| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A7030 |
Cpap full face mask |
9,200 |
9,089 |
$536K |
| E1390 |
Oxygen concentrator |
9,885 |
9,721 |
$405K |
| E0601 |
Cont airway pressure device |
14,973 |
14,696 |
$393K |
| A4604 |
Tubing with heating element |
13,791 |
13,651 |
$316K |
| E0260 |
Hosp bed semi-electr w/ matt |
13,718 |
13,506 |
$309K |
| A7034 |
Nasal application device |
5,876 |
5,815 |
$208K |
| K0001 |
Standard wheelchair |
16,363 |
16,143 |
$189K |
| E0143 |
Walker folding wheeled w/o s |
5,196 |
5,139 |
$152K |
| A7031 |
Replacement facemask interfa |
6,709 |
6,615 |
$149K |
| E0562 |
Humidifier heated used w pap |
13,229 |
12,977 |
$148K |
| E0470 |
Rad w/o backup non-inv intfc |
2,297 |
2,249 |
$122K |
| E0570 |
Nebulizer with compression |
2,496 |
2,447 |
$117K |
| A7035 |
Pos airway press headgear |
8,795 |
8,700 |
$107K |
| E0630 |
Patient lift hydraulic |
3,787 |
3,755 |
$78K |
| E0431 |
Portable gaseous 02 |
7,903 |
7,775 |
$63K |
| A7032 |
Replacement nasal cushion |
2,791 |
2,749 |
$63K |
| K0195 |
Elevating whlchair leg rests |
11,321 |
11,158 |
$51K |
| A7046 |
Repl water chamber, pap dev |
6,401 |
6,337 |
$42K |
| A7038 |
Pos airway pressure filter |
14,164 |
13,970 |
$42K |
| K0003 |
Lightweight wheelchair |
1,971 |
1,937 |
$40K |
| E0250 |
Hosp bed fixed ht w/ mattres |
2,182 |
2,151 |
$32K |
| K0006 |
Heavy duty wheelchair |
1,062 |
1,052 |
$31K |
| A7033 |
Replacement nasal pillows |
1,571 |
1,548 |
$30K |
| E2201 |
Man w/ch acc seat w>=20"<24" |
1,936 |
1,912 |
$27K |
| E0163 |
Commode chair with fixed arm |
839 |
829 |
$23K |
| E0971 |
Wheelchair anti-tipping devi |
3,063 |
1,662 |
$19K |
| A4239 |
Non-adju cgm supply allow |
194 |
192 |
$18K |
| E2601 |
Gen w/c cushion wdth < 22 in |
1,015 |
990 |
$16K |
| A7039 |
Filter, non disposable w pap |
3,170 |
3,128 |
$15K |
| K0002 |
Stnd hemi (low seat) whlchr |
783 |
774 |
$15K |
| E2611 |
Gen use back cush wdth <22in |
220 |
216 |
$14K |
| A7005 |
Nondisposable nebulizer set |
542 |
538 |
$11K |
| E0181 |
Press pad alternating w/ pum |
1,651 |
1,649 |
$8K |
| E0149 |
Heavy duty wheeled walker |
839 |
827 |
$8K |
| E0255 |
Hospital bed var ht w/ mattr |
433 |
433 |
$7K |
| E0245 |
Tub stool or bench |
174 |
173 |
$7K |
| A9276 |
Disposable sensor, cgm sys |
25 |
24 |
$6K |
| A7037 |
Pos airway pressure tubing |
371 |
366 |
$3K |
| E0261 |
Hosp bed semi-electr w/o mat |
193 |
190 |
$3K |
| A7036 |
Pos airway press chinstrap |
527 |
522 |
$3K |
| E0600 |
Suction pump portab hom modl |
117 |
104 |
$3K |
| E0165 |
Commode chair with detacharm |
222 |
215 |
$2K |
| E1038 |
Transport chair pt wt<=300lb |
408 |
404 |
$2K |
| A9901 |
Delivery/set up/dispensing |
709 |
700 |
$2K |
| A4627 |
Spacer bag/reservoir |
127 |
126 |
$2K |
| A7015 |
Aerosol mask used w nebulize |
846 |
825 |
$1K |
| A7003 |
Nebulizer administration set |
326 |
320 |
$622.61 |
| E0156 |
Walker seat attachment |
107 |
107 |
$516.56 |
| K0007 |
Extra heavy duty wheelchair |
13 |
12 |
$442.20 |
| E1226 |
Manual fully reclining back |
25 |
25 |
$363.73 |
| E0114 |
Crutch underarm pair no wood |
13 |
13 |
$273.80 |
| E0100 |
Cane adjust/fixed with tip |
24 |
24 |
$221.59 |
| A7013 |
Disposable compressor filter |
72 |
71 |
$57.12 |
| K0045 |
Ftrst compl assembly repl ea |
16 |
16 |
$0.00 |