| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
10,549 |
9,074 |
$786K |
| A7030 |
Cpap full face mask |
5,405 |
4,856 |
$488K |
| E0601 |
Cont airway pressure device |
6,480 |
5,533 |
$452K |
| A7031 |
Replacement facemask interfa |
7,019 |
6,303 |
$399K |
| E0570 |
Nebulizer with compression |
4,225 |
3,849 |
$162K |
| E0470 |
Rad w/o backup non-inv intfc |
1,417 |
1,236 |
$161K |
| A7034 |
Nasal application device |
3,302 |
3,064 |
$147K |
| A7032 |
Replacement nasal cushion |
2,993 |
2,792 |
$144K |
| A7038 |
Pos airway pressure filter |
8,403 |
7,521 |
$128K |
| E0562 |
Humidifier heated used w pap |
706 |
651 |
$125K |
| E0603 |
Electric breast pump |
503 |
494 |
$122K |
| K0738 |
Portable gas oxygen system |
4,974 |
4,354 |
$119K |
| A7035 |
Pos airway press headgear |
5,588 |
5,095 |
$114K |
| L4387 |
Non-pneum walk boot pre ots |
725 |
686 |
$83K |
| L3908 |
Who cock-up nonmolde pre ots |
1,458 |
1,326 |
$57K |
| A7033 |
Replacement nasal pillows |
943 |
850 |
$38K |
| A7039 |
Filter, non disposable w pap |
4,447 |
4,047 |
$35K |
| E0114 |
Crutch underarm pair no wood |
780 |
757 |
$28K |
| E0143 |
Walker folding wheeled w/o s |
619 |
589 |
$28K |
| E0260 |
Hosp bed semi-electr w/ matt |
975 |
812 |
$28K |
| A7046 |
Repl water chamber, pap dev |
2,341 |
2,149 |
$23K |
| A7005 |
Nondisposable nebulizer set |
763 |
738 |
$17K |
| T4534 |
Youth size pull-on |
107 |
92 |
$16K |
| A7037 |
Pos airway pressure tubing |
5,251 |
4,779 |
$13K |
| E1028 |
W/c manual swingaway |
326 |
243 |
$11K |
| A4604 |
Tubing with heating element |
3,470 |
3,124 |
$9K |
| K0001 |
Standard wheelchair |
431 |
396 |
$8K |
| E0431 |
Portable gaseous 02 |
759 |
732 |
$7K |
| K0003 |
Lightweight wheelchair |
120 |
111 |
$7K |
| L4361 |
Pneuma/vac walk boot pre ots |
27 |
26 |
$5K |
| L3809 |
Whfo w/o joints pre ots |
40 |
36 |
$5K |
| K0108 |
W/c component-accessory nos |
69 |
25 |
$5K |
| L1902 |
Afo ankle gauntlet pre ots |
94 |
87 |
$5K |
| E0971 |
Wheelchair anti-tipping devi |
1,120 |
585 |
$5K |
| K0739 |
Repair/svc dme non-oxygen eq |
247 |
211 |
$2K |
| A4565 |
Slings |
169 |
168 |
$1K |
| E1392 |
Portable oxygen concentrator |
633 |
562 |
$873.56 |
| A7003 |
Nebulizer administration set |
212 |
195 |
$678.78 |
| L3260 |
Ambulatory surgical boot eac |
13 |
12 |
$185.86 |
| E0156 |
Walker seat attachment |
14 |
13 |
$62.67 |