| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
4,678 |
4,097 |
$476K |
| E0601 |
Cont airway pressure device |
4,594 |
3,821 |
$417K |
| A7030 |
Cpap full face mask |
2,483 |
2,017 |
$241K |
| E0570 |
Nebulizer with compression |
3,188 |
2,729 |
$204K |
| A7031 |
Replacement facemask interfa |
3,268 |
2,754 |
$176K |
| E0470 |
Rad w/o backup non-inv intfc |
818 |
702 |
$112K |
| E0562 |
Humidifier heated used w pap |
1,521 |
1,231 |
$108K |
| A7035 |
Pos airway press headgear |
3,382 |
2,718 |
$69K |
| A7038 |
Pos airway pressure filter |
6,532 |
5,413 |
$69K |
| K0738 |
Portable gas oxygen system |
2,424 |
2,177 |
$63K |
| L4387 |
Non-pneum walk boot pre ots |
508 |
478 |
$62K |
| E0114 |
Crutch underarm pair no wood |
1,620 |
1,539 |
$58K |
| A7034 |
Nasal application device |
1,195 |
954 |
$50K |
| L3908 |
Who cock-up nonmolde pre ots |
1,053 |
913 |
$45K |
| A7032 |
Replacement nasal cushion |
1,157 |
969 |
$39K |
| A7005 |
Nondisposable nebulizer set |
1,288 |
1,113 |
$29K |
| A7046 |
Repl water chamber, pap dev |
2,168 |
1,716 |
$22K |
| E0445 |
Oximeter non-invasive |
81 |
74 |
$22K |
| A7039 |
Filter, non disposable w pap |
2,479 |
1,909 |
$19K |
| E0600 |
Suction pump portab hom modl |
371 |
318 |
$14K |
| E0465 |
Home vent invasive interface |
20 |
12 |
$13K |
| E0143 |
Walker folding wheeled w/o s |
208 |
188 |
$11K |
| A4351 |
Straight tip urine catheter |
169 |
134 |
$10K |
| A7037 |
Pos airway pressure tubing |
3,435 |
2,756 |
$10K |
| A4385 |
Ost skn barrier sld ext wear |
72 |
50 |
$4K |
| A7000 |
Disposable canister for pump |
634 |
542 |
$4K |
| E0250 |
Hosp bed fixed ht w/ mattres |
113 |
73 |
$3K |
| A7526 |
Tracheostomy tube collar |
162 |
125 |
$3K |
| A7002 |
Tubing used w suction pump |
850 |
617 |
$2K |
| A7013 |
Disposable compressor filter |
1,429 |
1,245 |
$2K |
| E0431 |
Portable gaseous 02 |
57 |
55 |
$2K |
| A4604 |
Tubing with heating element |
792 |
625 |
$2K |
| A7015 |
Aerosol mask used w nebulize |
1,458 |
1,220 |
$2K |
| L1830 |
Ko immob canvas long pre ots |
26 |
25 |
$2K |
| A4606 |
Oxygen probe used w oximeter |
14 |
14 |
$1K |
| A7033 |
Replacement nasal pillows |
13 |
13 |
$596.43 |
| A7003 |
Nebulizer administration set |
134 |
123 |
$325.75 |
| A4927 |
Non-sterile gloves |
17 |
12 |
$194.13 |