| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| L4361 |
Pneuma/vac walk boot pre ots |
4,132 |
3,937 |
$935K |
| E0603 |
Electric breast pump |
2,456 |
2,397 |
$552K |
| A7030 |
Cpap full face mask |
4,096 |
3,871 |
$522K |
| E1390 |
Oxygen concentrator |
5,345 |
4,995 |
$480K |
| E0601 |
Cont airway pressure device |
6,440 |
6,159 |
$477K |
| A7031 |
Replacement facemask interfa |
3,672 |
3,476 |
$426K |
| L1833 |
Ko adj jnt pos r sup pre ots |
997 |
928 |
$328K |
| E0570 |
Nebulizer with compression |
3,732 |
3,489 |
$257K |
| L3908 |
Who cock-up nonmolde pre ots |
4,475 |
3,800 |
$224K |
| A7034 |
Nasal application device |
2,295 |
2,186 |
$179K |
| E0562 |
Humidifier heated used w pap |
7,723 |
7,409 |
$173K |
| E0470 |
Rad w/o backup non-inv intfc |
1,075 |
1,036 |
$159K |
| L3809 |
Whfo w/o joints pre ots |
1,734 |
1,618 |
$128K |
| L1902 |
Afo ankle gauntlet pre ots |
1,854 |
1,764 |
$120K |
| A7037 |
Pos airway pressure tubing |
4,424 |
4,150 |
$108K |
| L3660 |
So 8 ab rstr can/web pre ots |
1,377 |
1,325 |
$106K |
| A7033 |
Replacement nasal pillows |
961 |
920 |
$104K |
| A7038 |
Pos airway pressure filter |
6,055 |
5,743 |
$104K |
| A7032 |
Replacement nasal cushion |
808 |
767 |
$101K |
| A4604 |
Tubing with heating element |
2,061 |
2,003 |
$98K |
| A7035 |
Pos airway press headgear |
3,804 |
3,601 |
$89K |
| E0260 |
Hosp bed semi-electr w/ matt |
1,314 |
1,273 |
$77K |
| T4534 |
Youth size pull-on |
466 |
461 |
$75K |
| K0738 |
Portable gas oxygen system |
3,614 |
3,358 |
$74K |
| E0114 |
Crutch underarm pair no wood |
1,874 |
1,814 |
$73K |
| L4387 |
Non-pneum walk boot pre ots |
464 |
451 |
$61K |
| L1812 |
Ko elastic w/joints pre ots |
876 |
837 |
$61K |
| E0143 |
Walker folding wheeled w/o s |
866 |
822 |
$54K |
| T4526 |
Adult size pull-on med |
409 |
380 |
$49K |
| T4527 |
Adult size pull-on lg |
278 |
271 |
$38K |
| A7046 |
Repl water chamber, pap dev |
2,793 |
2,658 |
$35K |
| A7005 |
Nondisposable nebulizer set |
1,491 |
1,396 |
$35K |
| T4522 |
Adult size brief/diaper med |
180 |
164 |
$23K |
| E1392 |
Portable oxygen concentrator |
1,275 |
1,200 |
$21K |
| K0001 |
Standard wheelchair |
616 |
539 |
$16K |
| A4627 |
Spacer bag/reservoir |
812 |
783 |
$16K |
| L1820 |
Ko elas w/ condyle pads & jo |
274 |
241 |
$15K |
| E1399 |
Durable medical equipment mi |
36 |
12 |
$13K |
| T4535 |
Disposable liner/shield/pad |
221 |
214 |
$11K |
| T4524 |
Adult size brief/diaper xl |
65 |
63 |
$9K |
| K0004 |
High strength ltwt whlchr |
109 |
100 |
$8K |
| K0002 |
Stnd hemi (low seat) whlchr |
204 |
187 |
$7K |
| E0149 |
Heavy duty wheeled walker |
320 |
294 |
$7K |
| A4351 |
Straight tip urine catheter |
43 |
38 |
$6K |
| A4670 |
Automatic bp monitor, dial |
67 |
67 |
$6K |
| E0971 |
Wheelchair anti-tipping devi |
764 |
659 |
$5K |
| T4541 |
Large disposable underpad |
123 |
117 |
$5K |
| T4528 |
Adult size pull-on xl |
52 |
50 |
$5K |
| E0630 |
Patient lift hydraulic |
137 |
133 |
$5K |
| L3984 |
Upper ext fx orthosis wrist |
29 |
28 |
$4K |
| E0156 |
Walker seat attachment |
446 |
423 |
$3K |
| K0195 |
Elevating whlchair leg rests |
387 |
356 |
$3K |
| A4927 |
Non-sterile gloves |
166 |
156 |
$2K |
| B4150 |
Ef complet w/intact nutrient |
15 |
14 |
$2K |
| L3924 |
Hfo without joints pre ots |
29 |
24 |
$2K |
| A6530 |
Compression stocking bk18-30 |
17 |
15 |
$817.96 |
| A7015 |
Aerosol mask used w nebulize |
564 |
532 |
$769.79 |
| E0973 |
W/ch access det adj armrest |
15 |
12 |
$648.01 |
| E0240 |
Bath/shower chair |
12 |
12 |
$506.72 |
| A4554 |
Disposable underpads |
19 |
18 |
$391.00 |
| K0003 |
Lightweight wheelchair |
13 |
13 |
$379.52 |
| K0739 |
Repair/svc dme non-oxygen eq |
19 |
15 |
$286.08 |
| A7036 |
Pos airway press chinstrap |
27 |
27 |
$280.83 |
| E0181 |
Press pad alternating w/ pum |
12 |
12 |
$63.63 |
| A7003 |
Nebulizer administration set |
36 |
36 |
$10.72 |