| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E0601 |
Cont airway pressure device |
10,905 |
9,260 |
$239K |
| E1390 |
Oxygen concentrator |
6,916 |
5,397 |
$152K |
| A7030 |
Cpap full face mask |
3,334 |
2,679 |
$127K |
| A7031 |
Replacement facemask interfa |
6,736 |
5,378 |
$102K |
| E0562 |
Humidifier heated used w pap |
10,596 |
9,048 |
$81K |
| A7034 |
Nasal application device |
2,155 |
1,879 |
$67K |
| A7032 |
Replacement nasal cushion |
2,014 |
1,749 |
$46K |
| E0470 |
Rad w/o backup non-inv intfc |
655 |
528 |
$36K |
| A7033 |
Replacement nasal pillows |
1,966 |
1,654 |
$34K |
| A7035 |
Pos airway press headgear |
3,674 |
3,050 |
$34K |
| A4604 |
Tubing with heating element |
1,582 |
1,337 |
$31K |
| A7037 |
Pos airway pressure tubing |
3,947 |
3,250 |
$25K |
| A7038 |
Pos airway pressure filter |
9,930 |
8,033 |
$22K |
| E0431 |
Portable gaseous 02 |
4,113 |
3,233 |
$20K |
| K0001 |
Standard wheelchair |
3,459 |
2,696 |
$19K |
| E0570 |
Nebulizer with compression |
3,345 |
2,914 |
$16K |
| E0260 |
Hosp bed semi-electr w/ matt |
1,096 |
815 |
$12K |
| K0003 |
Lightweight wheelchair |
1,889 |
1,531 |
$11K |
| A7039 |
Filter, non disposable w pap |
2,413 |
2,065 |
$8K |
| A7046 |
Repl water chamber, pap dev |
1,457 |
1,204 |
$7K |
| E0261 |
Hosp bed semi-electr w/o mat |
692 |
556 |
$7K |
| E0630 |
Patient lift hydraulic |
452 |
376 |
$6K |
| E1392 |
Portable oxygen concentrator |
544 |
423 |
$5K |
| E0443 |
Portable 02 contents, gas |
351 |
265 |
$5K |
| K0006 |
Heavy duty wheelchair |
337 |
266 |
$4K |
| E0295 |
Hosp bed semi-elect w/o matt |
914 |
613 |
$4K |
| K0195 |
Elevating whlchair leg rests |
998 |
735 |
$2K |
| E0143 |
Walker folding wheeled w/o s |
147 |
94 |
$1K |
| A7036 |
Pos airway press chinstrap |
228 |
208 |
$1K |
| E0973 |
W/ch access det adj armrest |
2,704 |
970 |
$1K |
| E2201 |
Man w/ch acc seat w>=20"<24" |
219 |
160 |
$993.46 |
| E0971 |
Wheelchair anti-tipping devi |
3,031 |
1,120 |
$687.90 |
| E2611 |
Gen use back cush wdth <22in |
16 |
12 |
$591.78 |
| A7005 |
Nondisposable nebulizer set |
109 |
88 |
$560.17 |
| E0961 |
Wheelchair brake extension |
2,163 |
789 |
$280.66 |
| E0305 |
Rails bed side half length |
415 |
305 |
$230.83 |
| E0181 |
Press pad alternating w/ pum |
84 |
79 |
$188.17 |
| E2601 |
Gen w/c cushion wdth < 22 in |
23 |
15 |
$161.56 |
| E0163 |
Commode chair with fixed arm |
16 |
12 |
$149.35 |
| E0149 |
Heavy duty wheeled walker |
29 |
24 |
$134.83 |
| E0951 |
Loop heel |
1,322 |
454 |
$133.76 |
| E0910 |
Trapeze bar attached to bed |
283 |
194 |
$104.40 |