| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
14,531 |
12,082 |
$626K |
| E0601 |
Cont airway pressure device |
1,385 |
1,291 |
$61K |
| E0431 |
Portable gaseous 02 |
12,865 |
10,764 |
$51K |
| K0001 |
Standard wheelchair |
5,833 |
4,383 |
$44K |
| E0570 |
Nebulizer with compression |
3,735 |
3,293 |
$29K |
| E0143 |
Walker folding wheeled w/o s |
973 |
836 |
$23K |
| E0466 |
Home vent non-invasive inter |
89 |
72 |
$18K |
| E0261 |
Hosp bed semi-electr w/o mat |
1,894 |
1,472 |
$7K |
| K0195 |
Elevating whlchair leg rests |
1,802 |
1,301 |
$7K |
| E0562 |
Humidifier heated used w pap |
986 |
921 |
$7K |
| E0630 |
Patient lift hydraulic |
244 |
172 |
$4K |
| E0260 |
Hosp bed semi-electr w/ matt |
60 |
53 |
$2K |
| E0163 |
Commode chair with fixed arm |
42 |
38 |
$1K |
| A7037 |
Pos airway pressure tubing |
295 |
246 |
$1K |
| A7038 |
Pos airway pressure filter |
457 |
370 |
$418.92 |
| E1392 |
Portable oxygen concentrator |
70 |
59 |
$91.82 |
| E0156 |
Walker seat attachment |
33 |
26 |
$40.64 |
| A7015 |
Aerosol mask used w nebulize |
13 |
13 |
$1.01 |
| A7013 |
Disposable compressor filter |
12 |
12 |
$0.90 |
| A7030 |
Cpap full face mask |
20 |
14 |
$0.86 |
| A7031 |
Replacement facemask interfa |
41 |
27 |
$0.00 |
| A7035 |
Pos airway press headgear |
15 |
12 |
$0.00 |
| A7046 |
Repl water chamber, pap dev |
18 |
12 |
$0.00 |