| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
21,883 |
16,478 |
$857K |
| E0601 |
Cont airway pressure device |
9,639 |
7,827 |
$296K |
| E0603 |
Electric breast pump |
784 |
634 |
$199K |
| E0570 |
Nebulizer with compression |
10,461 |
7,496 |
$154K |
| E0470 |
Rad w/o backup non-inv intfc |
2,288 |
1,756 |
$125K |
| E0431 |
Portable gaseous 02 |
11,605 |
8,693 |
$94K |
| A7030 |
Cpap full face mask |
1,545 |
1,230 |
$91K |
| E0562 |
Humidifier heated used w pap |
5,852 |
4,795 |
$89K |
| A4604 |
Tubing with heating element |
2,183 |
1,740 |
$52K |
| A7031 |
Replacement facemask interfa |
1,616 |
1,227 |
$41K |
| E0600 |
Suction pump portab hom modl |
826 |
686 |
$34K |
| E1392 |
Portable oxygen concentrator |
2,432 |
1,779 |
$33K |
| A7005 |
Nondisposable nebulizer set |
3,006 |
2,356 |
$31K |
| E0143 |
Walker folding wheeled w/o s |
1,150 |
802 |
$28K |
| A7035 |
Pos airway press headgear |
2,305 |
1,802 |
$26K |
| E1140 |
Wheelchair standard detach a |
754 |
622 |
$25K |
| A7034 |
Nasal application device |
553 |
466 |
$21K |
| E1086 |
Hemi-wheelchair detachable a |
434 |
403 |
$18K |
| E0260 |
Hosp bed semi-electr w/ matt |
846 |
559 |
$16K |
| A7038 |
Pos airway pressure filter |
3,949 |
3,071 |
$13K |
| A7032 |
Replacement nasal cushion |
404 |
342 |
$12K |
| E0261 |
Hosp bed semi-electr w/o mat |
416 |
291 |
$12K |
| A7046 |
Repl water chamber, pap dev |
1,037 |
823 |
$9K |
| A7037 |
Pos airway pressure tubing |
709 |
568 |
$7K |
| K0738 |
Portable gas oxygen system |
917 |
702 |
$6K |
| A7039 |
Filter, non disposable w pap |
1,432 |
1,091 |
$5K |
| E0184 |
Dry pressure mattress |
401 |
255 |
$4K |
| A6530 |
Compression stocking bk18-30 |
88 |
38 |
$2K |
| K0001 |
Standard wheelchair |
664 |
522 |
$2K |
| L3908 |
Who cock-up nonmolde pre ots |
40 |
25 |
$2K |
| E1093 |
Wheelchair wide w/ foot rest |
43 |
38 |
$1K |
| A7003 |
Nebulizer administration set |
1,970 |
1,470 |
$965.34 |
| E0973 |
W/ch access det adj armrest |
34 |
12 |
$909.44 |
| A7015 |
Aerosol mask used w nebulize |
1,081 |
870 |
$906.23 |
| E2611 |
Gen use back cush wdth <22in |
16 |
12 |
$710.20 |
| E0961 |
Wheelchair brake extension |
71 |
26 |
$602.27 |
| A7033 |
Replacement nasal pillows |
15 |
13 |
$392.47 |
| E2601 |
Gen w/c cushion wdth < 22 in |
16 |
12 |
$293.63 |
| E0951 |
Loop heel |
27 |
12 |
$271.84 |
| E0156 |
Walker seat attachment |
39 |
25 |
$192.85 |
| E0443 |
Portable 02 contents, gas |
19 |
13 |
$76.88 |
| A4649 |
Surgical supplies |
16 |
13 |
$56.25 |
| K0002 |
Stnd hemi (low seat) whlchr |
536 |
404 |
$0.00 |