| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
8,726 |
7,228 |
$180K |
| E0601 |
Cont airway pressure device |
2,632 |
2,241 |
$46K |
| A7030 |
Cpap full face mask |
1,109 |
874 |
$37K |
| A7031 |
Replacement facemask interfa |
2,454 |
1,916 |
$36K |
| E0570 |
Nebulizer with compression |
4,564 |
4,143 |
$32K |
| E0431 |
Portable gaseous 02 |
5,049 |
4,062 |
$23K |
| K0003 |
Lightweight wheelchair |
1,522 |
1,356 |
$15K |
| E0562 |
Humidifier heated used w pap |
2,156 |
1,776 |
$15K |
| K0001 |
Standard wheelchair |
2,148 |
1,784 |
$13K |
| E0260 |
Hosp bed semi-electr w/ matt |
745 |
650 |
$13K |
| E0261 |
Hosp bed semi-electr w/o mat |
897 |
718 |
$8K |
| A7032 |
Replacement nasal cushion |
528 |
385 |
$7K |
| A7035 |
Pos airway press headgear |
921 |
726 |
$6K |
| E0443 |
Portable 02 contents, gas |
1,259 |
678 |
$6K |
| A7038 |
Pos airway pressure filter |
2,981 |
2,306 |
$6K |
| A7037 |
Pos airway pressure tubing |
1,277 |
981 |
$6K |
| A7034 |
Nasal application device |
178 |
129 |
$3K |
| E2201 |
Man w/ch acc seat w>=20"<24" |
166 |
152 |
$2K |
| E0295 |
Hosp bed semi-elect w/o matt |
101 |
90 |
$1K |
| A7039 |
Filter, non disposable w pap |
514 |
409 |
$1K |
| E1392 |
Portable oxygen concentrator |
108 |
97 |
$1K |
| A7005 |
Nondisposable nebulizer set |
165 |
142 |
$1K |
| A4604 |
Tubing with heating element |
39 |
36 |
$900.06 |
| A7046 |
Repl water chamber, pap dev |
157 |
121 |
$841.98 |
| E0630 |
Patient lift hydraulic |
30 |
25 |
$282.03 |
| A7033 |
Replacement nasal pillows |
17 |
14 |
$202.43 |
| E0910 |
Trapeze bar attached to bed |
26 |
24 |
$97.35 |
| E0143 |
Walker folding wheeled w/o s |
17 |
12 |
$96.39 |
| A7003 |
Nebulizer administration set |
62 |
54 |
$70.10 |
| K0195 |
Elevating whlchair leg rests |
13 |
12 |
$24.12 |
| E0961 |
Wheelchair brake extension |
110 |
49 |
$22.43 |