| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
5,689 |
4,271 |
$267K |
| E0601 |
Cont airway pressure device |
4,373 |
3,304 |
$144K |
| A7030 |
Cpap full face mask |
2,011 |
1,642 |
$104K |
| A7031 |
Replacement facemask interfa |
2,798 |
2,038 |
$61K |
| E0260 |
Hosp bed semi-electr w/ matt |
2,463 |
1,771 |
$51K |
| K0001 |
Standard wheelchair |
3,748 |
2,795 |
$27K |
| E0431 |
Portable gaseous 02 |
3,483 |
2,592 |
$25K |
| B4035 |
Enteral feed supp pump per d |
103 |
79 |
$24K |
| A4554 |
Disposable underpads |
469 |
386 |
$24K |
| A7035 |
Pos airway press headgear |
1,698 |
1,389 |
$21K |
| A7034 |
Nasal application device |
659 |
557 |
$20K |
| E0562 |
Humidifier heated used w pap |
140 |
130 |
$19K |
| A7037 |
Pos airway pressure tubing |
1,244 |
953 |
$18K |
| A7038 |
Pos airway pressure filter |
4,396 |
3,293 |
$16K |
| E0630 |
Patient lift hydraulic |
706 |
520 |
$13K |
| A4604 |
Tubing with heating element |
1,304 |
1,185 |
$13K |
| A7046 |
Repl water chamber, pap dev |
1,030 |
877 |
$4K |
| E0570 |
Nebulizer with compression |
711 |
588 |
$4K |
| A7032 |
Replacement nasal cushion |
258 |
193 |
$4K |
| K0195 |
Elevating whlchair leg rests |
722 |
532 |
$3K |
| A7033 |
Replacement nasal pillows |
238 |
175 |
$3K |
| E0143 |
Walker folding wheeled w/o s |
91 |
82 |
$2K |
| E1392 |
Portable oxygen concentrator |
77 |
50 |
$869.04 |
| E2601 |
Gen w/c cushion wdth < 22 in |
44 |
38 |
$742.45 |
| B9998 |
Enteral supp not otherwise c |
79 |
38 |
$735.99 |
| A7526 |
Tracheostomy tube collar |
32 |
25 |
$713.69 |