| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
10,924 |
8,756 |
$544K |
| E0601 |
Cont airway pressure device |
6,083 |
4,952 |
$300K |
| A7030 |
Cpap full face mask |
3,164 |
2,785 |
$289K |
| A7034 |
Nasal application device |
3,372 |
2,940 |
$212K |
| E0562 |
Humidifier heated used w pap |
5,092 |
4,053 |
$156K |
| E0431 |
Portable gaseous 02 |
3,586 |
2,945 |
$135K |
| A7035 |
Pos airway press headgear |
5,679 |
5,014 |
$130K |
| A7037 |
Pos airway pressure tubing |
5,355 |
4,711 |
$119K |
| E0603 |
Electric breast pump |
778 |
709 |
$107K |
| A7038 |
Pos airway pressure filter |
6,926 |
6,060 |
$37K |
| E0570 |
Nebulizer with compression |
3,080 |
2,424 |
$33K |
| A7046 |
Repl water chamber, pap dev |
2,745 |
2,436 |
$21K |
| A7039 |
Filter, non disposable w pap |
3,083 |
2,688 |
$19K |
| A7031 |
Replacement facemask interfa |
1,253 |
1,049 |
$17K |
| K0001 |
Standard wheelchair |
2,223 |
1,918 |
$16K |
| E0470 |
Rad w/o backup non-inv intfc |
247 |
221 |
$14K |
| E1392 |
Portable oxygen concentrator |
826 |
617 |
$9K |
| A7003 |
Nebulizer administration set |
2,356 |
1,918 |
$7K |
| E0118 |
Crutch substitute |
404 |
202 |
$7K |
| E0143 |
Walker folding wheeled w/o s |
257 |
225 |
$6K |
| K0738 |
Portable gas oxygen system |
1,289 |
1,041 |
$5K |
| A4604 |
Tubing with heating element |
590 |
507 |
$4K |
| A7013 |
Disposable compressor filter |
2,221 |
1,690 |
$2K |
| E1399 |
Durable medical equipment mi |
20 |
15 |
$1K |
| E0261 |
Hosp bed semi-electr w/o mat |
84 |
74 |
$1K |
| A7015 |
Aerosol mask used w nebulize |
1,054 |
871 |
$1K |
| E0156 |
Walker seat attachment |
243 |
167 |
$1K |
| A7033 |
Replacement nasal pillows |
59 |
40 |
$561.88 |
| A5500 |
Diab shoe for density insert |
28 |
12 |
$382.52 |
| K0739 |
Repair/svc dme non-oxygen eq |
13 |
12 |
$272.78 |
| A7032 |
Replacement nasal cushion |
63 |
50 |
$248.88 |
| A4357 |
Bedside drainage bag |
52 |
39 |
$212.96 |