| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
18,319 |
13,538 |
$546K |
| A7030 |
Cpap full face mask |
8,351 |
5,400 |
$322K |
| E0601 |
Cont airway pressure device |
10,768 |
8,217 |
$269K |
| A7031 |
Replacement facemask interfa |
11,611 |
7,966 |
$257K |
| E0470 |
Rad w/o backup non-inv intfc |
4,972 |
3,459 |
$219K |
| A7034 |
Nasal application device |
5,084 |
3,309 |
$120K |
| E0562 |
Humidifier heated used w pap |
8,379 |
6,894 |
$118K |
| A4604 |
Tubing with heating element |
6,510 |
4,470 |
$116K |
| A7032 |
Replacement nasal cushion |
3,830 |
2,642 |
$93K |
| E0431 |
Portable gaseous 02 |
11,403 |
8,595 |
$75K |
| A7035 |
Pos airway press headgear |
7,261 |
4,723 |
$60K |
| A7033 |
Replacement nasal pillows |
2,381 |
1,764 |
$51K |
| A7038 |
Pos airway pressure filter |
17,833 |
12,294 |
$47K |
| A7037 |
Pos airway pressure tubing |
6,547 |
4,030 |
$34K |
| E0570 |
Nebulizer with compression |
6,362 |
4,489 |
$33K |
| E0466 |
Home vent non-invasive inter |
82 |
64 |
$29K |
| A7046 |
Repl water chamber, pap dev |
6,028 |
3,931 |
$28K |
| E0260 |
Hosp bed semi-electr w/ matt |
3,247 |
2,184 |
$26K |
| E1140 |
Wheelchair standard detach a |
1,633 |
1,418 |
$24K |
| E0143 |
Walker folding wheeled w/o s |
976 |
739 |
$20K |
| E1392 |
Portable oxygen concentrator |
1,503 |
1,139 |
$17K |
| A7039 |
Filter, non disposable w pap |
4,212 |
2,635 |
$10K |
| K0001 |
Standard wheelchair |
4,276 |
2,941 |
$3K |
| A7005 |
Nondisposable nebulizer set |
352 |
291 |
$3K |
| E0163 |
Commode chair with fixed arm |
151 |
106 |
$3K |
| E0250 |
Hosp bed fixed ht w/ mattres |
455 |
247 |
$2K |
| E1130 |
Whlchr stand fxd arm ft rest |
634 |
479 |
$2K |
| E1090 |
Wheelchair lightweight det a |
76 |
68 |
$2K |
| K0003 |
Lightweight wheelchair |
448 |
341 |
$1K |
| E0971 |
Wheelchair anti-tipping devi |
1,028 |
331 |
$1K |
| K0738 |
Portable gas oxygen system |
396 |
216 |
$1K |
| K0195 |
Elevating whlchair leg rests |
1,843 |
1,087 |
$730.84 |
| A7036 |
Pos airway press chinstrap |
80 |
50 |
$602.44 |
| E2601 |
Gen w/c cushion wdth < 22 in |
47 |
29 |
$481.74 |
| E0990 |
Wheelchair elevating leg res |
462 |
280 |
$437.76 |
| E0156 |
Walker seat attachment |
48 |
42 |
$266.56 |
| E0961 |
Wheelchair brake extension |
449 |
144 |
$181.56 |
| E0165 |
Commode chair with detacharm |
112 |
62 |
$141.95 |
| A7013 |
Disposable compressor filter |
92 |
80 |
$33.86 |
| K0007 |
Extra heavy duty wheelchair |
76 |
39 |
$0.00 |