| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
13,798 |
11,359 |
$916K |
| E0466 |
Home vent non-invasive inter |
769 |
634 |
$272K |
| E0601 |
Cont airway pressure device |
4,008 |
3,693 |
$221K |
| E0470 |
Rad w/o backup non-inv intfc |
592 |
545 |
$85K |
| E0431 |
Portable gaseous 02 |
11,262 |
9,343 |
$56K |
| K0001 |
Standard wheelchair |
4,485 |
3,423 |
$46K |
| E0570 |
Nebulizer with compression |
3,785 |
3,083 |
$32K |
| E0143 |
Walker folding wheeled w/o s |
1,100 |
908 |
$31K |
| E0562 |
Humidifier heated used w pap |
3,831 |
3,580 |
$10K |
| E0260 |
Hosp bed semi-electr w/ matt |
572 |
448 |
$9K |
| K0195 |
Elevating whlchair leg rests |
1,000 |
731 |
$6K |
| K0003 |
Lightweight wheelchair |
296 |
243 |
$6K |
| E1399 |
Durable medical equipment mi |
336 |
308 |
$3K |
| E1392 |
Portable oxygen concentrator |
583 |
474 |
$2K |
| E0156 |
Walker seat attachment |
207 |
168 |
$534.56 |
| E0261 |
Hosp bed semi-electr w/o mat |
318 |
221 |
$325.28 |
| A7003 |
Nebulizer administration set |
31 |
24 |
$25.41 |
| A7038 |
Pos airway pressure filter |
401 |
303 |
$20.27 |
| A7034 |
Nasal application device |
56 |
49 |
$7.94 |
| A7037 |
Pos airway pressure tubing |
210 |
173 |
$6.98 |
| A7013 |
Disposable compressor filter |
16 |
12 |
$2.91 |
| A7039 |
Filter, non disposable w pap |
16 |
13 |
$0.00 |
| A7035 |
Pos airway press headgear |
109 |
86 |
$0.00 |
| A7046 |
Repl water chamber, pap dev |
16 |
12 |
$0.00 |