| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
9,305 |
9,283 |
$832K |
| E0601 |
Cont airway pressure device |
4,429 |
4,398 |
$222K |
| E0431 |
Portable gaseous 02 |
5,428 |
5,415 |
$114K |
| E0470 |
Rad w/o backup non-inv intfc |
579 |
579 |
$59K |
| E0260 |
Hosp bed semi-electr w/ matt |
1,900 |
1,899 |
$50K |
| K0003 |
Lightweight wheelchair |
1,143 |
1,132 |
$40K |
| A7030 |
Cpap full face mask |
499 |
496 |
$32K |
| E0570 |
Nebulizer with compression |
860 |
860 |
$18K |
| A7035 |
Pos airway press headgear |
933 |
916 |
$17K |
| K0001 |
Standard wheelchair |
1,800 |
1,767 |
$15K |
| E0562 |
Humidifier heated used w pap |
158 |
158 |
$12K |
| A7037 |
Pos airway pressure tubing |
453 |
451 |
$11K |
| A7038 |
Pos airway pressure filter |
1,427 |
1,409 |
$10K |
| K0004 |
High strength ltwt whlchr |
123 |
123 |
$10K |
| A7031 |
Replacement facemask interfa |
149 |
143 |
$4K |
| A7034 |
Nasal application device |
102 |
101 |
$4K |
| K0195 |
Elevating whlchair leg rests |
670 |
667 |
$3K |
| E0630 |
Patient lift hydraulic |
105 |
105 |
$3K |
| E0143 |
Walker folding wheeled w/o s |
12 |
12 |
$692.06 |
| E2201 |
Man w/ch acc seat w>=20"<24" |
37 |
37 |
$459.87 |
| A7046 |
Repl water chamber, pap dev |
49 |
49 |
$242.68 |
| A4604 |
Tubing with heating element |
12 |
12 |
$77.88 |