| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
24,569 |
20,496 |
$1.11M |
| E0570 |
Nebulizer with compression |
4,884 |
4,135 |
$198K |
| E0431 |
Portable gaseous 02 |
9,695 |
8,032 |
$98K |
| E0601 |
Cont airway pressure device |
2,679 |
2,112 |
$80K |
| A5512 |
Multi den insert direct form |
822 |
466 |
$43K |
| A7031 |
Replacement facemask interfa |
1,929 |
1,627 |
$41K |
| A5500 |
Diab shoe for density insert |
822 |
469 |
$37K |
| E0562 |
Humidifier heated used w pap |
3,473 |
2,759 |
$28K |
| E0260 |
Hosp bed semi-electr w/ matt |
1,284 |
964 |
$28K |
| A4618 |
Breathing circuits |
2,305 |
1,940 |
$25K |
| A7030 |
Cpap full face mask |
486 |
401 |
$23K |
| K0001 |
Standard wheelchair |
2,180 |
1,708 |
$18K |
| A7035 |
Pos airway press headgear |
644 |
545 |
$7K |
| A7038 |
Pos airway pressure filter |
2,097 |
1,765 |
$5K |
| A7003 |
Nebulizer administration set |
1,528 |
1,384 |
$3K |
| A4604 |
Tubing with heating element |
154 |
121 |
$3K |
| A7037 |
Pos airway pressure tubing |
211 |
191 |
$2K |
| A7039 |
Filter, non disposable w pap |
352 |
278 |
$1K |
| E0470 |
Rad w/o backup non-inv intfc |
13 |
12 |
$533.20 |
| A7015 |
Aerosol mask used w nebulize |
355 |
327 |
$378.22 |