| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A7030 |
Cpap full face mask |
6,599 |
5,832 |
$504K |
| E1390 |
Oxygen concentrator |
11,906 |
9,671 |
$429K |
| E0601 |
Cont airway pressure device |
11,818 |
10,090 |
$334K |
| E0603 |
Electric breast pump |
1,612 |
1,445 |
$214K |
| E0562 |
Humidifier heated used w pap |
10,518 |
8,977 |
$134K |
| E0570 |
Nebulizer with compression |
7,066 |
6,044 |
$119K |
| A7037 |
Pos airway pressure tubing |
5,154 |
4,596 |
$117K |
| A7035 |
Pos airway press headgear |
6,454 |
5,767 |
$112K |
| E0431 |
Portable gaseous 02 |
8,777 |
7,307 |
$78K |
| A7034 |
Nasal application device |
1,649 |
1,450 |
$68K |
| A7031 |
Replacement facemask interfa |
3,028 |
2,473 |
$46K |
| E0114 |
Crutch underarm pair no wood |
1,269 |
1,161 |
$35K |
| A7038 |
Pos airway pressure filter |
7,994 |
6,889 |
$34K |
| A7005 |
Nondisposable nebulizer set |
2,366 |
2,150 |
$31K |
| K0001 |
Standard wheelchair |
3,054 |
2,678 |
$23K |
| A7046 |
Repl water chamber, pap dev |
2,861 |
2,477 |
$17K |
| E0143 |
Walker folding wheeled w/o s |
670 |
555 |
$16K |
| A4604 |
Tubing with heating element |
2,816 |
2,387 |
$16K |
| E0470 |
Rad w/o backup non-inv intfc |
232 |
200 |
$15K |
| E0260 |
Hosp bed semi-electr w/ matt |
1,636 |
1,497 |
$12K |
| K0002 |
Stnd hemi (low seat) whlchr |
886 |
789 |
$6K |
| A4385 |
Ost skn barrier sld ext wear |
185 |
164 |
$4K |
| K0108 |
W/c component-accessory nos |
135 |
55 |
$4K |
| K0739 |
Repair/svc dme non-oxygen eq |
1,116 |
502 |
$3K |
| E1028 |
W/c manual swingaway |
386 |
268 |
$3K |
| E1392 |
Portable oxygen concentrator |
369 |
247 |
$3K |
| E0443 |
Portable 02 contents, gas |
456 |
402 |
$2K |
| E0149 |
Heavy duty wheeled walker |
93 |
77 |
$1K |
| A4362 |
Solid skin barrier |
45 |
42 |
$995.12 |
| E0955 |
Cushioned headrest |
59 |
52 |
$703.42 |
| E0156 |
Walker seat attachment |
129 |
112 |
$567.50 |
| A4456 |
Adhesive remover, wipes |
165 |
158 |
$524.05 |
| K0195 |
Elevating whlchair leg rests |
503 |
446 |
$348.16 |
| A7003 |
Nebulizer administration set |
582 |
508 |
$340.83 |
| E0971 |
Wheelchair anti-tipping devi |
33 |
12 |
$335.80 |
| A7015 |
Aerosol mask used w nebulize |
359 |
320 |
$332.40 |
| E0630 |
Patient lift hydraulic |
140 |
137 |
$280.56 |
| E0261 |
Hosp bed semi-electr w/o mat |
122 |
116 |
$254.23 |
| A5120 |
Skin barrier, wipe or swab |
92 |
86 |
$236.89 |
| A4407 |
Ext wear ost skn barr <=4sq" |
12 |
12 |
$214.80 |
| E0181 |
Press pad alternating w/ pum |
12 |
12 |
$2.26 |