| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
13,515 |
12,580 |
$787K |
| E0431 |
Portable gaseous 02 |
9,925 |
9,197 |
$236K |
| E0601 |
Cont airway pressure device |
3,233 |
3,093 |
$186K |
| L4361 |
Pneuma/vac walk boot pre ots |
958 |
871 |
$112K |
| L4360 |
Pneumat walking boot pre cst |
624 |
590 |
$92K |
| E0470 |
Rad w/o backup non-inv intfc |
715 |
651 |
$79K |
| L3809 |
Whfo w/o joints pre ots |
603 |
552 |
$77K |
| A4222 |
Infusion supplies with pump |
625 |
90 |
$75K |
| E0570 |
Nebulizer with compression |
1,328 |
1,223 |
$69K |
| E0562 |
Humidifier heated used w pap |
519 |
455 |
$56K |
| A7030 |
Cpap full face mask |
853 |
795 |
$56K |
| L1820 |
Ko elas w/ condyle pads & jo |
513 |
436 |
$41K |
| L3908 |
Who cock-up nonmolde pre ots |
1,114 |
919 |
$39K |
| A7035 |
Pos airway press headgear |
1,216 |
1,124 |
$27K |
| L1902 |
Afo ankle gauntlet pre ots |
625 |
564 |
$24K |
| A7037 |
Pos airway pressure tubing |
1,232 |
1,144 |
$22K |
| E0114 |
Crutch underarm pair no wood |
936 |
885 |
$20K |
| A4305 |
Drug delivery system >=50 ml |
356 |
37 |
$12K |
| L1810 |
Ko elastic with joints |
96 |
83 |
$6K |
| A7038 |
Pos airway pressure filter |
1,861 |
1,604 |
$5K |
| L1812 |
Ko elastic w/joints pre ots |
119 |
99 |
$5K |
| A4221 |
Supp non-insulin inf cath/wk |
303 |
128 |
$5K |
| B4152 |
Ef calorie dense>/=1.5kcal |
32 |
25 |
$4K |
| E1392 |
Portable oxygen concentrator |
559 |
529 |
$3K |
| E0143 |
Walker folding wheeled w/o s |
82 |
65 |
$3K |
| L3807 |
Whfo w/o joints pre cst |
16 |
15 |
$2K |
| E0260 |
Hosp bed semi-electr w/ matt |
56 |
51 |
$2K |
| A7034 |
Nasal application device |
30 |
24 |
$1K |
| A7003 |
Nebulizer administration set |
566 |
510 |
$1K |
| K0001 |
Standard wheelchair |
50 |
49 |
$1K |
| A7046 |
Repl water chamber, pap dev |
39 |
31 |
$211.94 |
| A7015 |
Aerosol mask used w nebulize |
96 |
93 |
$152.99 |
| A7013 |
Disposable compressor filter |
163 |
149 |
$8.49 |