| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
24,991 |
23,154 |
$977K |
| E0465 |
Home vent invasive interface |
1,349 |
682 |
$708K |
| E0431 |
Portable gaseous 02 |
11,885 |
11,005 |
$295K |
| E0601 |
Cont airway pressure device |
5,691 |
4,999 |
$90K |
| A7030 |
Cpap full face mask |
2,712 |
2,324 |
$70K |
| A7031 |
Replacement facemask interfa |
3,729 |
3,152 |
$44K |
| A7034 |
Nasal application device |
2,139 |
1,884 |
$35K |
| A7032 |
Replacement nasal cushion |
2,179 |
1,930 |
$33K |
| A7037 |
Pos airway pressure tubing |
5,333 |
4,728 |
$30K |
| A7038 |
Pos airway pressure filter |
10,242 |
9,055 |
$29K |
| E0562 |
Humidifier heated used w pap |
3,700 |
3,270 |
$27K |
| A7035 |
Pos airway press headgear |
3,416 |
3,026 |
$27K |
| E1392 |
Portable oxygen concentrator |
1,990 |
1,867 |
$24K |
| E0466 |
Home vent non-invasive inter |
108 |
87 |
$21K |
| E0570 |
Nebulizer with compression |
2,152 |
2,006 |
$16K |
| A7046 |
Repl water chamber, pap dev |
3,017 |
2,675 |
$15K |
| K0001 |
Standard wheelchair |
625 |
576 |
$6K |
| E0600 |
Suction pump portab hom modl |
253 |
236 |
$5K |
| A7039 |
Filter, non disposable w pap |
1,448 |
1,283 |
$5K |
| A7033 |
Replacement nasal pillows |
313 |
290 |
$3K |
| E0260 |
Hosp bed semi-electr w/ matt |
62 |
61 |
$2K |
| E0470 |
Rad w/o backup non-inv intfc |
30 |
24 |
$2K |
| K0195 |
Elevating whlchair leg rests |
149 |
143 |
$778.26 |
| Q0513 |
Disp fee inhal drugs/30 days |
91 |
77 |
$396.98 |
| A7003 |
Nebulizer administration set |
817 |
713 |
$149.97 |
| A7002 |
Tubing used w suction pump |
53 |
39 |
$106.58 |
| A7000 |
Disposable canister for pump |
21 |
14 |
$103.20 |
| A6402 |
Sterile gauze <= 16 sq in |
14 |
13 |
$50.29 |