| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
7,869 |
7,735 |
$498K |
| E0260 |
Hosp bed semi-electr w/ matt |
3,434 |
3,226 |
$117K |
| K0001 |
Standard wheelchair |
5,179 |
4,938 |
$77K |
| E0431 |
Portable gaseous 02 |
6,068 |
5,983 |
$74K |
| E0601 |
Cont airway pressure device |
1,623 |
1,589 |
$63K |
| E0570 |
Nebulizer with compression |
2,864 |
2,809 |
$44K |
| K0738 |
Portable gas oxygen system |
1,304 |
1,279 |
$25K |
| E0630 |
Patient lift hydraulic |
738 |
715 |
$19K |
| E0971 |
Wheelchair anti-tipping devi |
314 |
295 |
$7K |
| A7037 |
Pos airway pressure tubing |
480 |
471 |
$7K |
| A7035 |
Pos airway press headgear |
504 |
497 |
$7K |
| A7030 |
Cpap full face mask |
90 |
90 |
$7K |
| A5500 |
Diab shoe for density insert |
155 |
146 |
$6K |
| E0143 |
Walker folding wheeled w/o s |
181 |
155 |
$5K |
| K0195 |
Elevating whlchair leg rests |
632 |
548 |
$5K |
| A5512 |
Multi den insert direct form |
104 |
99 |
$4K |
| E0149 |
Heavy duty wheeled walker |
169 |
169 |
$2K |
| E0163 |
Commode chair with fixed arm |
59 |
54 |
$2K |
| A7038 |
Pos airway pressure filter |
302 |
297 |
$1K |
| E0951 |
Loop heel |
113 |
103 |
$1K |
| K0007 |
Extra heavy duty wheelchair |
14 |
12 |
$1K |
| A7005 |
Nondisposable nebulizer set |
75 |
70 |
$976.34 |
| E2601 |
Gen w/c cushion wdth < 22 in |
43 |
38 |
$761.39 |
| K0006 |
Heavy duty wheelchair |
24 |
24 |
$658.40 |
| E0165 |
Commode chair with detacharm |
26 |
26 |
$458.67 |
| A7031 |
Replacement facemask interfa |
12 |
12 |
$249.57 |
| A7039 |
Filter, non disposable w pap |
30 |
30 |
$154.53 |
| A7015 |
Aerosol mask used w nebulize |
64 |
57 |
$64.81 |