| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E0601 |
Cont airway pressure device |
6,580 |
6,331 |
$345K |
| A7034 |
Nasal application device |
3,168 |
3,124 |
$199K |
| A4604 |
Tubing with heating element |
3,252 |
3,207 |
$130K |
| E0562 |
Humidifier heated used w pap |
2,747 |
2,611 |
$115K |
| A7033 |
Replacement nasal pillows |
2,982 |
2,920 |
$109K |
| A7035 |
Pos airway press headgear |
4,120 |
4,047 |
$87K |
| A7032 |
Replacement nasal cushion |
2,636 |
2,573 |
$80K |
| A7030 |
Cpap full face mask |
1,460 |
1,420 |
$80K |
| E1390 |
Oxygen concentrator |
2,007 |
1,988 |
$78K |
| A7038 |
Pos airway pressure filter |
11,150 |
10,803 |
$71K |
| E0470 |
Rad w/o backup non-inv intfc |
715 |
684 |
$60K |
| A7031 |
Replacement facemask interfa |
1,414 |
1,353 |
$48K |
| A7046 |
Repl water chamber, pap dev |
3,175 |
3,135 |
$39K |
| A7037 |
Pos airway pressure tubing |
1,619 |
1,571 |
$24K |
| A7039 |
Filter, non disposable w pap |
2,151 |
2,109 |
$17K |
| J7606 |
Formoterol fumarate, inh |
114 |
104 |
$7K |
| E0431 |
Portable gaseous 02 |
1,217 |
1,204 |
$6K |
| Q0513 |
Disp fee inhal drugs/30 days |
968 |
879 |
$3K |
| J7626 |
Budesonide non-comp unit |
161 |
138 |
$2K |
| J7613 |
Albuterol non-comp unit |
243 |
218 |
$406.38 |
| J7620 |
Albuterol ipratrop non-comp |
578 |
512 |
$337.46 |
| E0443 |
Portable 02 contents, gas |
84 |
78 |
$308.33 |
| E0570 |
Nebulizer with compression |
277 |
276 |
$162.43 |
| A7005 |
Nondisposable nebulizer set |
38 |
37 |
$152.88 |
| A7036 |
Pos airway press chinstrap |
13 |
13 |
$108.52 |
| K0001 |
Standard wheelchair |
467 |
467 |
$0.00 |
| E0143 |
Walker folding wheeled w/o s |
30 |
29 |
$0.00 |
| K0195 |
Elevating whlchair leg rests |
123 |
123 |
$0.00 |