| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
4,298 |
4,219 |
$232K |
| A7030 |
Cpap full face mask |
2,139 |
2,114 |
$110K |
| A7031 |
Replacement facemask interfa |
2,935 |
2,800 |
$88K |
| E0601 |
Cont airway pressure device |
3,341 |
3,298 |
$66K |
| E0260 |
Hosp bed semi-electr w/ matt |
3,327 |
3,278 |
$55K |
| K0001 |
Standard wheelchair |
6,300 |
6,201 |
$47K |
| E1399 |
Durable medical equipment mi |
657 |
253 |
$39K |
| A7034 |
Nasal application device |
1,232 |
1,221 |
$36K |
| E0431 |
Portable gaseous 02 |
2,868 |
2,803 |
$28K |
| A7032 |
Replacement nasal cushion |
740 |
696 |
$26K |
| E0470 |
Rad w/o backup non-inv intfc |
565 |
547 |
$25K |
| A7038 |
Pos airway pressure filter |
5,094 |
4,847 |
$21K |
| E0143 |
Walker folding wheeled w/o s |
1,404 |
1,332 |
$19K |
| A7037 |
Pos airway pressure tubing |
1,526 |
1,506 |
$19K |
| A7035 |
Pos airway press headgear |
1,869 |
1,849 |
$16K |
| E0630 |
Patient lift hydraulic |
1,132 |
1,115 |
$16K |
| A7033 |
Replacement nasal pillows |
475 |
448 |
$13K |
| E0570 |
Nebulizer with compression |
1,611 |
1,566 |
$8K |
| A7046 |
Repl water chamber, pap dev |
1,179 |
1,171 |
$5K |
| K0003 |
Lightweight wheelchair |
432 |
423 |
$5K |
| E0250 |
Hosp bed fixed ht w/ mattres |
399 |
397 |
$5K |
| E0163 |
Commode chair with fixed arm |
311 |
290 |
$5K |
| K0195 |
Elevating whlchair leg rests |
1,572 |
1,545 |
$5K |
| E0562 |
Humidifier heated used w pap |
87 |
83 |
$3K |
| E0149 |
Heavy duty wheeled walker |
549 |
541 |
$2K |
| A4604 |
Tubing with heating element |
1,582 |
1,568 |
$2K |
| E0971 |
Wheelchair anti-tipping devi |
216 |
135 |
$2K |
| K0006 |
Heavy duty wheelchair |
78 |
75 |
$1K |
| E0185 |
Gel pressure mattress pad |
44 |
39 |
$1K |
| E2611 |
Gen use back cush wdth <22in |
61 |
54 |
$1K |
| E2601 |
Gen w/c cushion wdth < 22 in |
109 |
101 |
$1K |
| E0114 |
Crutch underarm pair no wood |
46 |
45 |
$765.08 |
| L3670 |
So acro/clav can web pre ots |
13 |
12 |
$456.13 |
| K0007 |
Extra heavy duty wheelchair |
14 |
13 |
$139.97 |
| A6402 |
Sterile gauze <= 16 sq in |
124 |
102 |
$107.02 |
| E0951 |
Loop heel |
26 |
13 |
$97.35 |
| E0600 |
Suction pump portab hom modl |
16 |
12 |
$0.00 |