| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
4,029 |
3,732 |
$99K |
| A7038 |
Pos airway pressure filter |
2,243 |
2,123 |
$30K |
| A7046 |
Repl water chamber, pap dev |
420 |
401 |
$18K |
| E0601 |
Cont airway pressure device |
1,168 |
1,098 |
$16K |
| A7031 |
Replacement facemask interfa |
1,049 |
994 |
$13K |
| A7030 |
Cpap full face mask |
797 |
756 |
$7K |
| E0431 |
Portable gaseous 02 |
2,883 |
2,650 |
$7K |
| E0562 |
Humidifier heated used w pap |
1,280 |
1,226 |
$6K |
| A7034 |
Nasal application device |
226 |
204 |
$5K |
| A7035 |
Pos airway press headgear |
612 |
582 |
$3K |
| E0570 |
Nebulizer with compression |
1,549 |
1,451 |
$3K |
| A4604 |
Tubing with heating element |
790 |
750 |
$2K |
| A7032 |
Replacement nasal cushion |
119 |
110 |
$2K |
| A7037 |
Pos airway pressure tubing |
176 |
170 |
$1K |
| K0001 |
Standard wheelchair |
24 |
24 |
$316.31 |
| A7033 |
Replacement nasal pillows |
14 |
13 |
$228.57 |
| A7003 |
Nebulizer administration set |
150 |
141 |
$63.51 |
| J7613 |
Albuterol non-comp unit |
81 |
70 |
$0.00 |
| J7626 |
Budesonide non-comp unit |
47 |
40 |
$0.00 |
| Q0513 |
Disp fee inhal drugs/30 days |
201 |
176 |
$0.00 |
| E1392 |
Portable oxygen concentrator |
12 |
12 |
$0.00 |
| J7606 |
Formoterol fumarate, inh |
27 |
24 |
$0.00 |