| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
2,782 |
2,563 |
$109K |
| E0601 |
Cont airway pressure device |
2,600 |
2,325 |
$67K |
| K0001 |
Standard wheelchair |
3,042 |
2,655 |
$30K |
| E0143 |
Walker folding wheeled w/o s |
679 |
616 |
$19K |
| K0195 |
Elevating whlchair leg rests |
1,721 |
1,500 |
$13K |
| E0445 |
Oximeter non-invasive |
79 |
74 |
$11K |
| E0260 |
Hosp bed semi-electr w/ matt |
364 |
333 |
$11K |
| K0003 |
Lightweight wheelchair |
542 |
466 |
$7K |
| E0562 |
Humidifier heated used w pap |
163 |
144 |
$6K |
| A7035 |
Pos airway press headgear |
217 |
199 |
$4K |
| K0004 |
High strength ltwt whlchr |
74 |
65 |
$4K |
| K0738 |
Portable gas oxygen system |
61 |
40 |
$4K |
| A4604 |
Tubing with heating element |
297 |
263 |
$4K |
| A7038 |
Pos airway pressure filter |
1,090 |
927 |
$3K |
| A7037 |
Pos airway pressure tubing |
109 |
104 |
$3K |
| A7034 |
Nasal application device |
90 |
81 |
$3K |
| E0431 |
Portable gaseous 02 |
352 |
339 |
$2K |
| E0250 |
Hosp bed fixed ht w/ mattres |
148 |
147 |
$1K |
| E0630 |
Patient lift hydraulic |
69 |
66 |
$1K |
| A7031 |
Replacement facemask interfa |
75 |
67 |
$1K |
| E0114 |
Crutch underarm pair no wood |
24 |
24 |
$1K |
| A7032 |
Replacement nasal cushion |
42 |
39 |
$441.48 |
| A7046 |
Repl water chamber, pap dev |
30 |
27 |
$231.74 |
| A7030 |
Cpap full face mask |
12 |
12 |
$191.61 |