| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
9,930 |
9,871 |
$687K |
| E0601 |
Cont airway pressure device |
2,872 |
2,855 |
$136K |
| E0570 |
Nebulizer with compression |
2,603 |
2,587 |
$94K |
| E0431 |
Portable gaseous 02 |
4,534 |
4,498 |
$76K |
| B4150 |
Ef complet w/intact nutrient |
508 |
490 |
$54K |
| B4035 |
Enteral feed supp pump per d |
296 |
279 |
$48K |
| A7030 |
Cpap full face mask |
744 |
727 |
$36K |
| B4087 |
Gastro/jejuno tube, std |
526 |
496 |
$33K |
| E0470 |
Rad w/o backup non-inv intfc |
241 |
238 |
$26K |
| E0260 |
Hosp bed semi-electr w/ matt |
764 |
756 |
$25K |
| B4160 |
Ef ped caloric dense>/=0.7kc |
155 |
141 |
$20K |
| A7031 |
Replacement facemask interfa |
763 |
741 |
$18K |
| A7037 |
Pos airway pressure tubing |
996 |
989 |
$16K |
| A7035 |
Pos airway press headgear |
1,039 |
1,024 |
$15K |
| A7005 |
Nondisposable nebulizer set |
881 |
877 |
$13K |
| A7038 |
Pos airway pressure filter |
2,261 |
2,215 |
$11K |
| K0003 |
Lightweight wheelchair |
331 |
330 |
$9K |
| K0738 |
Portable gas oxygen system |
1,031 |
1,025 |
$9K |
| A7034 |
Nasal application device |
208 |
200 |
$6K |
| E0562 |
Humidifier heated used w pap |
105 |
105 |
$4K |
| A7046 |
Repl water chamber, pap dev |
476 |
466 |
$2K |
| A7032 |
Replacement nasal cushion |
28 |
27 |
$1K |
| B4088 |
Gastro/jejuno tube, low-pro |
13 |
13 |
$1K |
| A7015 |
Aerosol mask used w nebulize |
304 |
302 |
$517.47 |
| A4604 |
Tubing with heating element |
66 |
66 |
$426.39 |
| E1392 |
Portable oxygen concentrator |
38 |
38 |
$190.79 |
| A7000 |
Disposable canister for pump |
12 |
12 |
$74.15 |
| A4213 |
20+ cc syringe only |
14 |
13 |
$66.94 |