| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
4,044 |
3,858 |
$231K |
| E0601 |
Cont airway pressure device |
2,630 |
2,559 |
$76K |
| A7030 |
Cpap full face mask |
1,028 |
995 |
$47K |
| K0738 |
Portable gas oxygen system |
2,161 |
2,017 |
$47K |
| A7031 |
Replacement facemask interfa |
1,531 |
1,473 |
$30K |
| E0562 |
Humidifier heated used w pap |
2,123 |
2,048 |
$28K |
| A4604 |
Tubing with heating element |
1,237 |
1,215 |
$18K |
| E0260 |
Hosp bed semi-electr w/ matt |
725 |
709 |
$16K |
| A7035 |
Pos airway press headgear |
1,322 |
1,262 |
$16K |
| K0001 |
Standard wheelchair |
1,382 |
1,349 |
$15K |
| A7034 |
Nasal application device |
339 |
335 |
$10K |
| E0143 |
Walker folding wheeled w/o s |
267 |
265 |
$9K |
| E0250 |
Hosp bed fixed ht w/ mattres |
711 |
701 |
$9K |
| A7038 |
Pos airway pressure filter |
1,614 |
1,579 |
$7K |
| E0431 |
Portable gaseous 02 |
364 |
343 |
$5K |
| E0570 |
Nebulizer with compression |
439 |
422 |
$5K |
| A7046 |
Repl water chamber, pap dev |
708 |
684 |
$5K |
| A7037 |
Pos airway pressure tubing |
187 |
174 |
$3K |
| E1392 |
Portable oxygen concentrator |
172 |
172 |
$2K |
| E0630 |
Patient lift hydraulic |
40 |
38 |
$2K |
| A7033 |
Replacement nasal pillows |
51 |
51 |
$1K |
| K0823 |
Pwc gp 2 std cap chair |
12 |
12 |
$863.81 |
| E0971 |
Wheelchair anti-tipping devi |
138 |
98 |
$448.28 |
| A7032 |
Replacement nasal cushion |
12 |
12 |
$418.26 |
| K0195 |
Elevating whlchair leg rests |
231 |
227 |
$373.74 |
| E1028 |
W/c manual swingaway |
55 |
51 |
$176.73 |