| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
11,020 |
10,965 |
$915K |
| E0601 |
Cont airway pressure device |
4,966 |
4,948 |
$293K |
| E0431 |
Portable gaseous 02 |
7,984 |
7,945 |
$150K |
| E0562 |
Humidifier heated used w pap |
2,185 |
2,170 |
$56K |
| E0570 |
Nebulizer with compression |
1,418 |
1,417 |
$53K |
| A7030 |
Cpap full face mask |
747 |
735 |
$47K |
| S5161 |
Emer rspns sys serv permonth |
1,468 |
1,468 |
$46K |
| E0260 |
Hosp bed semi-electr w/ matt |
607 |
598 |
$27K |
| E0470 |
Rad w/o backup non-inv intfc |
261 |
260 |
$24K |
| A7034 |
Nasal application device |
520 |
515 |
$21K |
| E0143 |
Walker folding wheeled w/o s |
334 |
332 |
$21K |
| A7035 |
Pos airway press headgear |
1,236 |
1,217 |
$20K |
| K0001 |
Standard wheelchair |
743 |
733 |
$17K |
| A7031 |
Replacement facemask interfa |
435 |
428 |
$13K |
| A7037 |
Pos airway pressure tubing |
706 |
698 |
$12K |
| E0466 |
Home vent non-invasive inter |
40 |
39 |
$9K |
| E0261 |
Hosp bed semi-electr w/o mat |
489 |
489 |
$8K |
| A7038 |
Pos airway pressure filter |
1,697 |
1,681 |
$7K |
| A7005 |
Nondisposable nebulizer set |
451 |
451 |
$7K |
| K0003 |
Lightweight wheelchair |
468 |
464 |
$6K |
| E0561 |
Humidifier nonheated w pap |
519 |
517 |
$5K |
| A7032 |
Replacement nasal cushion |
103 |
103 |
$4K |
| L3908 |
Who cock-up nonmolde pre ots |
60 |
52 |
$3K |
| E0630 |
Patient lift hydraulic |
172 |
172 |
$3K |
| A7046 |
Repl water chamber, pap dev |
423 |
423 |
$3K |
| E0971 |
Wheelchair anti-tipping devi |
960 |
484 |
$2K |
| E0973 |
W/ch access det adj armrest |
832 |
422 |
$2K |
| A4604 |
Tubing with heating element |
372 |
370 |
$1K |
| K0738 |
Portable gas oxygen system |
209 |
209 |
$957.59 |
| E2201 |
Man w/ch acc seat w>=20"<24" |
52 |
51 |
$779.98 |
| E0961 |
Wheelchair brake extension |
725 |
378 |
$766.85 |
| A5500 |
Diab shoe for density insert |
15 |
12 |
$734.02 |
| E1392 |
Portable oxygen concentrator |
188 |
188 |
$667.08 |
| E0951 |
Loop heel |
895 |
463 |
$572.82 |
| E0135 |
Walker folding adjust/fixed |
12 |
12 |
$541.26 |
| K0195 |
Elevating whlchair leg rests |
77 |
76 |
$540.06 |
| A7033 |
Replacement nasal pillows |
12 |
12 |
$538.02 |
| E0978 |
W/c acc,saf belt pelv strap |
292 |
288 |
$503.66 |
| E0156 |
Walker seat attachment |
12 |
12 |
$164.03 |
| A7003 |
Nebulizer administration set |
442 |
426 |
$158.24 |