| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
3,003 |
2,961 |
$281K |
| A7030 |
Cpap full face mask |
1,206 |
1,194 |
$145K |
| E0601 |
Cont airway pressure device |
1,523 |
1,511 |
$115K |
| A7031 |
Replacement facemask interfa |
1,069 |
1,054 |
$56K |
| E0562 |
Humidifier heated used w pap |
2,458 |
2,435 |
$51K |
| E0570 |
Nebulizer with compression |
2,388 |
2,356 |
$33K |
| A4604 |
Tubing with heating element |
697 |
691 |
$33K |
| E0431 |
Portable gaseous 02 |
2,033 |
1,993 |
$31K |
| K0001 |
Standard wheelchair |
1,102 |
1,082 |
$25K |
| E0470 |
Rad w/o backup non-inv intfc |
176 |
173 |
$22K |
| E0260 |
Hosp bed semi-electr w/ matt |
336 |
333 |
$20K |
| A7035 |
Pos airway press headgear |
876 |
867 |
$19K |
| T4527 |
Adult size pull-on lg |
91 |
88 |
$16K |
| A7038 |
Pos airway pressure filter |
1,820 |
1,801 |
$13K |
| A7037 |
Pos airway pressure tubing |
225 |
221 |
$5K |
| T4541 |
Large disposable underpad |
183 |
180 |
$5K |
| A7046 |
Repl water chamber, pap dev |
237 |
234 |
$3K |
| A7039 |
Filter, non disposable w pap |
197 |
197 |
$2K |
| T4528 |
Adult size pull-on xl |
14 |
12 |
$2K |
| A7034 |
Nasal application device |
24 |
24 |
$2K |
| T4537 |
Reusable underpad bed size |
12 |
12 |
$504.00 |
| A4927 |
Non-sterile gloves |
13 |
13 |
$313.36 |