| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
13,599 |
13,572 |
$994K |
| E0601 |
Cont airway pressure device |
8,659 |
8,620 |
$658K |
| E0570 |
Nebulizer with compression |
8,846 |
8,834 |
$281K |
| K0001 |
Standard wheelchair |
12,069 |
12,057 |
$246K |
| E0562 |
Humidifier heated used w pap |
8,463 |
8,424 |
$234K |
| E0470 |
Rad w/o backup non-inv intfc |
1,467 |
1,464 |
$224K |
| E0431 |
Portable gaseous 02 |
10,251 |
10,223 |
$156K |
| A7032 |
Replacement nasal cushion |
2,239 |
2,091 |
$150K |
| E0443 |
Portable 02 contents, gas |
2,406 |
2,405 |
$145K |
| A7030 |
Cpap full face mask |
3,119 |
3,113 |
$123K |
| A7031 |
Replacement facemask interfa |
3,211 |
3,159 |
$116K |
| E0295 |
Hosp bed semi-elect w/o matt |
839 |
836 |
$113K |
| A7034 |
Nasal application device |
2,221 |
2,157 |
$112K |
| A7038 |
Pos airway pressure filter |
7,680 |
7,487 |
$107K |
| A7035 |
Pos airway press headgear |
4,983 |
4,793 |
$107K |
| E0143 |
Walker folding wheeled w/o s |
2,687 |
2,682 |
$87K |
| E0260 |
Hosp bed semi-electr w/ matt |
4,736 |
4,734 |
$77K |
| A7037 |
Pos airway pressure tubing |
4,128 |
3,990 |
$65K |
| E0630 |
Patient lift hydraulic |
1,907 |
1,905 |
$63K |
| E0245 |
Tub stool or bench |
1,333 |
1,331 |
$54K |
| A4604 |
Tubing with heating element |
1,795 |
1,751 |
$46K |
| A7033 |
Replacement nasal pillows |
1,220 |
1,150 |
$45K |
| K0195 |
Elevating whlchair leg rests |
4,381 |
4,378 |
$44K |
| A7005 |
Nondisposable nebulizer set |
3,631 |
3,622 |
$41K |
| K0738 |
Portable gas oxygen system |
1,491 |
1,486 |
$36K |
| K0003 |
Lightweight wheelchair |
1,387 |
1,387 |
$36K |
| A7039 |
Filter, non disposable w pap |
3,900 |
3,732 |
$28K |
| K0006 |
Heavy duty wheelchair |
434 |
428 |
$25K |
| E0247 |
Trans bench w/wo comm open |
223 |
222 |
$16K |
| A7046 |
Repl water chamber, pap dev |
963 |
961 |
$16K |
| E0271 |
Mattress innerspring |
648 |
646 |
$16K |
| E0305 |
Rails bed side half length |
547 |
545 |
$12K |
| E0156 |
Walker seat attachment |
1,121 |
1,119 |
$11K |
| K0007 |
Extra heavy duty wheelchair |
139 |
139 |
$10K |
| A7015 |
Aerosol mask used w nebulize |
3,774 |
3,766 |
$5K |
| E0244 |
Toilet seat raised |
102 |
102 |
$4K |
| E0603 |
Electric breast pump |
17 |
17 |
$4K |
| A7003 |
Nebulizer administration set |
1,278 |
1,267 |
$4K |
| E0114 |
Crutch underarm pair no wood |
130 |
129 |
$3K |
| E0149 |
Heavy duty wheeled walker |
49 |
49 |
$818.82 |
| E0181 |
Press pad alternating w/ pum |
81 |
81 |
$749.51 |
| A7036 |
Pos airway press chinstrap |
14 |
14 |
$160.89 |
| E0100 |
Cane adjust/fixed with tip |
12 |
12 |
$159.90 |
| E0250 |
Hosp bed fixed ht w/ mattres |
12 |
12 |
$133.10 |