| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E0601 |
Cont airway pressure device |
3,081 |
2,834 |
$194K |
| E1390 |
Oxygen concentrator |
2,165 |
1,843 |
$122K |
| A7030 |
Cpap full face mask |
872 |
762 |
$79K |
| A7031 |
Replacement facemask interfa |
798 |
694 |
$51K |
| A4604 |
Tubing with heating element |
1,611 |
1,388 |
$50K |
| S5161 |
Emer rspns sys serv permonth |
1,561 |
1,123 |
$38K |
| A7038 |
Pos airway pressure filter |
2,138 |
1,879 |
$31K |
| A7034 |
Nasal application device |
376 |
325 |
$21K |
| A7035 |
Pos airway press headgear |
1,072 |
924 |
$21K |
| E0570 |
Nebulizer with compression |
524 |
482 |
$10K |
| E0260 |
Hosp bed semi-electr w/ matt |
266 |
206 |
$6K |
| K0001 |
Standard wheelchair |
245 |
183 |
$5K |
| E1392 |
Portable oxygen concentrator |
212 |
198 |
$4K |
| A7039 |
Filter, non disposable w pap |
314 |
268 |
$2K |
| E0470 |
Rad w/o backup non-inv intfc |
15 |
12 |
$2K |
| E0431 |
Portable gaseous 02 |
147 |
135 |
$1K |
| A4927 |
Non-sterile gloves |
15 |
12 |
$266.56 |