| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E0603 |
Electric breast pump |
3,417 |
3,256 |
$716K |
| E1390 |
Oxygen concentrator |
6,484 |
5,960 |
$672K |
| A7030 |
Cpap full face mask |
2,866 |
2,707 |
$359K |
| E0601 |
Cont airway pressure device |
4,799 |
4,553 |
$352K |
| A7031 |
Replacement facemask interfa |
2,495 |
2,351 |
$252K |
| E0570 |
Nebulizer with compression |
2,038 |
1,842 |
$142K |
| A7034 |
Nasal application device |
1,604 |
1,513 |
$121K |
| E0260 |
Hosp bed semi-electr w/ matt |
1,906 |
1,756 |
$119K |
| E0562 |
Humidifier heated used w pap |
5,216 |
4,962 |
$114K |
| A4604 |
Tubing with heating element |
2,461 |
2,327 |
$110K |
| K0738 |
Portable gas oxygen system |
2,815 |
2,663 |
$76K |
| A7038 |
Pos airway pressure filter |
3,967 |
3,728 |
$65K |
| A7035 |
Pos airway press headgear |
2,659 |
2,502 |
$62K |
| E0143 |
Walker folding wheeled w/o s |
850 |
760 |
$55K |
| A7037 |
Pos airway pressure tubing |
1,978 |
1,859 |
$49K |
| A7032 |
Replacement nasal cushion |
448 |
436 |
$48K |
| K0004 |
High strength ltwt whlchr |
534 |
451 |
$41K |
| T4522 |
Adult size brief/diaper med |
304 |
294 |
$35K |
| K0002 |
Stnd hemi (low seat) whlchr |
678 |
585 |
$30K |
| A7033 |
Replacement nasal pillows |
357 |
337 |
$26K |
| E1392 |
Portable oxygen concentrator |
1,186 |
1,134 |
$25K |
| A7046 |
Repl water chamber, pap dev |
2,000 |
1,864 |
$23K |
| E0470 |
Rad w/o backup non-inv intfc |
188 |
162 |
$20K |
| A7005 |
Nondisposable nebulizer set |
784 |
715 |
$17K |
| K0001 |
Standard wheelchair |
630 |
559 |
$13K |
| A4627 |
Spacer bag/reservoir |
568 |
532 |
$10K |
| K0003 |
Lightweight wheelchair |
195 |
185 |
$9K |
| E0630 |
Patient lift hydraulic |
282 |
263 |
$7K |
| T4535 |
Disposable liner/shield/pad |
135 |
127 |
$7K |
| E0971 |
Wheelchair anti-tipping devi |
1,471 |
964 |
$6K |
| K0195 |
Elevating whlchair leg rests |
638 |
553 |
$4K |
| B4150 |
Ef complet w/intact nutrient |
14 |
12 |
$2K |
| E0240 |
Bath/shower chair |
42 |
41 |
$1K |
| A7015 |
Aerosol mask used w nebulize |
294 |
274 |
$367.86 |
| E0156 |
Walker seat attachment |
20 |
16 |
$150.57 |
| K0053 |
Elevate footrest articulate |
34 |
25 |
$144.82 |