| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
6,387 |
5,974 |
$348K |
| E0601 |
Cont airway pressure device |
4,387 |
4,139 |
$172K |
| E0470 |
Rad w/o backup non-inv intfc |
540 |
533 |
$68K |
| E0562 |
Humidifier heated used w pap |
5,522 |
5,219 |
$63K |
| A7030 |
Cpap full face mask |
600 |
560 |
$53K |
| E0260 |
Hosp bed semi-electr w/ matt |
1,539 |
1,465 |
$49K |
| E0570 |
Nebulizer with compression |
5,056 |
4,695 |
$42K |
| E0431 |
Portable gaseous 02 |
3,888 |
3,623 |
$35K |
| K0001 |
Standard wheelchair |
1,376 |
1,254 |
$20K |
| A4604 |
Tubing with heating element |
721 |
679 |
$17K |
| A7035 |
Pos airway press headgear |
928 |
862 |
$12K |
| A7038 |
Pos airway pressure filter |
939 |
898 |
$3K |
| A7034 |
Nasal application device |
64 |
53 |
$3K |
| E0143 |
Walker folding wheeled w/o s |
82 |
74 |
$3K |
| A7037 |
Pos airway pressure tubing |
135 |
127 |
$2K |
| A7039 |
Filter, non disposable w pap |
276 |
245 |
$1K |
| A7031 |
Replacement facemask interfa |
59 |
51 |
$1K |
| A7003 |
Nebulizer administration set |
480 |
452 |
$1K |
| E0630 |
Patient lift hydraulic |
56 |
53 |
$841.77 |
| K0195 |
Elevating whlchair leg rests |
157 |
125 |
$504.87 |
| A7046 |
Repl water chamber, pap dev |
77 |
69 |
$376.83 |
| E0971 |
Wheelchair anti-tipping devi |
188 |
91 |
$370.46 |