| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
11,388 |
10,159 |
$394K |
| E0570 |
Nebulizer with compression |
3,443 |
3,079 |
$102K |
| E0260 |
Hosp bed semi-electr w/ matt |
4,026 |
3,520 |
$95K |
| L4361 |
Pneuma/vac walk boot pre ots |
504 |
419 |
$88K |
| E0431 |
Portable gaseous 02 |
9,738 |
8,678 |
$75K |
| K0001 |
Standard wheelchair |
6,649 |
5,741 |
$59K |
| A5512 |
Multi den insert direct form |
599 |
452 |
$40K |
| L3908 |
Who cock-up nonmolde pre ots |
1,071 |
759 |
$37K |
| A5500 |
Diab shoe for density insert |
630 |
474 |
$36K |
| K0195 |
Elevating whlchair leg rests |
6,668 |
5,849 |
$33K |
| L4386 |
Non-pneum walk boot pre cst |
393 |
327 |
$30K |
| E0143 |
Walker folding wheeled w/o s |
857 |
746 |
$21K |
| A5063 |
Drain ostomy pouch w/flange |
991 |
833 |
$19K |
| E0601 |
Cont airway pressure device |
481 |
397 |
$9K |
| A4409 |
Ost skn barr convex <=4 sq i |
135 |
111 |
$6K |
| E0163 |
Commode chair with fixed arm |
257 |
225 |
$6K |
| L1820 |
Ko elas w/ condyle pads & jo |
86 |
66 |
$5K |
| A7003 |
Nebulizer administration set |
1,754 |
1,621 |
$4K |
| E0562 |
Humidifier heated used w pap |
570 |
475 |
$4K |
| A4406 |
Pectin based ostomy paste |
487 |
400 |
$3K |
| A7037 |
Pos airway pressure tubing |
335 |
287 |
$2K |
| A7030 |
Cpap full face mask |
53 |
44 |
$2K |
| E1392 |
Portable oxygen concentrator |
88 |
74 |
$2K |
| A7035 |
Pos airway press headgear |
75 |
65 |
$968.75 |
| A7038 |
Pos airway pressure filter |
721 |
640 |
$882.83 |
| A4414 |
Ost sknbar w/o conv<=4 sq in |
16 |
14 |
$664.68 |
| A7039 |
Filter, non disposable w pap |
51 |
45 |
$181.82 |
| E0305 |
Rails bed side half length |
47 |
38 |
$120.49 |
| A4371 |
Skin barrier powder per oz |
14 |
12 |
$51.03 |