| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
5,228 |
5,202 |
$500K |
| E0601 |
Cont airway pressure device |
8,428 |
8,351 |
$476K |
| E0603 |
Electric breast pump |
1,989 |
1,953 |
$254K |
| E0470 |
Rad w/o backup non-inv intfc |
1,563 |
1,546 |
$181K |
| A7030 |
Cpap full face mask |
1,903 |
1,891 |
$130K |
| L3908 |
Who cock-up nonmolde pre ots |
2,267 |
2,079 |
$93K |
| E0143 |
Walker folding wheeled w/o s |
1,579 |
1,559 |
$87K |
| E0114 |
Crutch underarm pair no wood |
2,762 |
2,754 |
$79K |
| E0562 |
Humidifier heated used w pap |
6,087 |
6,043 |
$71K |
| E0431 |
Portable gaseous 02 |
3,498 |
3,485 |
$70K |
| L4350 |
Ankle control ortho pre ots |
1,082 |
1,056 |
$69K |
| E0570 |
Nebulizer with compression |
1,537 |
1,536 |
$64K |
| L4361 |
Pneuma/vac walk boot pre ots |
346 |
336 |
$49K |
| A7035 |
Pos airway press headgear |
2,425 |
2,409 |
$46K |
| A7037 |
Pos airway pressure tubing |
2,439 |
2,421 |
$44K |
| K0001 |
Standard wheelchair |
1,762 |
1,745 |
$44K |
| A7034 |
Nasal application device |
1,044 |
1,039 |
$43K |
| A7031 |
Replacement facemask interfa |
736 |
732 |
$23K |
| A7038 |
Pos airway pressure filter |
3,208 |
3,155 |
$21K |
| L3260 |
Ambulatory surgical boot eac |
709 |
691 |
$13K |
| A7046 |
Repl water chamber, pap dev |
1,758 |
1,751 |
$11K |
| L1830 |
Ko immob canvas long pre ots |
190 |
186 |
$9K |
| E0156 |
Walker seat attachment |
427 |
420 |
$4K |
| A4627 |
Spacer bag/reservoir |
262 |
262 |
$4K |
| A4385 |
Ost skn barrier sld ext wear |
68 |
65 |
$3K |
| A7032 |
Replacement nasal cushion |
37 |
37 |
$518.82 |
| E0971 |
Wheelchair anti-tipping devi |
143 |
90 |
$413.32 |
| A6446 |
Conform band s w>=3" <5"/yd |
29 |
27 |
$374.24 |
| A5063 |
Drain ostomy pouch w/flange |
13 |
13 |
$368.00 |
| A4604 |
Tubing with heating element |
41 |
41 |
$287.89 |
| A6216 |
Non-sterile gauze<=16 sq in |
43 |
41 |
$210.40 |