| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| L2630 |
Pelvic control band & belt u |
1,719 |
1,340 |
$359K |
| A4287 |
Disp col sto bag breast milk |
7,938 |
7,904 |
$302K |
| E0603 |
Electric breast pump |
2,431 |
1,987 |
$272K |
| E0601 |
Cont airway pressure device |
5,516 |
4,557 |
$229K |
| K1005 |
Disp col sto bag breast milk |
5,091 |
5,088 |
$194K |
| E1390 |
Oxygen concentrator |
1,835 |
1,612 |
$156K |
| A7030 |
Cpap full face mask |
1,432 |
1,141 |
$116K |
| A6530 |
Compression stocking bk18-30 |
1,706 |
1,356 |
$113K |
| E0562 |
Humidifier heated used w pap |
1,349 |
1,097 |
$107K |
| L0621 |
Sio flex pelvic/sacr pre ots |
1,395 |
1,142 |
$93K |
| A4604 |
Tubing with heating element |
2,578 |
2,054 |
$63K |
| A7034 |
Nasal application device |
991 |
799 |
$47K |
| A7035 |
Pos airway press headgear |
2,028 |
1,695 |
$40K |
| E0470 |
Rad w/o backup non-inv intfc |
246 |
239 |
$33K |
| K0001 |
Standard wheelchair |
1,411 |
1,116 |
$26K |
| A7032 |
Replacement nasal cushion |
510 |
443 |
$23K |
| A7031 |
Replacement facemask interfa |
650 |
505 |
$22K |
| E0570 |
Nebulizer with compression |
886 |
616 |
$22K |
| A7038 |
Pos airway pressure filter |
3,377 |
2,781 |
$18K |
| E1392 |
Portable oxygen concentrator |
792 |
702 |
$16K |
| A7046 |
Repl water chamber, pap dev |
1,202 |
1,014 |
$13K |
| L0625 |
Lo flex l1-below l5 pre ots |
272 |
223 |
$9K |
| A7039 |
Filter, non disposable w pap |
1,290 |
1,034 |
$9K |
| E0260 |
Hosp bed semi-electr w/ matt |
152 |
149 |
$8K |
| A7005 |
Nondisposable nebulizer set |
116 |
100 |
$2K |
| E0143 |
Walker folding wheeled w/o s |
58 |
38 |
$2K |
| A7033 |
Replacement nasal pillows |
12 |
12 |
$430.63 |
| A7037 |
Pos airway pressure tubing |
13 |
13 |
$82.38 |