| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
8,099 |
6,177 |
$215K |
| E0570 |
Nebulizer with compression |
2,730 |
2,089 |
$79K |
| E0601 |
Cont airway pressure device |
2,335 |
1,847 |
$59K |
| E0431 |
Portable gaseous 02 |
6,731 |
5,133 |
$42K |
| E0260 |
Hosp bed semi-electr w/ matt |
1,421 |
1,140 |
$30K |
| E0562 |
Humidifier heated used w pap |
2,339 |
1,847 |
$19K |
| K0001 |
Standard wheelchair |
2,009 |
1,621 |
$17K |
| A7030 |
Cpap full face mask |
347 |
271 |
$13K |
| A7035 |
Pos airway press headgear |
1,143 |
929 |
$11K |
| A7037 |
Pos airway pressure tubing |
1,373 |
1,109 |
$9K |
| A7031 |
Replacement facemask interfa |
382 |
307 |
$7K |
| A7038 |
Pos airway pressure filter |
2,794 |
2,297 |
$6K |
| A7005 |
Nondisposable nebulizer set |
871 |
692 |
$6K |
| K0006 |
Heavy duty wheelchair |
189 |
138 |
$4K |
| A7034 |
Nasal application device |
133 |
115 |
$4K |
| E0143 |
Walker folding wheeled w/o s |
159 |
137 |
$3K |
| A5512 |
Multi den insert direct form |
88 |
38 |
$3K |
| A7039 |
Filter, non disposable w pap |
864 |
701 |
$3K |
| A5500 |
Diab shoe for density insert |
87 |
38 |
$3K |
| A4253 |
Blood glucose/reagent strips |
988 |
809 |
$2K |
| A7046 |
Repl water chamber, pap dev |
157 |
125 |
$1K |
| K0195 |
Elevating whlchair leg rests |
92 |
66 |
$341.27 |
| Q0513 |
Disp fee inhal drugs/30 days |
18 |
13 |
$202.35 |
| E0971 |
Wheelchair anti-tipping devi |
17 |
12 |
$29.10 |
| A4259 |
Lancets per box |
118 |
92 |
$24.90 |