| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
9,852 |
7,992 |
$571K |
| E0601 |
Cont airway pressure device |
8,053 |
7,137 |
$309K |
| A7030 |
Cpap full face mask |
1,878 |
1,637 |
$159K |
| A4604 |
Tubing with heating element |
3,965 |
3,433 |
$138K |
| L3908 |
Who cock-up nonmolde pre ots |
2,621 |
2,329 |
$129K |
| E0562 |
Humidifier heated used w pap |
6,785 |
5,916 |
$113K |
| L4361 |
Pneuma/vac walk boot pre ots |
445 |
414 |
$105K |
| A7031 |
Replacement facemask interfa |
2,953 |
2,552 |
$94K |
| L3809 |
Whfo w/o joints pre ots |
528 |
476 |
$92K |
| E0431 |
Portable gaseous 02 |
7,067 |
5,786 |
$83K |
| A7034 |
Nasal application device |
1,276 |
1,081 |
$68K |
| A7035 |
Pos airway press headgear |
3,359 |
2,885 |
$59K |
| T4534 |
Youth size pull-on |
474 |
378 |
$44K |
| E0570 |
Nebulizer with compression |
5,066 |
4,621 |
$40K |
| A7038 |
Pos airway pressure filter |
7,472 |
6,430 |
$33K |
| L1902 |
Afo ankle gauntlet pre ots |
398 |
370 |
$26K |
| A7033 |
Replacement nasal pillows |
1,226 |
1,028 |
$25K |
| A7032 |
Replacement nasal cushion |
568 |
477 |
$20K |
| E0143 |
Walker folding wheeled w/o s |
847 |
730 |
$15K |
| K0001 |
Standard wheelchair |
997 |
809 |
$15K |
| T4541 |
Large disposable underpad |
509 |
416 |
$13K |
| A7046 |
Repl water chamber, pap dev |
1,083 |
907 |
$11K |
| E0114 |
Crutch underarm pair no wood |
215 |
207 |
$11K |
| E0470 |
Rad w/o backup non-inv intfc |
100 |
90 |
$9K |
| L4387 |
Non-pneum walk boot pre ots |
47 |
45 |
$6K |
| L1812 |
Ko elastic w/joints pre ots |
65 |
60 |
$5K |
| T4528 |
Adult size pull-on xl |
42 |
25 |
$3K |
| T4526 |
Adult size pull-on med |
29 |
25 |
$3K |
| T4527 |
Adult size pull-on lg |
31 |
25 |
$3K |
| T4535 |
Disposable liner/shield/pad |
49 |
39 |
$3K |
| A4927 |
Non-sterile gloves |
41 |
38 |
$2K |
| E0971 |
Wheelchair anti-tipping devi |
817 |
333 |
$1K |
| A7039 |
Filter, non disposable w pap |
207 |
195 |
$1K |
| L3650 |
So 8 abd restraint pre ots |
17 |
13 |
$557.64 |