| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E0466 |
Home vent non-invasive inter |
2,597 |
2,287 |
$711K |
| E1390 |
Oxygen concentrator |
19,934 |
15,609 |
$521K |
| E0601 |
Cont airway pressure device |
15,293 |
12,808 |
$322K |
| A7030 |
Cpap full face mask |
7,433 |
5,947 |
$293K |
| A4604 |
Tubing with heating element |
11,894 |
9,585 |
$216K |
| A7031 |
Replacement facemask interfa |
11,435 |
9,249 |
$200K |
| A7034 |
Nasal application device |
6,680 |
5,394 |
$180K |
| A7032 |
Replacement nasal cushion |
7,305 |
6,102 |
$155K |
| E0562 |
Humidifier heated used w pap |
8,827 |
7,342 |
$120K |
| A7035 |
Pos airway press headgear |
7,908 |
6,277 |
$70K |
| E0431 |
Portable gaseous 02 |
10,401 |
8,420 |
$64K |
| A7033 |
Replacement nasal pillows |
4,041 |
3,290 |
$61K |
| A7038 |
Pos airway pressure filter |
24,405 |
19,976 |
$60K |
| E0470 |
Rad w/o backup non-inv intfc |
1,295 |
1,090 |
$56K |
| E1392 |
Portable oxygen concentrator |
5,044 |
3,991 |
$42K |
| A7046 |
Repl water chamber, pap dev |
5,494 |
4,470 |
$30K |
| E0570 |
Nebulizer with compression |
4,080 |
3,362 |
$20K |
| A7037 |
Pos airway pressure tubing |
1,893 |
1,539 |
$12K |
| A7039 |
Filter, non disposable w pap |
1,146 |
942 |
$4K |
| A7526 |
Tracheostomy tube collar |
48 |
36 |
$3K |
| A4606 |
Oxygen probe used w oximeter |
88 |
38 |
$2K |
| A7000 |
Disposable canister for pump |
222 |
141 |
$2K |
| E0600 |
Suction pump portab hom modl |
111 |
106 |
$2K |
| A7036 |
Pos airway press chinstrap |
367 |
317 |
$2K |
| A7005 |
Nondisposable nebulizer set |
357 |
296 |
$1K |
| E0260 |
Hosp bed semi-electr w/ matt |
116 |
97 |
$1K |
| A7002 |
Tubing used w suction pump |
204 |
133 |
$899.88 |
| K0001 |
Standard wheelchair |
156 |
135 |
$624.26 |
| A4628 |
Oropharyngeal suction cath |
119 |
73 |
$488.67 |
| E0445 |
Oximeter non-invasive |
14 |
12 |
$360.68 |
| A4216 |
Sterile water/saline, 10 ml |
26 |
12 |
$130.26 |
| A7003 |
Nebulizer administration set |
71 |
36 |
$107.09 |
| A6402 |
Sterile gauze <= 16 sq in |
48 |
24 |
$84.71 |
| A7013 |
Disposable compressor filter |
59 |
53 |
$21.96 |