| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
13,724 |
9,537 |
$336K |
| E0601 |
Cont airway pressure device |
3,962 |
2,807 |
$75K |
| A7030 |
Cpap full face mask |
1,360 |
1,096 |
$57K |
| E0570 |
Nebulizer with compression |
4,262 |
3,334 |
$46K |
| E0431 |
Portable gaseous 02 |
6,736 |
4,852 |
$40K |
| A7034 |
Nasal application device |
1,079 |
933 |
$40K |
| E0562 |
Humidifier heated used w pap |
2,889 |
2,148 |
$27K |
| E1392 |
Portable oxygen concentrator |
2,179 |
1,648 |
$26K |
| E0260 |
Hosp bed semi-electr w/ matt |
2,166 |
1,468 |
$25K |
| A7035 |
Pos airway press headgear |
2,044 |
1,709 |
$22K |
| A7031 |
Replacement facemask interfa |
921 |
709 |
$15K |
| A7037 |
Pos airway pressure tubing |
1,744 |
1,460 |
$13K |
| K0001 |
Standard wheelchair |
1,758 |
1,293 |
$11K |
| E0114 |
Crutch underarm pair no wood |
291 |
280 |
$11K |
| K0738 |
Portable gas oxygen system |
1,105 |
767 |
$10K |
| A7005 |
Nondisposable nebulizer set |
919 |
838 |
$8K |
| E0470 |
Rad w/o backup non-inv intfc |
146 |
104 |
$7K |
| A7046 |
Repl water chamber, pap dev |
944 |
798 |
$7K |
| K0003 |
Lightweight wheelchair |
421 |
253 |
$5K |
| A7038 |
Pos airway pressure filter |
3,207 |
2,342 |
$5K |
| A4604 |
Tubing with heating element |
226 |
179 |
$4K |
| A7032 |
Replacement nasal cushion |
123 |
101 |
$2K |
| A7039 |
Filter, non disposable w pap |
217 |
174 |
$659.99 |
| A6402 |
Sterile gauze <= 16 sq in |
35 |
13 |
$602.04 |
| E0143 |
Walker folding wheeled w/o s |
16 |
12 |
$267.54 |
| K0195 |
Elevating whlchair leg rests |
131 |
65 |
$140.26 |
| A7015 |
Aerosol mask used w nebulize |
30 |
27 |
$29.05 |