| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
32,263 |
22,866 |
$821K |
| E0601 |
Cont airway pressure device |
12,426 |
9,473 |
$328K |
| A7030 |
Cpap full face mask |
8,335 |
5,667 |
$230K |
| A7031 |
Replacement facemask interfa |
10,992 |
7,870 |
$210K |
| E0470 |
Rad w/o backup non-inv intfc |
3,490 |
2,274 |
$124K |
| E0562 |
Humidifier heated used w pap |
13,278 |
9,810 |
$110K |
| E0431 |
Portable gaseous 02 |
17,466 |
12,338 |
$97K |
| A7034 |
Nasal application device |
4,097 |
2,907 |
$83K |
| A7037 |
Pos airway pressure tubing |
8,889 |
6,444 |
$59K |
| A7033 |
Replacement nasal pillows |
2,889 |
2,213 |
$56K |
| A7032 |
Replacement nasal cushion |
2,700 |
1,961 |
$55K |
| A7035 |
Pos airway press headgear |
7,577 |
5,341 |
$52K |
| A4604 |
Tubing with heating element |
4,398 |
2,889 |
$50K |
| A7038 |
Pos airway pressure filter |
18,650 |
13,949 |
$48K |
| E0570 |
Nebulizer with compression |
10,397 |
7,018 |
$47K |
| E0260 |
Hosp bed semi-electr w/ matt |
4,278 |
2,672 |
$40K |
| A7046 |
Repl water chamber, pap dev |
5,928 |
4,150 |
$21K |
| K0001 |
Standard wheelchair |
3,888 |
3,151 |
$16K |
| E1392 |
Portable oxygen concentrator |
3,321 |
2,369 |
$14K |
| E1130 |
Whlchr stand fxd arm ft rest |
1,395 |
1,303 |
$7K |
| E0439 |
Stationary liquid 02 |
146 |
116 |
$6K |
| E0630 |
Patient lift hydraulic |
374 |
217 |
$3K |
| E0443 |
Portable 02 contents, gas |
900 |
774 |
$3K |
| A7039 |
Filter, non disposable w pap |
1,764 |
1,151 |
$3K |
| E0442 |
Stationary o2 contents, liq |
306 |
162 |
$2K |
| A7003 |
Nebulizer administration set |
2,581 |
1,746 |
$2K |
| E0434 |
Portable liquid 02 |
252 |
189 |
$2K |
| E0143 |
Walker folding wheeled w/o s |
76 |
51 |
$1K |
| E0444 |
Portable 02 contents, liquid |
226 |
126 |
$452.50 |
| A7013 |
Disposable compressor filter |
1,271 |
857 |
$322.05 |
| E0156 |
Walker seat attachment |
17 |
12 |
$124.33 |
| A7015 |
Aerosol mask used w nebulize |
166 |
122 |
$74.06 |
| K0195 |
Elevating whlchair leg rests |
58 |
54 |
$59.70 |