| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E0601 |
Cont airway pressure device |
4,328 |
4,044 |
$242K |
| A7030 |
Cpap full face mask |
1,694 |
1,503 |
$182K |
| A7031 |
Replacement facemask interfa |
3,033 |
2,660 |
$146K |
| E1161 |
Manual adult wc w tiltinspac |
463 |
407 |
$90K |
| E1028 |
W/c manual swingaway |
1,498 |
861 |
$68K |
| K0108 |
W/c component-accessory nos |
683 |
308 |
$61K |
| A7032 |
Replacement nasal cushion |
1,192 |
1,054 |
$60K |
| E1390 |
Oxygen concentrator |
960 |
873 |
$49K |
| A7038 |
Pos airway pressure filter |
5,695 |
5,024 |
$44K |
| A4604 |
Tubing with heating element |
1,082 |
949 |
$43K |
| A7035 |
Pos airway press headgear |
1,635 |
1,482 |
$37K |
| E0562 |
Humidifier heated used w pap |
240 |
228 |
$35K |
| A7034 |
Nasal application device |
626 |
579 |
$34K |
| E0955 |
Cushioned headrest |
703 |
622 |
$23K |
| E0973 |
W/ch access det adj armrest |
108 |
91 |
$12K |
| A7046 |
Repl water chamber, pap dev |
771 |
690 |
$9K |
| K0739 |
Repair/svc dme non-oxygen eq |
364 |
307 |
$8K |
| K0040 |
Adjustable angle footplate |
82 |
69 |
$7K |
| A7037 |
Pos airway pressure tubing |
1,251 |
1,177 |
$5K |
| E0956 |
W/c lateral trunk/hip suppor |
47 |
27 |
$5K |
| E1392 |
Portable oxygen concentrator |
214 |
204 |
$4K |
| E0971 |
Wheelchair anti-tipping devi |
77 |
65 |
$4K |
| E0470 |
Rad w/o backup non-inv intfc |
16 |
12 |
$2K |
| E0960 |
W/c shoulder harness/straps |
28 |
24 |
$1K |
| A7033 |
Replacement nasal pillows |
29 |
26 |
$1K |
| E0978 |
W/c acc,saf belt pelv strap |
72 |
59 |
$1K |
| E0570 |
Nebulizer with compression |
26 |
25 |
$434.79 |