| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
3,661 |
3,391 |
$113K |
| E0601 |
Cont airway pressure device |
2,331 |
2,133 |
$57K |
| T4530 |
Ped size brief/diaper lg |
640 |
533 |
$36K |
| E0431 |
Portable gaseous 02 |
3,143 |
2,915 |
$30K |
| E0261 |
Hosp bed semi-electr w/o mat |
1,463 |
1,366 |
$29K |
| K0001 |
Standard wheelchair |
1,671 |
1,580 |
$16K |
| A7030 |
Cpap full face mask |
422 |
356 |
$16K |
| A7031 |
Replacement facemask interfa |
673 |
413 |
$8K |
| A7037 |
Pos airway pressure tubing |
745 |
631 |
$7K |
| E0570 |
Nebulizer with compression |
361 |
343 |
$5K |
| A7035 |
Pos airway press headgear |
902 |
772 |
$5K |
| K0003 |
Lightweight wheelchair |
318 |
315 |
$3K |
| E0470 |
Rad w/o backup non-inv intfc |
38 |
36 |
$2K |
| A7038 |
Pos airway pressure filter |
801 |
659 |
$2K |
| E1392 |
Portable oxygen concentrator |
82 |
81 |
$1K |
| E0260 |
Hosp bed semi-electr w/ matt |
28 |
25 |
$985.98 |
| A4554 |
Disposable underpads |
18 |
17 |
$867.52 |
| E0143 |
Walker folding wheeled w/o s |
13 |
12 |
$450.71 |
| A7039 |
Filter, non disposable w pap |
109 |
85 |
$245.22 |