| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| L4361 |
Pneuma/vac walk boot pre ots |
449 |
428 |
$52K |
| E1390 |
Oxygen concentrator |
1,251 |
1,023 |
$45K |
| L3660 |
So 8 ab rstr can/web pre ots |
185 |
181 |
$15K |
| E0114 |
Crutch underarm pair no wood |
331 |
330 |
$14K |
| E0570 |
Nebulizer with compression |
1,298 |
1,254 |
$13K |
| K0001 |
Standard wheelchair |
518 |
366 |
$9K |
| E0601 |
Cont airway pressure device |
388 |
341 |
$8K |
| L0621 |
Sio flex pelvic/sacr pre ots |
75 |
70 |
$6K |
| A7031 |
Replacement facemask interfa |
109 |
105 |
$5K |
| A7038 |
Pos airway pressure filter |
741 |
695 |
$5K |
| L3908 |
Who cock-up nonmolde pre ots |
261 |
209 |
$4K |
| A7037 |
Pos airway pressure tubing |
130 |
122 |
$3K |
| K0738 |
Portable gas oxygen system |
92 |
86 |
$3K |
| A7035 |
Pos airway press headgear |
99 |
98 |
$3K |
| E0562 |
Humidifier heated used w pap |
202 |
183 |
$2K |
| A7030 |
Cpap full face mask |
14 |
14 |
$1K |
| A7046 |
Repl water chamber, pap dev |
39 |
39 |
$486.98 |
| E0260 |
Hosp bed semi-electr w/ matt |
15 |
12 |
$309.29 |
| A7003 |
Nebulizer administration set |
12 |
12 |
$13.56 |