| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
11,105 |
9,025 |
$249K |
| E0601 |
Cont airway pressure device |
4,242 |
3,693 |
$76K |
| A7031 |
Replacement facemask interfa |
5,060 |
3,935 |
$74K |
| A7030 |
Cpap full face mask |
2,168 |
1,740 |
$74K |
| K0823 |
Pwc gp 2 std cap chair |
592 |
494 |
$36K |
| E0562 |
Humidifier heated used w pap |
4,031 |
3,483 |
$26K |
| E0431 |
Portable gaseous 02 |
5,458 |
4,558 |
$25K |
| E0570 |
Nebulizer with compression |
4,782 |
4,351 |
$23K |
| E0260 |
Hosp bed semi-electr w/ matt |
1,543 |
1,285 |
$22K |
| A7032 |
Replacement nasal cushion |
1,292 |
958 |
$20K |
| E0466 |
Home vent non-invasive inter |
343 |
278 |
$19K |
| E1392 |
Portable oxygen concentrator |
2,209 |
1,736 |
$18K |
| K0001 |
Standard wheelchair |
2,873 |
2,385 |
$17K |
| A4604 |
Tubing with heating element |
973 |
772 |
$14K |
| K0003 |
Lightweight wheelchair |
1,796 |
1,507 |
$14K |
| A7035 |
Pos airway press headgear |
1,859 |
1,502 |
$13K |
| E0261 |
Hosp bed semi-electr w/o mat |
1,340 |
998 |
$13K |
| A7034 |
Nasal application device |
622 |
490 |
$13K |
| A7038 |
Pos airway pressure filter |
6,222 |
4,800 |
$12K |
| A7037 |
Pos airway pressure tubing |
1,903 |
1,521 |
$10K |
| E0443 |
Portable 02 contents, gas |
2,045 |
1,288 |
$9K |
| E0470 |
Rad w/o backup non-inv intfc |
141 |
134 |
$5K |
| A7039 |
Filter, non disposable w pap |
1,635 |
1,336 |
$4K |
| A7046 |
Repl water chamber, pap dev |
797 |
638 |
$4K |
| E0295 |
Hosp bed semi-elect w/o matt |
549 |
529 |
$3K |
| E0973 |
W/ch access det adj armrest |
2,905 |
1,283 |
$2K |
| A7005 |
Nondisposable nebulizer set |
305 |
257 |
$1K |
| K0195 |
Elevating whlchair leg rests |
370 |
297 |
$1K |
| E0971 |
Wheelchair anti-tipping devi |
2,896 |
1,232 |
$1K |
| E0143 |
Walker folding wheeled w/o s |
124 |
91 |
$1K |
| E0630 |
Patient lift hydraulic |
134 |
120 |
$1K |
| E0961 |
Wheelchair brake extension |
3,127 |
1,390 |
$1K |
| E0910 |
Trapeze bar attached to bed |
444 |
402 |
$643.97 |
| E0951 |
Loop heel |
2,112 |
859 |
$550.01 |
| E2201 |
Man w/ch acc seat w>=20"<24" |
26 |
24 |
$166.43 |
| E0156 |
Walker seat attachment |
31 |
25 |
$131.53 |
| A7033 |
Replacement nasal pillows |
19 |
12 |
$122.68 |
| E0305 |
Rails bed side half length |
139 |
137 |
$111.95 |