| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
6,859 |
5,135 |
$358K |
| E0601 |
Cont airway pressure device |
2,651 |
2,047 |
$99K |
| K0001 |
Standard wheelchair |
6,863 |
5,069 |
$82K |
| A7030 |
Cpap full face mask |
1,289 |
1,088 |
$77K |
| E0260 |
Hosp bed semi-electr w/ matt |
3,583 |
2,525 |
$76K |
| E0143 |
Walker folding wheeled w/o s |
1,035 |
732 |
$37K |
| A7031 |
Replacement facemask interfa |
1,683 |
1,239 |
$35K |
| E0431 |
Portable gaseous 02 |
3,091 |
2,277 |
$25K |
| K0195 |
Elevating whlchair leg rests |
3,308 |
2,482 |
$25K |
| E0570 |
Nebulizer with compression |
1,528 |
1,152 |
$21K |
| E1236 |
Folding ped wc adjustable |
202 |
169 |
$20K |
| E0163 |
Commode chair with fixed arm |
401 |
299 |
$15K |
| A7035 |
Pos airway press headgear |
1,078 |
910 |
$14K |
| K0738 |
Portable gas oxygen system |
1,069 |
815 |
$14K |
| A4604 |
Tubing with heating element |
808 |
744 |
$11K |
| A7037 |
Pos airway pressure tubing |
585 |
472 |
$9K |
| K0003 |
Lightweight wheelchair |
547 |
391 |
$8K |
| A7034 |
Nasal application device |
228 |
207 |
$8K |
| A7038 |
Pos airway pressure filter |
2,796 |
2,105 |
$8K |
| K0007 |
Extra heavy duty wheelchair |
239 |
159 |
$7K |
| E0562 |
Humidifier heated used w pap |
68 |
55 |
$6K |
| E1392 |
Portable oxygen concentrator |
535 |
417 |
$6K |
| E1226 |
Manual fully reclining back |
336 |
190 |
$6K |
| E0630 |
Patient lift hydraulic |
200 |
144 |
$5K |
| E0470 |
Rad w/o backup non-inv intfc |
51 |
39 |
$4K |
| A7046 |
Repl water chamber, pap dev |
579 |
518 |
$4K |
| E0165 |
Commode chair with detacharm |
270 |
187 |
$3K |
| B4152 |
Ef calorie dense>/=1.5kcal |
18 |
12 |
$2K |
| E2201 |
Man w/ch acc seat w>=20"<24" |
309 |
219 |
$2K |
| A4554 |
Disposable underpads |
26 |
26 |
$1K |
| A4670 |
Automatic bp monitor, dial |
17 |
16 |
$991.95 |
| E0600 |
Suction pump portab hom modl |
45 |
25 |
$953.66 |
| A7032 |
Replacement nasal cushion |
57 |
45 |
$864.17 |
| K0053 |
Elevate footrest articulate |
170 |
115 |
$524.59 |
| E2601 |
Gen w/c cushion wdth < 22 in |
19 |
13 |
$350.79 |
| K0006 |
Heavy duty wheelchair |
14 |
13 |
$244.20 |
| A7005 |
Nondisposable nebulizer set |
12 |
12 |
$188.42 |