| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
2,760 |
2,638 |
$230K |
| B4152 |
Ef calorie dense>/=1.5kcal |
1,303 |
940 |
$148K |
| A7030 |
Cpap full face mask |
915 |
857 |
$124K |
| E0601 |
Cont airway pressure device |
2,276 |
2,199 |
$112K |
| A4223 |
Infusion supplies w/o pump |
366 |
86 |
$98K |
| E0562 |
Humidifier heated used w pap |
1,725 |
1,686 |
$63K |
| A4604 |
Tubing with heating element |
1,169 |
1,089 |
$42K |
| B4035 |
Enteral feed supp pump per d |
229 |
162 |
$39K |
| E0431 |
Portable gaseous 02 |
1,852 |
1,797 |
$27K |
| A7035 |
Pos airway press headgear |
903 |
848 |
$24K |
| B4034 |
Enter feed supkit syr by day |
189 |
140 |
$21K |
| A4221 |
Supp non-insulin inf cath/wk |
762 |
324 |
$15K |
| A7038 |
Pos airway pressure filter |
1,624 |
1,493 |
$13K |
| E0470 |
Rad w/o backup non-inv intfc |
166 |
165 |
$11K |
| A7031 |
Replacement facemask interfa |
176 |
169 |
$8K |
| E0570 |
Nebulizer with compression |
410 |
400 |
$8K |
| A7034 |
Nasal application device |
45 |
43 |
$4K |
| A7039 |
Filter, non disposable w pap |
116 |
114 |
$914.14 |
| A7046 |
Repl water chamber, pap dev |
31 |
25 |
$391.06 |