| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
8,793 |
6,682 |
$327K |
| E0601 |
Cont airway pressure device |
3,047 |
2,397 |
$81K |
| K0001 |
Standard wheelchair |
2,773 |
2,079 |
$30K |
| E0431 |
Portable gaseous 02 |
6,612 |
4,975 |
$27K |
| E0260 |
Hosp bed semi-electr w/ matt |
1,094 |
809 |
$26K |
| E0570 |
Nebulizer with compression |
3,005 |
2,203 |
$14K |
| E0470 |
Rad w/o backup non-inv intfc |
198 |
152 |
$10K |
| E0562 |
Humidifier heated used w pap |
1,651 |
1,409 |
$8K |
| K0195 |
Elevating whlchair leg rests |
1,665 |
1,246 |
$6K |
| K0002 |
Stnd hemi (low seat) whlchr |
179 |
151 |
$5K |
| E1392 |
Portable oxygen concentrator |
1,394 |
1,080 |
$4K |
| E0143 |
Walker folding wheeled w/o s |
135 |
102 |
$3K |
| A7031 |
Replacement facemask interfa |
1,207 |
962 |
$2K |
| A7030 |
Cpap full face mask |
1,104 |
878 |
$2K |
| A7032 |
Replacement nasal cushion |
613 |
507 |
$1K |
| K0003 |
Lightweight wheelchair |
162 |
119 |
$1K |
| A4604 |
Tubing with heating element |
1,077 |
867 |
$894.86 |
| A7034 |
Nasal application device |
830 |
686 |
$587.02 |
| A7038 |
Pos airway pressure filter |
2,618 |
2,106 |
$501.71 |
| A7033 |
Replacement nasal pillows |
119 |
98 |
$268.97 |
| A7035 |
Pos airway press headgear |
982 |
788 |
$212.14 |
| A7046 |
Repl water chamber, pap dev |
504 |
409 |
$55.96 |
| A7037 |
Pos airway pressure tubing |
515 |
421 |
$38.62 |
| A7003 |
Nebulizer administration set |
13 |
12 |
$30.14 |
| E0156 |
Walker seat attachment |
15 |
13 |
$1.25 |
| A7039 |
Filter, non disposable w pap |
159 |
120 |
$0.00 |
| E0294 |
Hosp bed semi-elect w/ mattr |
313 |
255 |
$0.00 |