| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
3,577 |
3,151 |
$257K |
| E0260 |
Hosp bed semi-electr w/ matt |
1,608 |
1,388 |
$66K |
| E0601 |
Cont airway pressure device |
1,669 |
1,506 |
$63K |
| K0001 |
Standard wheelchair |
1,925 |
1,733 |
$42K |
| E0143 |
Walker folding wheeled w/o s |
659 |
579 |
$29K |
| E1392 |
Portable oxygen concentrator |
1,641 |
1,474 |
$20K |
| E0466 |
Home vent non-invasive inter |
62 |
55 |
$19K |
| E0431 |
Portable gaseous 02 |
1,353 |
1,170 |
$15K |
| E0470 |
Rad w/o backup non-inv intfc |
176 |
157 |
$14K |
| E0630 |
Patient lift hydraulic |
557 |
464 |
$14K |
| K0195 |
Elevating whlchair leg rests |
1,145 |
1,044 |
$10K |
| E0570 |
Nebulizer with compression |
685 |
583 |
$10K |
| A4604 |
Tubing with heating element |
351 |
301 |
$9K |
| E0163 |
Commode chair with fixed arm |
260 |
207 |
$8K |
| E0562 |
Humidifier heated used w pap |
86 |
70 |
$6K |
| A7030 |
Cpap full face mask |
101 |
85 |
$6K |
| A7034 |
Nasal application device |
117 |
95 |
$4K |
| T4541 |
Large disposable underpad |
106 |
92 |
$3K |
| A7035 |
Pos airway press headgear |
218 |
185 |
$2K |
| A7038 |
Pos airway pressure filter |
588 |
385 |
$2K |
| E0240 |
Bath/shower chair |
76 |
68 |
$1K |
| A4927 |
Non-sterile gloves |
115 |
90 |
$885.97 |
| A7031 |
Replacement facemask interfa |
13 |
12 |
$583.52 |
| E0600 |
Suction pump portab hom modl |
14 |
12 |
$392.82 |
| K0003 |
Lightweight wheelchair |
12 |
12 |
$356.52 |
| A7046 |
Repl water chamber, pap dev |
16 |
16 |
$161.89 |