| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
4,056 |
3,799 |
$180K |
| A7030 |
Cpap full face mask |
417 |
405 |
$38K |
| E0601 |
Cont airway pressure device |
805 |
738 |
$32K |
| A4604 |
Tubing with heating element |
587 |
579 |
$23K |
| A7031 |
Replacement facemask interfa |
534 |
512 |
$19K |
| E1392 |
Portable oxygen concentrator |
1,733 |
1,597 |
$17K |
| A7034 |
Nasal application device |
225 |
224 |
$16K |
| E0431 |
Portable gaseous 02 |
1,768 |
1,672 |
$15K |
| E0562 |
Humidifier heated used w pap |
743 |
694 |
$14K |
| E0470 |
Rad w/o backup non-inv intfc |
110 |
108 |
$13K |
| E0600 |
Suction pump portab hom modl |
185 |
185 |
$10K |
| A7035 |
Pos airway press headgear |
473 |
464 |
$9K |
| E0570 |
Nebulizer with compression |
430 |
366 |
$8K |
| A4239 |
Non-adju cgm supply allow |
41 |
41 |
$7K |
| K0001 |
Standard wheelchair |
272 |
262 |
$5K |
| A7032 |
Replacement nasal cushion |
94 |
94 |
$5K |
| A7038 |
Pos airway pressure filter |
901 |
877 |
$5K |
| A7046 |
Repl water chamber, pap dev |
168 |
166 |
$2K |
| A4927 |
Non-sterile gloves |
54 |
49 |
$608.08 |
| A7000 |
Disposable canister for pump |
26 |
26 |
$354.20 |
| A7005 |
Nondisposable nebulizer set |
12 |
12 |
$264.37 |
| A7037 |
Pos airway pressure tubing |
13 |
12 |
$217.60 |
| A7002 |
Tubing used w suction pump |
29 |
26 |
$161.15 |
| A4628 |
Oropharyngeal suction cath |
13 |
13 |
$113.62 |