| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E0466 |
Home vent non-invasive inter |
618 |
461 |
$244K |
| E1390 |
Oxygen concentrator |
4,805 |
3,950 |
$169K |
| E0601 |
Cont airway pressure device |
2,903 |
2,534 |
$128K |
| E0603 |
Electric breast pump |
591 |
555 |
$110K |
| K0738 |
Portable gas oxygen system |
3,285 |
2,794 |
$61K |
| A7031 |
Replacement facemask interfa |
1,710 |
1,421 |
$49K |
| E0562 |
Humidifier heated used w pap |
2,635 |
2,269 |
$44K |
| A7030 |
Cpap full face mask |
889 |
733 |
$43K |
| A7034 |
Nasal application device |
813 |
718 |
$36K |
| A7032 |
Replacement nasal cushion |
1,042 |
838 |
$35K |
| E0260 |
Hosp bed semi-electr w/ matt |
1,498 |
1,175 |
$33K |
| K0001 |
Standard wheelchair |
2,615 |
2,080 |
$25K |
| A7035 |
Pos airway press headgear |
1,322 |
1,147 |
$18K |
| E0570 |
Nebulizer with compression |
1,275 |
996 |
$16K |
| A7037 |
Pos airway pressure tubing |
1,602 |
1,407 |
$16K |
| E0470 |
Rad w/o backup non-inv intfc |
129 |
107 |
$12K |
| A7038 |
Pos airway pressure filter |
3,185 |
2,616 |
$12K |
| A7046 |
Repl water chamber, pap dev |
1,124 |
981 |
$9K |
| A4604 |
Tubing with heating element |
324 |
265 |
$8K |
| E0143 |
Walker folding wheeled w/o s |
266 |
221 |
$6K |
| K0195 |
Elevating whlchair leg rests |
1,239 |
991 |
$6K |
| A7039 |
Filter, non disposable w pap |
1,189 |
1,048 |
$6K |
| E0163 |
Commode chair with fixed arm |
145 |
117 |
$3K |
| E0431 |
Portable gaseous 02 |
291 |
269 |
$3K |
| E0630 |
Patient lift hydraulic |
90 |
80 |
$2K |
| A7033 |
Replacement nasal pillows |
48 |
40 |
$1K |
| E0971 |
Wheelchair anti-tipping devi |
797 |
339 |
$968.14 |
| E0730 |
Tens four lead |
33 |
27 |
$660.78 |
| E2201 |
Man w/ch acc seat w>=20"<24" |
19 |
12 |
$212.91 |
| E0165 |
Commode chair with detacharm |
13 |
12 |
$209.27 |
| A7036 |
Pos airway press chinstrap |
25 |
15 |
$117.67 |