| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
19,908 |
17,774 |
$921K |
| E0601 |
Cont airway pressure device |
3,983 |
3,559 |
$148K |
| E0466 |
Home vent non-invasive inter |
381 |
301 |
$135K |
| E0431 |
Portable gaseous 02 |
8,496 |
7,246 |
$121K |
| E0470 |
Rad w/o backup non-inv intfc |
1,295 |
1,146 |
$111K |
| E0562 |
Humidifier heated used w pap |
957 |
801 |
$56K |
| E0260 |
Hosp bed semi-electr w/ matt |
1,773 |
1,474 |
$55K |
| A7030 |
Cpap full face mask |
816 |
699 |
$43K |
| A7031 |
Replacement facemask interfa |
1,229 |
1,060 |
$30K |
| E0570 |
Nebulizer with compression |
1,704 |
1,354 |
$23K |
| K0001 |
Standard wheelchair |
1,100 |
883 |
$19K |
| E0114 |
Crutch underarm pair no wood |
675 |
650 |
$18K |
| E1392 |
Portable oxygen concentrator |
810 |
712 |
$14K |
| A7035 |
Pos airway press headgear |
735 |
633 |
$11K |
| A4604 |
Tubing with heating element |
507 |
447 |
$10K |
| K0003 |
Lightweight wheelchair |
485 |
395 |
$10K |
| L4350 |
Ankle control ortho pre ots |
198 |
193 |
$9K |
| A7038 |
Pos airway pressure filter |
2,220 |
1,834 |
$5K |
| L3908 |
Who cock-up nonmolde pre ots |
163 |
145 |
$5K |
| A7032 |
Replacement nasal cushion |
250 |
206 |
$4K |
| L3660 |
So 8 ab rstr can/web pre ots |
75 |
71 |
$4K |
| L4361 |
Pneuma/vac walk boot pre ots |
25 |
25 |
$3K |
| A7033 |
Replacement nasal pillows |
163 |
138 |
$3K |
| A7034 |
Nasal application device |
87 |
79 |
$3K |
| A7037 |
Pos airway pressure tubing |
203 |
176 |
$3K |
| K0004 |
High strength ltwt whlchr |
100 |
79 |
$2K |
| L3809 |
Whfo w/o joints pre ots |
15 |
14 |
$2K |
| L1830 |
Ko immob canvas long pre ots |
25 |
25 |
$975.21 |
| E0143 |
Walker folding wheeled w/o s |
49 |
41 |
$974.77 |
| A7046 |
Repl water chamber, pap dev |
263 |
233 |
$901.76 |
| E0973 |
W/ch access det adj armrest |
187 |
86 |
$458.92 |
| A7005 |
Nondisposable nebulizer set |
45 |
38 |
$401.49 |
| A7039 |
Filter, non disposable w pap |
14 |
13 |
$108.86 |
| A7013 |
Disposable compressor filter |
13 |
12 |
$0.51 |