| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
10,573 |
8,694 |
$395K |
| E0466 |
Home vent non-invasive inter |
254 |
215 |
$66K |
| E0431 |
Portable gaseous 02 |
5,746 |
4,727 |
$54K |
| E0601 |
Cont airway pressure device |
1,219 |
1,092 |
$50K |
| A7030 |
Cpap full face mask |
246 |
228 |
$21K |
| E0570 |
Nebulizer with compression |
1,018 |
812 |
$21K |
| A7031 |
Replacement facemask interfa |
429 |
390 |
$14K |
| E0562 |
Humidifier heated used w pap |
1,075 |
949 |
$14K |
| K0001 |
Standard wheelchair |
1,082 |
876 |
$14K |
| B4160 |
Ef ped caloric dense>/=0.7kc |
49 |
27 |
$12K |
| A4604 |
Tubing with heating element |
306 |
277 |
$10K |
| E0260 |
Hosp bed semi-electr w/ matt |
282 |
237 |
$9K |
| A7035 |
Pos airway press headgear |
321 |
290 |
$6K |
| A7038 |
Pos airway pressure filter |
775 |
686 |
$3K |
| A7034 |
Nasal application device |
49 |
45 |
$3K |
| A7032 |
Replacement nasal cushion |
104 |
89 |
$2K |
| A7046 |
Repl water chamber, pap dev |
119 |
94 |
$615.76 |
| A7039 |
Filter, non disposable w pap |
105 |
89 |
$549.71 |
| A7037 |
Pos airway pressure tubing |
39 |
37 |
$454.57 |
| A7005 |
Nondisposable nebulizer set |
13 |
13 |
$75.21 |