| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
4,280 |
3,719 |
$202K |
| E0261 |
Hosp bed semi-electr w/o mat |
738 |
699 |
$74K |
| E0277 |
Powered pres-redu air mattrs |
229 |
198 |
$52K |
| E0601 |
Cont airway pressure device |
2,421 |
2,042 |
$45K |
| A7030 |
Cpap full face mask |
1,194 |
1,009 |
$40K |
| E0260 |
Hosp bed semi-electr w/ matt |
1,512 |
1,302 |
$25K |
| E0431 |
Portable gaseous 02 |
2,447 |
2,142 |
$22K |
| E0562 |
Humidifier heated used w pap |
1,369 |
1,133 |
$17K |
| E0570 |
Nebulizer with compression |
1,396 |
1,316 |
$15K |
| E0265 |
Hosp bed total electr w/ mat |
107 |
99 |
$13K |
| A7031 |
Replacement facemask interfa |
902 |
775 |
$12K |
| A7034 |
Nasal application device |
558 |
464 |
$10K |
| E0630 |
Patient lift hydraulic |
237 |
206 |
$10K |
| A4604 |
Tubing with heating element |
751 |
634 |
$9K |
| A7035 |
Pos airway press headgear |
1,152 |
961 |
$9K |
| A7037 |
Pos airway pressure tubing |
1,020 |
873 |
$6K |
| E0303 |
Hosp bed hvy dty xtra wide |
86 |
79 |
$5K |
| A7038 |
Pos airway pressure filter |
2,161 |
1,838 |
$4K |
| K0003 |
Lightweight wheelchair |
210 |
182 |
$4K |
| A7032 |
Replacement nasal cushion |
256 |
227 |
$4K |
| E1399 |
Durable medical equipment mi |
43 |
37 |
$3K |
| K0001 |
Standard wheelchair |
265 |
239 |
$3K |
| A7046 |
Repl water chamber, pap dev |
485 |
425 |
$2K |
| E1392 |
Portable oxygen concentrator |
120 |
115 |
$922.43 |
| E0470 |
Rad w/o backup non-inv intfc |
13 |
13 |
$760.14 |
| A7033 |
Replacement nasal pillows |
60 |
55 |
$682.49 |
| K0195 |
Elevating whlchair leg rests |
40 |
37 |
$236.86 |
| E0181 |
Press pad alternating w/ pum |
47 |
41 |
$200.21 |
| A7005 |
Nondisposable nebulizer set |
13 |
12 |
$188.07 |
| A7039 |
Filter, non disposable w pap |
31 |
25 |
$102.57 |