| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
5,614 |
5,136 |
$231K |
| E0601 |
Cont airway pressure device |
1,608 |
1,449 |
$59K |
| E0570 |
Nebulizer with compression |
1,825 |
1,689 |
$46K |
| K0003 |
Lightweight wheelchair |
922 |
846 |
$36K |
| E0431 |
Portable gaseous 02 |
2,554 |
2,234 |
$36K |
| E1392 |
Portable oxygen concentrator |
958 |
869 |
$14K |
| A7030 |
Cpap full face mask |
397 |
323 |
$13K |
| E0260 |
Hosp bed semi-electr w/ matt |
234 |
211 |
$13K |
| E0250 |
Hosp bed fixed ht w/ mattres |
999 |
951 |
$11K |
| E0562 |
Humidifier heated used w pap |
287 |
242 |
$8K |
| A7031 |
Replacement facemask interfa |
202 |
168 |
$7K |
| A7035 |
Pos airway press headgear |
460 |
371 |
$6K |
| K0001 |
Standard wheelchair |
277 |
251 |
$6K |
| T4528 |
Adult size pull-on xl |
75 |
60 |
$6K |
| T4541 |
Large disposable underpad |
198 |
166 |
$5K |
| A7037 |
Pos airway pressure tubing |
478 |
401 |
$4K |
| T4535 |
Disposable liner/shield/pad |
113 |
97 |
$4K |
| K0738 |
Portable gas oxygen system |
148 |
138 |
$3K |
| T4527 |
Adult size pull-on lg |
42 |
34 |
$3K |
| A4927 |
Non-sterile gloves |
233 |
187 |
$2K |
| A7038 |
Pos airway pressure filter |
926 |
715 |
$2K |
| B4152 |
Ef calorie dense>/=1.5kcal |
19 |
13 |
$2K |
| A7039 |
Filter, non disposable w pap |
266 |
222 |
$1K |
| E0470 |
Rad w/o backup non-inv intfc |
15 |
13 |
$1K |
| A7005 |
Nondisposable nebulizer set |
82 |
79 |
$1K |
| T4537 |
Reusable underpad bed size |
14 |
12 |
$804.00 |
| T4540 |
Reusable underpad chair size |
14 |
12 |
$402.00 |
| A7003 |
Nebulizer administration set |
253 |
232 |
$383.75 |
| K0195 |
Elevating whlchair leg rests |
59 |
52 |
$317.68 |
| A7015 |
Aerosol mask used w nebulize |
14 |
14 |
$54.47 |
| A7046 |
Repl water chamber, pap dev |
44 |
25 |
$25.74 |