| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
15,227 |
11,935 |
$588K |
| E0601 |
Cont airway pressure device |
5,458 |
4,762 |
$179K |
| E0260 |
Hosp bed semi-electr w/ matt |
3,615 |
2,439 |
$47K |
| E0431 |
Portable gaseous 02 |
7,803 |
6,177 |
$37K |
| K0001 |
Standard wheelchair |
2,972 |
2,231 |
$22K |
| E0570 |
Nebulizer with compression |
4,654 |
3,744 |
$20K |
| E0562 |
Humidifier heated used w pap |
2,868 |
2,631 |
$14K |
| E1392 |
Portable oxygen concentrator |
1,806 |
1,509 |
$10K |
| K0002 |
Stnd hemi (low seat) whlchr |
887 |
628 |
$10K |
| A7031 |
Replacement facemask interfa |
1,836 |
1,512 |
$3K |
| A7030 |
Cpap full face mask |
1,426 |
1,146 |
$3K |
| A7038 |
Pos airway pressure filter |
3,357 |
2,714 |
$1K |
| E0143 |
Walker folding wheeled w/o s |
31 |
27 |
$886.83 |
| A4604 |
Tubing with heating element |
1,487 |
1,190 |
$720.70 |
| A7035 |
Pos airway press headgear |
1,081 |
863 |
$635.28 |
| A7005 |
Nondisposable nebulizer set |
75 |
64 |
$331.99 |
| E0971 |
Wheelchair anti-tipping devi |
529 |
165 |
$311.73 |
| A7033 |
Replacement nasal pillows |
332 |
260 |
$204.35 |
| A7037 |
Pos airway pressure tubing |
209 |
182 |
$203.05 |
| E0910 |
Trapeze bar attached to bed |
116 |
74 |
$188.82 |
| K0195 |
Elevating whlchair leg rests |
32 |
25 |
$137.78 |
| A7046 |
Repl water chamber, pap dev |
608 |
489 |
$110.92 |
| A7032 |
Replacement nasal cushion |
445 |
353 |
$99.56 |
| A7034 |
Nasal application device |
571 |
458 |
$39.38 |
| E0443 |
Portable 02 contents, gas |
17 |
12 |
$0.00 |
| K0738 |
Portable gas oxygen system |
15 |
12 |
$0.00 |