| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
21,536 |
19,498 |
$965K |
| E0466 |
Home vent non-invasive inter |
1,216 |
1,064 |
$347K |
| E0431 |
Portable gaseous 02 |
13,741 |
12,602 |
$220K |
| E0601 |
Cont airway pressure device |
5,176 |
4,729 |
$199K |
| A7030 |
Cpap full face mask |
1,872 |
1,714 |
$83K |
| E0562 |
Humidifier heated used w pap |
889 |
791 |
$59K |
| E0260 |
Hosp bed semi-electr w/ matt |
1,398 |
1,247 |
$53K |
| E0470 |
Rad w/o backup non-inv intfc |
627 |
527 |
$47K |
| K0001 |
Standard wheelchair |
1,900 |
1,691 |
$45K |
| E0570 |
Nebulizer with compression |
2,197 |
2,042 |
$41K |
| A7035 |
Pos airway press headgear |
2,483 |
2,250 |
$33K |
| A7034 |
Nasal application device |
1,066 |
951 |
$25K |
| A7031 |
Replacement facemask interfa |
1,133 |
980 |
$18K |
| A4604 |
Tubing with heating element |
1,210 |
1,077 |
$18K |
| A7037 |
Pos airway pressure tubing |
1,325 |
1,211 |
$15K |
| A7038 |
Pos airway pressure filter |
3,826 |
3,306 |
$7K |
| K0002 |
Stnd hemi (low seat) whlchr |
114 |
105 |
$4K |
| E1392 |
Portable oxygen concentrator |
166 |
160 |
$3K |
| E0973 |
W/ch access det adj armrest |
930 |
397 |
$3K |
| A7039 |
Filter, non disposable w pap |
431 |
400 |
$3K |
| K0003 |
Lightweight wheelchair |
40 |
39 |
$2K |
| E0114 |
Crutch underarm pair no wood |
145 |
137 |
$2K |
| A7005 |
Nondisposable nebulizer set |
219 |
202 |
$2K |
| A7032 |
Replacement nasal cushion |
92 |
83 |
$2K |
| E0250 |
Hosp bed fixed ht w/ mattres |
72 |
70 |
$2K |
| E0971 |
Wheelchair anti-tipping devi |
865 |
372 |
$2K |
| A7033 |
Replacement nasal pillows |
31 |
24 |
$804.76 |
| E0961 |
Wheelchair brake extension |
689 |
289 |
$730.29 |
| E0978 |
W/c acc,saf belt pelv strap |
367 |
309 |
$534.87 |
| E0951 |
Loop heel |
701 |
294 |
$473.40 |
| E0143 |
Walker folding wheeled w/o s |
14 |
13 |
$351.40 |
| K0195 |
Elevating whlchair leg rests |
54 |
54 |
$270.90 |
| A7046 |
Repl water chamber, pap dev |
229 |
213 |
$245.58 |
| A7003 |
Nebulizer administration set |
235 |
222 |
$124.58 |
| E2201 |
Man w/ch acc seat w>=20"<24" |
15 |
13 |
$82.67 |