| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
13,177 |
12,283 |
$1.07M |
| E0601 |
Cont airway pressure device |
7,583 |
7,059 |
$543K |
| E0570 |
Nebulizer with compression |
4,738 |
4,478 |
$283K |
| E0562 |
Humidifier heated used w pap |
2,081 |
2,023 |
$227K |
| A7030 |
Cpap full face mask |
2,039 |
1,979 |
$206K |
| E0470 |
Rad w/o backup non-inv intfc |
1,475 |
1,371 |
$168K |
| E0431 |
Portable gaseous 02 |
8,126 |
7,533 |
$131K |
| K0738 |
Portable gas oxygen system |
3,551 |
3,362 |
$75K |
| A7035 |
Pos airway press headgear |
3,313 |
3,205 |
$71K |
| E1028 |
W/c manual swingaway |
1,900 |
1,353 |
$69K |
| E0114 |
Crutch underarm pair no wood |
1,841 |
1,817 |
$65K |
| K0823 |
Pwc gp 2 std cap chair |
515 |
454 |
$60K |
| A7034 |
Nasal application device |
1,144 |
1,106 |
$58K |
| A7031 |
Replacement facemask interfa |
1,746 |
1,659 |
$55K |
| A7005 |
Nondisposable nebulizer set |
2,087 |
2,015 |
$51K |
| K0001 |
Standard wheelchair |
1,698 |
1,591 |
$41K |
| E0260 |
Hosp bed semi-electr w/ matt |
880 |
792 |
$35K |
| E0143 |
Walker folding wheeled w/o s |
538 |
516 |
$33K |
| A7037 |
Pos airway pressure tubing |
3,810 |
3,670 |
$23K |
| A7038 |
Pos airway pressure filter |
6,018 |
5,795 |
$20K |
| A7046 |
Repl water chamber, pap dev |
1,709 |
1,653 |
$19K |
| A7032 |
Replacement nasal cushion |
601 |
587 |
$11K |
| E0971 |
Wheelchair anti-tipping devi |
261 |
164 |
$6K |
| K0739 |
Repair/svc dme non-oxygen eq |
327 |
265 |
$5K |
| E0443 |
Portable 02 contents, gas |
430 |
412 |
$4K |
| K0108 |
W/c component-accessory nos |
56 |
41 |
$4K |
| A7015 |
Aerosol mask used w nebulize |
1,757 |
1,704 |
$3K |
| E0630 |
Patient lift hydraulic |
29 |
26 |
$2K |
| K0003 |
Lightweight wheelchair |
31 |
28 |
$2K |
| E0955 |
Cushioned headrest |
12 |
12 |
$684.30 |
| E0978 |
W/c acc,saf belt pelv strap |
19 |
13 |
$409.37 |
| A7033 |
Replacement nasal pillows |
13 |
12 |
$401.01 |
| K0195 |
Elevating whlchair leg rests |
44 |
38 |
$385.68 |
| E0250 |
Hosp bed fixed ht w/ mattres |
13 |
12 |
$312.23 |
| A7003 |
Nebulizer administration set |
114 |
110 |
$147.14 |
| A7013 |
Disposable compressor filter |
107 |
106 |
$48.58 |
| A4604 |
Tubing with heating element |
13 |
13 |
$35.58 |