| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
12,438 |
11,757 |
$523K |
| E0601 |
Cont airway pressure device |
7,231 |
6,899 |
$214K |
| K0738 |
Portable gas oxygen system |
5,415 |
5,096 |
$180K |
| A7030 |
Cpap full face mask |
1,713 |
1,630 |
$119K |
| E0570 |
Nebulizer with compression |
4,595 |
4,443 |
$103K |
| E0470 |
Rad w/o backup non-inv intfc |
1,105 |
1,054 |
$80K |
| E0431 |
Portable gaseous 02 |
1,863 |
1,797 |
$63K |
| A7037 |
Pos airway pressure tubing |
3,455 |
3,298 |
$56K |
| A7034 |
Nasal application device |
1,020 |
971 |
$53K |
| A7035 |
Pos airway press headgear |
2,844 |
2,735 |
$51K |
| L4387 |
Non-pneum walk boot pre ots |
488 |
426 |
$49K |
| A7031 |
Replacement facemask interfa |
1,546 |
1,474 |
$42K |
| E0260 |
Hosp bed semi-electr w/ matt |
971 |
908 |
$31K |
| A7038 |
Pos airway pressure filter |
5,587 |
5,328 |
$28K |
| L3908 |
Who cock-up nonmolde pre ots |
1,315 |
1,150 |
$25K |
| K0001 |
Standard wheelchair |
1,815 |
1,536 |
$25K |
| K0007 |
Extra heavy duty wheelchair |
634 |
478 |
$24K |
| E0562 |
Humidifier heated used w pap |
136 |
133 |
$24K |
| E0143 |
Walker folding wheeled w/o s |
1,053 |
936 |
$20K |
| E0114 |
Crutch underarm pair no wood |
504 |
485 |
$19K |
| B4160 |
Ef ped caloric dense>/=0.7kc |
105 |
90 |
$12K |
| A7039 |
Filter, non disposable w pap |
1,608 |
1,523 |
$10K |
| K0823 |
Pwc gp 2 std cap chair |
56 |
48 |
$9K |
| A7033 |
Replacement nasal pillows |
331 |
318 |
$6K |
| A4565 |
Slings |
588 |
539 |
$5K |
| K0003 |
Lightweight wheelchair |
277 |
209 |
$5K |
| L4386 |
Non-pneum walk boot pre cst |
42 |
41 |
$4K |
| E1028 |
W/c manual swingaway |
100 |
55 |
$2K |
| A4604 |
Tubing with heating element |
84 |
82 |
$2K |
| E0630 |
Patient lift hydraulic |
38 |
37 |
$2K |
| A7003 |
Nebulizer administration set |
787 |
774 |
$2K |
| E1392 |
Portable oxygen concentrator |
114 |
108 |
$930.69 |
| K0002 |
Stnd hemi (low seat) whlchr |
27 |
24 |
$740.06 |
| K0739 |
Repair/svc dme non-oxygen eq |
19 |
12 |
$166.28 |