| Code | Description | Claims | Beneficiaries | Total Paid |
| E1390 |
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate |
4,652 |
4,387 |
$188K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
974 |
955 |
$42K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
1,512 |
1,372 |
$24K |
| E0601 |
Continuous positive airway pressure (cpap) device |
1,357 |
1,206 |
$15K |
| A7030 |
Full face mask used with positive airway pressure device, each |
550 |
527 |
$12K |
| E0570 |
Nebulizer, with compressor |
825 |
796 |
$11K |
| A7031 |
Face mask interface, replacement for full face mask, each |
483 |
460 |
$10K |
| E1392 |
Portable oxygen concentrator, rental |
1,213 |
1,190 |
$8K |
| A7037 |
Tubing used with positive airway pressure device |
1,232 |
1,182 |
$6K |
| K0001 |
Standard wheelchair |
1,541 |
1,524 |
$5K |
| K0738 |
Portable gaseous oxygen system, rental; home compressor used to fill portable oxygen cylinders; includes portable containers, regulator, flowmeter, humidifier, cannula or mask, and tubing |
886 |
858 |
$4K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
1,346 |
1,280 |
$4K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
138 |
138 |
$3K |
| A7035 |
Headgear used with positive airway pressure device |
581 |
549 |
$2K |
| E0443 |
Portable oxygen contents, gaseous, 1 month's supply = 1 unit |
37 |
36 |
$2K |
| E0630 |
Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s) |
29 |
26 |
$2K |
| K0195 |
Elevating leg rests, pair (for use with capped rental wheelchair base) |
581 |
571 |
$1K |
| A7039 |
Filter, non disposable, used with positive airway pressure device |
506 |
480 |
$722.47 |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
53 |
52 |
$605.69 |
| E0163 |
Commode chair, mobile or stationary, with fixed arms |
13 |
13 |
$527.20 |
| E0261 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, without mattress |
38 |
38 |
$189.76 |