| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
6,284 |
4,878 |
$354K |
| A7030 |
Cpap full face mask |
2,809 |
2,482 |
$267K |
| E0601 |
Cont airway pressure device |
4,580 |
4,031 |
$254K |
| A7031 |
Replacement facemask interfa |
3,429 |
2,962 |
$120K |
| A4604 |
Tubing with heating element |
3,049 |
2,676 |
$99K |
| E0562 |
Humidifier heated used w pap |
3,995 |
3,568 |
$73K |
| A7035 |
Pos airway press headgear |
2,410 |
2,116 |
$47K |
| T4527 |
Adult size pull-on lg |
520 |
491 |
$42K |
| E0431 |
Portable gaseous 02 |
4,505 |
3,406 |
$41K |
| E0570 |
Nebulizer with compression |
3,340 |
2,802 |
$37K |
| A7034 |
Nasal application device |
626 |
542 |
$37K |
| A7038 |
Pos airway pressure filter |
5,220 |
4,568 |
$29K |
| K0001 |
Standard wheelchair |
1,510 |
1,008 |
$16K |
| A7046 |
Repl water chamber, pap dev |
1,322 |
1,165 |
$13K |
| A4927 |
Non-sterile gloves |
1,192 |
792 |
$11K |
| A7032 |
Replacement nasal cushion |
209 |
176 |
$6K |
| E0470 |
Rad w/o backup non-inv intfc |
50 |
49 |
$6K |
| T4526 |
Adult size pull-on med |
53 |
51 |
$4K |
| T4541 |
Large disposable underpad |
240 |
228 |
$4K |
| E1392 |
Portable oxygen concentrator |
84 |
74 |
$1K |
| E0260 |
Hosp bed semi-electr w/ matt |
16 |
14 |
$513.28 |
| A7037 |
Pos airway pressure tubing |
30 |
24 |
$506.37 |
| A7005 |
Nondisposable nebulizer set |
16 |
14 |
$314.01 |
| A7003 |
Nebulizer administration set |
14 |
12 |
$13.16 |
| A4520 |
Incontinence garment anytype |
354 |
237 |
$0.00 |