| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
13,157 |
9,943 |
$435K |
| E0601 |
Cont airway pressure device |
3,612 |
2,945 |
$134K |
| A7030 |
Cpap full face mask |
1,838 |
1,462 |
$101K |
| E0570 |
Nebulizer with compression |
5,937 |
4,256 |
$52K |
| E0431 |
Portable gaseous 02 |
6,300 |
4,739 |
$46K |
| A7031 |
Replacement facemask interfa |
1,694 |
1,372 |
$43K |
| E1130 |
Whlchr stand fxd arm ft rest |
1,970 |
1,802 |
$42K |
| E0562 |
Humidifier heated used w pap |
4,181 |
3,347 |
$42K |
| A7034 |
Nasal application device |
857 |
677 |
$28K |
| A7037 |
Pos airway pressure tubing |
2,706 |
2,122 |
$23K |
| A7035 |
Pos airway press headgear |
1,999 |
1,584 |
$22K |
| E1392 |
Portable oxygen concentrator |
2,110 |
1,564 |
$21K |
| E0260 |
Hosp bed semi-electr w/ matt |
892 |
665 |
$20K |
| E0250 |
Hosp bed fixed ht w/ mattres |
1,470 |
826 |
$17K |
| A7038 |
Pos airway pressure filter |
3,547 |
2,827 |
$12K |
| A7005 |
Nondisposable nebulizer set |
737 |
611 |
$8K |
| A7046 |
Repl water chamber, pap dev |
856 |
712 |
$7K |
| K0738 |
Portable gas oxygen system |
1,258 |
839 |
$7K |
| A7039 |
Filter, non disposable w pap |
1,435 |
1,111 |
$6K |
| A7032 |
Replacement nasal cushion |
138 |
113 |
$4K |
| A4604 |
Tubing with heating element |
141 |
124 |
$4K |
| K0001 |
Standard wheelchair |
1,087 |
917 |
$3K |
| E0143 |
Walker folding wheeled w/o s |
45 |
37 |
$956.75 |
| E0470 |
Rad w/o backup non-inv intfc |
13 |
12 |
$696.99 |
| A6530 |
Compression stocking bk18-30 |
15 |
12 |
$522.62 |
| E0156 |
Walker seat attachment |
15 |
13 |
$131.36 |
| E0149 |
Heavy duty wheeled walker |
14 |
12 |
$65.44 |
| G0008 |
Admin influenza virus vac |
12 |
12 |
$0.00 |
| Q0513 |
Disp fee inhal drugs/30 days |
55 |
30 |
$0.00 |
| 0003A |
|
30 |
30 |
$0.00 |