| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
7,057 |
6,987 |
$431K |
| A7030 |
Cpap full face mask |
1,926 |
1,898 |
$143K |
| E0601 |
Cont airway pressure device |
2,631 |
2,601 |
$132K |
| K0738 |
Portable gas oxygen system |
2,150 |
2,138 |
$118K |
| E0470 |
Rad w/o backup non-inv intfc |
827 |
819 |
$117K |
| A7031 |
Replacement facemask interfa |
2,778 |
2,714 |
$93K |
| E0562 |
Humidifier heated used w pap |
508 |
500 |
$45K |
| E0260 |
Hosp bed semi-electr w/ matt |
1,470 |
1,452 |
$40K |
| E0431 |
Portable gaseous 02 |
2,494 |
2,457 |
$38K |
| A7037 |
Pos airway pressure tubing |
1,717 |
1,689 |
$28K |
| A7034 |
Nasal application device |
553 |
551 |
$26K |
| K0001 |
Standard wheelchair |
1,875 |
1,820 |
$22K |
| A7035 |
Pos airway press headgear |
1,493 |
1,475 |
$21K |
| A7038 |
Pos airway pressure filter |
4,548 |
4,446 |
$20K |
| L3660 |
So 8 ab rstr can/web pre ots |
455 |
441 |
$20K |
| L4361 |
Pneuma/vac walk boot pre ots |
204 |
196 |
$17K |
| A7032 |
Replacement nasal cushion |
442 |
429 |
$17K |
| E0114 |
Crutch underarm pair no wood |
539 |
534 |
$13K |
| A7033 |
Replacement nasal pillows |
372 |
363 |
$12K |
| E0570 |
Nebulizer with compression |
1,919 |
1,913 |
$11K |
| E0465 |
Home vent invasive interface |
14 |
12 |
$8K |
| A7046 |
Repl water chamber, pap dev |
772 |
764 |
$5K |
| E0630 |
Patient lift hydraulic |
125 |
118 |
$5K |
| L3908 |
Who cock-up nonmolde pre ots |
164 |
159 |
$4K |
| L4350 |
Ankle control ortho pre ots |
58 |
57 |
$2K |
| E1392 |
Portable oxygen concentrator |
953 |
945 |
$1K |
| E0143 |
Walker folding wheeled w/o s |
44 |
44 |
$1K |
| L1830 |
Ko immob canvas long pre ots |
26 |
26 |
$636.99 |
| L3260 |
Ambulatory surgical boot eac |
28 |
28 |
$390.42 |
| A4604 |
Tubing with heating element |
494 |
490 |
$200.98 |
| A7003 |
Nebulizer administration set |
39 |
38 |
$80.16 |
| A7039 |
Filter, non disposable w pap |
14 |
14 |
$63.04 |
| A7015 |
Aerosol mask used w nebulize |
19 |
17 |
$11.59 |