 |
$7K |
| E0260 |
Hosp bed semi-electr w/ matt |
322 |
266 |
$6K |
| L3908 |
Who cock-up nonmolde pre ots |
192 |
190 |
$4K |
| E0600 |
Suction pump portab hom modl |
94 |
94 |
$4K |
| L1820 |
Ko elas w/ condyle pads & jo |
27 |
27 |
$3K |
| L1902 |
Afo ankle gauntlet pre ots |
34 |
34 |
$2K |
| B4160 |
Ef ped caloric dense>/=0.7kc |
12 |
12 |
$1K |
| A7003 |
Nebulizer administration set |
656 |
648 |
$1K |
| E0776 |
Iv pole |
39 |
37 |
$512.53 |
| A7000 |
Disposable canister for pump |
30 |
26 |
$361.10 |
| A7005 |
Nondisposable nebulizer set |
25 |
25 |
$259.34 |
| A4628 |
Oropharyngeal suction cath |
27 |
27 |
$93.87 |
| A7039 |
Filter, non disposable w pap |
12 |
12 |
$93.71 |
| A7002 |
Tubing used w suction pump |
12 |
12 |
$84.49 |
| A7013 |
Disposable compressor filter |
50 |
49 |
$34.94 |