| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
12,170 |
10,495 |
$424K |
| E0431 |
Portable gaseous 02 |
9,432 |
8,145 |
$76K |
| L4387 |
Non-pneum walk boot pre ots |
552 |
477 |
$63K |
| K0001 |
Standard wheelchair |
2,966 |
2,426 |
$41K |
| E0260 |
Hosp bed semi-electr w/ matt |
2,000 |
1,554 |
$38K |
| E0570 |
Nebulizer with compression |
1,314 |
1,132 |
$32K |
| L3908 |
Who cock-up nonmolde pre ots |
890 |
732 |
$28K |
| L4386 |
Non-pneum walk boot pre cst |
287 |
211 |
$17K |
| K0195 |
Elevating whlchair leg rests |
1,926 |
1,656 |
$17K |
| E1392 |
Portable oxygen concentrator |
538 |
495 |
$12K |
| E0601 |
Cont airway pressure device |
519 |
384 |
$9K |
| E0114 |
Crutch underarm pair no wood |
234 |
221 |
$8K |
| E0143 |
Walker folding wheeled w/o s |
269 |
216 |
$6K |
| E0562 |
Humidifier heated used w pap |
721 |
551 |
$4K |
| A7030 |
Cpap full face mask |
85 |
65 |
$3K |
| A7003 |
Nebulizer administration set |
735 |
682 |
$1K |
| E0163 |
Commode chair with fixed arm |
56 |
43 |
$994.79 |
| A7037 |
Pos airway pressure tubing |
171 |
133 |
$965.85 |
| A7031 |
Replacement facemask interfa |
46 |
39 |
$958.42 |
| A7038 |
Pos airway pressure filter |
405 |
326 |
$717.80 |
| E0470 |
Rad w/o backup non-inv intfc |
19 |
12 |
$652.59 |
| A7035 |
Pos airway press headgear |
61 |
51 |
$613.18 |
| A7039 |
Filter, non disposable w pap |
16 |
16 |
$70.92 |