| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
26,399 |
18,201 |
$1.02M |
| E0431 |
Portable gaseous 02 |
17,370 |
12,437 |
$153K |
| A7030 |
Cpap full face mask |
2,433 |
1,744 |
$120K |
| B4035 |
Enteral feed supp pump per d |
595 |
452 |
$118K |
| A7031 |
Replacement facemask interfa |
3,074 |
2,285 |
$113K |
| B4160 |
Ef ped caloric dense>/=0.7kc |
771 |
703 |
$81K |
| E0601 |
Cont airway pressure device |
1,097 |
875 |
$37K |
| A7034 |
Nasal application device |
1,107 |
810 |
$34K |
| A7032 |
Replacement nasal cushion |
603 |
455 |
$27K |
| A7038 |
Pos airway pressure filter |
5,007 |
3,941 |
$24K |
| B4152 |
Ef calorie dense>/=1.5kcal |
124 |
105 |
$19K |
| A7037 |
Pos airway pressure tubing |
1,986 |
1,417 |
$18K |
| A7035 |
Pos airway press headgear |
1,918 |
1,425 |
$17K |
| E0562 |
Humidifier heated used w pap |
1,163 |
949 |
$13K |
| A4604 |
Tubing with heating element |
1,190 |
842 |
$13K |
| A7046 |
Repl water chamber, pap dev |
1,626 |
1,168 |
$7K |
| A7033 |
Replacement nasal pillows |
109 |
97 |
$4K |
| E0570 |
Nebulizer with compression |
685 |
538 |
$2K |
| E1392 |
Portable oxygen concentrator |
435 |
265 |
$1K |
| K0001 |
Standard wheelchair |
30 |
25 |
$665.83 |
| A7003 |
Nebulizer administration set |
167 |
148 |
$170.13 |