| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
23,395 |
23,328 |
$1.56M |
| E0466 |
Home vent non-invasive inter |
1,248 |
1,246 |
$396K |
| E0431 |
Portable gaseous 02 |
14,184 |
14,127 |
$170K |
| E0601 |
Cont airway pressure device |
2,678 |
2,660 |
$168K |
| K0001 |
Standard wheelchair |
3,493 |
3,480 |
$93K |
| E0570 |
Nebulizer with compression |
8,154 |
8,088 |
$70K |
| A7033 |
Replacement nasal pillows |
1,558 |
1,551 |
$58K |
| E0562 |
Humidifier heated used w pap |
2,124 |
2,109 |
$55K |
| K0738 |
Portable gas oxygen system |
2,191 |
2,191 |
$46K |
| A7030 |
Cpap full face mask |
686 |
683 |
$46K |
| A4604 |
Tubing with heating element |
1,636 |
1,636 |
$46K |
| A7034 |
Nasal application device |
1,018 |
1,018 |
$45K |
| E0443 |
Portable 02 contents, gas |
1,421 |
1,417 |
$38K |
| A7032 |
Replacement nasal cushion |
1,138 |
1,134 |
$35K |
| E0260 |
Hosp bed semi-electr w/ matt |
1,556 |
1,556 |
$34K |
| A7035 |
Pos airway press headgear |
2,014 |
2,009 |
$33K |
| A7038 |
Pos airway pressure filter |
5,547 |
5,532 |
$33K |
| E0470 |
Rad w/o backup non-inv intfc |
192 |
192 |
$29K |
| A7031 |
Replacement facemask interfa |
696 |
691 |
$22K |
| E1392 |
Portable oxygen concentrator |
1,174 |
1,174 |
$18K |
| A7046 |
Repl water chamber, pap dev |
1,726 |
1,723 |
$17K |
| E0295 |
Hosp bed semi-elect w/o matt |
131 |
131 |
$11K |
| K0195 |
Elevating whlchair leg rests |
696 |
696 |
$7K |
| A7037 |
Pos airway pressure tubing |
363 |
363 |
$5K |
| E0630 |
Patient lift hydraulic |
154 |
154 |
$5K |
| A7005 |
Nondisposable nebulizer set |
1,208 |
1,162 |
$4K |
| E0143 |
Walker folding wheeled w/o s |
133 |
130 |
$3K |
| E0271 |
Mattress innerspring |
107 |
107 |
$2K |
| A7039 |
Filter, non disposable w pap |
180 |
180 |
$1K |
| E0305 |
Rails bed side half length |
94 |
94 |
$1K |
| K0003 |
Lightweight wheelchair |
28 |
28 |
$615.48 |
| E0163 |
Commode chair with fixed arm |
13 |
12 |
$575.19 |
| A7003 |
Nebulizer administration set |
365 |
349 |
$421.15 |
| E0910 |
Trapeze bar attached to bed |
24 |
24 |
$195.11 |
| E0181 |
Press pad alternating w/ pum |
12 |
12 |
$74.92 |