| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E0466 |
Home vent non-invasive inter |
712 |
547 |
$343K |
| E1390 |
Oxygen concentrator |
9,043 |
6,242 |
$310K |
| A7030 |
Cpap full face mask |
2,250 |
1,678 |
$110K |
| B4035 |
Enteral feed supp pump per d |
744 |
432 |
$110K |
| E0601 |
Cont airway pressure device |
3,659 |
2,535 |
$103K |
| A7031 |
Replacement facemask interfa |
3,140 |
2,162 |
$64K |
| A7034 |
Nasal application device |
1,556 |
1,206 |
$51K |
| K0004 |
High strength ltwt whlchr |
1,560 |
1,000 |
$36K |
| A7032 |
Replacement nasal cushion |
1,318 |
932 |
$35K |
| K0738 |
Portable gas oxygen system |
3,373 |
2,299 |
$35K |
| E0260 |
Hosp bed semi-electr w/ matt |
1,831 |
1,144 |
$31K |
| E0562 |
Humidifier heated used w pap |
278 |
238 |
$26K |
| E1392 |
Portable oxygen concentrator |
2,570 |
1,721 |
$25K |
| A7035 |
Pos airway press headgear |
2,108 |
1,623 |
$23K |
| E0143 |
Walker folding wheeled w/o s |
837 |
664 |
$22K |
| A4604 |
Tubing with heating element |
2,313 |
1,769 |
$22K |
| A7037 |
Pos airway pressure tubing |
1,103 |
844 |
$22K |
| B4150 |
Ef complet w/intact nutrient |
149 |
125 |
$21K |
| A4554 |
Disposable underpads |
445 |
375 |
$21K |
| K0001 |
Standard wheelchair |
2,220 |
1,530 |
$19K |
| A7038 |
Pos airway pressure filter |
5,430 |
3,833 |
$17K |
| E0445 |
Oximeter non-invasive |
135 |
108 |
$13K |
| B4152 |
Ef calorie dense>/=1.5kcal |
98 |
65 |
$13K |
| K0003 |
Lightweight wheelchair |
803 |
537 |
$12K |
| E0431 |
Portable gaseous 02 |
1,572 |
1,087 |
$11K |
| E0570 |
Nebulizer with compression |
2,214 |
1,443 |
$11K |
| A7033 |
Replacement nasal pillows |
643 |
473 |
$10K |
| K0195 |
Elevating whlchair leg rests |
1,330 |
915 |
$8K |
| E0470 |
Rad w/o backup non-inv intfc |
184 |
107 |
$7K |
| E0465 |
Home vent invasive interface |
14 |
12 |
$6K |
| B4034 |
Enter feed supkit syr by day |
99 |
51 |
$6K |
| A7046 |
Repl water chamber, pap dev |
1,456 |
1,106 |
$5K |
| E0163 |
Commode chair with fixed arm |
147 |
104 |
$4K |
| T4535 |
Disposable liner/shield/pad |
28 |
25 |
$2K |
| E0156 |
Walker seat attachment |
133 |
117 |
$638.08 |
| A7000 |
Disposable canister for pump |
78 |
52 |
$549.21 |
| E0971 |
Wheelchair anti-tipping devi |
25 |
13 |
$521.76 |
| K0006 |
Heavy duty wheelchair |
39 |
25 |
$438.28 |
| A7526 |
Tracheostomy tube collar |
27 |
13 |
$311.51 |
| A7039 |
Filter, non disposable w pap |
48 |
40 |
$287.45 |
| A7002 |
Tubing used w suction pump |
122 |
80 |
$278.58 |
| A4606 |
Oxygen probe used w oximeter |
18 |
12 |
$63.84 |
| A4615 |
Cannula nasal |
108 |
54 |
$48.54 |