| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
18,247 |
13,458 |
$718K |
| E0601 |
Cont airway pressure device |
10,914 |
8,771 |
$382K |
| E0570 |
Nebulizer with compression |
9,093 |
6,650 |
$139K |
| A7030 |
Cpap full face mask |
2,012 |
1,549 |
$138K |
| E0562 |
Humidifier heated used w pap |
7,659 |
6,197 |
$129K |
| E0470 |
Rad w/o backup non-inv intfc |
1,862 |
1,537 |
$124K |
| A4604 |
Tubing with heating element |
3,423 |
2,574 |
$91K |
| E0431 |
Portable gaseous 02 |
7,958 |
6,011 |
$65K |
| A7031 |
Replacement facemask interfa |
2,295 |
1,733 |
$63K |
| A7034 |
Nasal application device |
1,090 |
839 |
$49K |
| A7035 |
Pos airway press headgear |
2,865 |
2,155 |
$39K |
| K0738 |
Portable gas oxygen system |
3,076 |
2,243 |
$33K |
| E0260 |
Hosp bed semi-electr w/ matt |
939 |
666 |
$32K |
| E1392 |
Portable oxygen concentrator |
2,336 |
1,794 |
$30K |
| E1086 |
Hemi-wheelchair detachable a |
337 |
300 |
$27K |
| A7005 |
Nondisposable nebulizer set |
2,390 |
1,861 |
$26K |
| A7032 |
Replacement nasal cushion |
860 |
681 |
$24K |
| A7038 |
Pos airway pressure filter |
4,943 |
3,793 |
$17K |
| A7046 |
Repl water chamber, pap dev |
1,640 |
1,268 |
$15K |
| E1140 |
Wheelchair standard detach a |
520 |
455 |
$15K |
| E0600 |
Suction pump portab hom modl |
291 |
252 |
$12K |
| E1093 |
Wheelchair wide w/ foot rest |
130 |
115 |
$11K |
| E0143 |
Walker folding wheeled w/o s |
404 |
292 |
$9K |
| A7037 |
Pos airway pressure tubing |
515 |
424 |
$7K |
| A6530 |
Compression stocking bk18-30 |
158 |
83 |
$6K |
| A7033 |
Replacement nasal pillows |
201 |
159 |
$5K |
| A7039 |
Filter, non disposable w pap |
1,047 |
828 |
$5K |
| E0184 |
Dry pressure mattress |
280 |
207 |
$3K |
| E0114 |
Crutch underarm pair no wood |
68 |
50 |
$3K |
| A5514 |
Mult den insert dir carv/cam |
30 |
12 |
$2K |
| L4361 |
Pneuma/vac walk boot pre ots |
17 |
12 |
$2K |
| L3908 |
Who cock-up nonmolde pre ots |
19 |
14 |
$1K |
| A7003 |
Nebulizer administration set |
1,669 |
1,272 |
$862.39 |
| A5500 |
Diab shoe for density insert |
33 |
12 |
$754.90 |
| E0434 |
Portable liquid 02 |
58 |
36 |
$710.07 |
| A7015 |
Aerosol mask used w nebulize |
863 |
694 |
$692.28 |
| K0001 |
Standard wheelchair |
495 |
349 |
$561.08 |
| E0156 |
Walker seat attachment |
43 |
30 |
$232.81 |
| K0002 |
Stnd hemi (low seat) whlchr |
49 |
36 |
$0.00 |
| K0052 |
Swingaway detach ftrest repl |
25 |
12 |
$0.00 |