| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
4,360 |
4,076 |
$433K |
| E0601 |
Cont airway pressure device |
3,853 |
3,689 |
$173K |
| A7030 |
Cpap full face mask |
1,042 |
987 |
$106K |
| E0562 |
Humidifier heated used w pap |
1,952 |
1,876 |
$66K |
| E0260 |
Hosp bed semi-electr w/ matt |
912 |
856 |
$52K |
| A4604 |
Tubing with heating element |
1,203 |
1,149 |
$50K |
| A7031 |
Replacement facemask interfa |
1,105 |
1,044 |
$45K |
| E1392 |
Portable oxygen concentrator |
1,122 |
1,023 |
$39K |
| E0471 |
Rad w/backup non inv intrfc |
94 |
93 |
$31K |
| E0603 |
Electric breast pump |
123 |
120 |
$31K |
| E0470 |
Rad w/o backup non-inv intfc |
257 |
245 |
$29K |
| K0001 |
Standard wheelchair |
981 |
939 |
$27K |
| E0431 |
Portable gaseous 02 |
1,196 |
1,157 |
$26K |
| E0570 |
Nebulizer with compression |
1,229 |
1,160 |
$23K |
| A7035 |
Pos airway press headgear |
1,091 |
1,039 |
$23K |
| E0118 |
Crutch substitute |
245 |
238 |
$16K |
| A7038 |
Pos airway pressure filter |
2,609 |
2,499 |
$14K |
| A7034 |
Nasal application device |
149 |
143 |
$10K |
| S5161 |
Emer rspns sys serv permonth |
370 |
313 |
$6K |
| A7046 |
Repl water chamber, pap dev |
387 |
367 |
$5K |
| E2201 |
Man w/ch acc seat w>=20"<24" |
178 |
177 |
$5K |
| E1399 |
Durable medical equipment mi |
15 |
12 |
$4K |
| A7032 |
Replacement nasal cushion |
97 |
90 |
$4K |
| K0002 |
Stnd hemi (low seat) whlchr |
110 |
103 |
$3K |
| A4452 |
Waterproof tape |
63 |
52 |
$1K |
| E0114 |
Crutch underarm pair no wood |
26 |
26 |
$1K |
| E0143 |
Walker folding wheeled w/o s |
13 |
13 |
$999.45 |
| A7037 |
Pos airway pressure tubing |
43 |
41 |
$728.55 |
| A6216 |
Non-sterile gauze<=16 sq in |
55 |
52 |
$447.49 |