| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
9,198 |
9,155 |
$586K |
| E0601 |
Cont airway pressure device |
3,124 |
3,066 |
$124K |
| E0431 |
Portable gaseous 02 |
6,265 |
6,235 |
$87K |
| E0570 |
Nebulizer with compression |
2,909 |
2,800 |
$68K |
| E0470 |
Rad w/o backup non-inv intfc |
803 |
771 |
$52K |
| E0260 |
Hosp bed semi-electr w/ matt |
1,668 |
1,658 |
$50K |
| A4239 |
Non-adju cgm supply allow |
180 |
179 |
$33K |
| K0003 |
Lightweight wheelchair |
1,007 |
993 |
$29K |
| A7030 |
Cpap full face mask |
410 |
405 |
$24K |
| A7037 |
Pos airway pressure tubing |
648 |
636 |
$13K |
| K0001 |
Standard wheelchair |
823 |
816 |
$11K |
| A7035 |
Pos airway press headgear |
569 |
550 |
$8K |
| E0603 |
Electric breast pump |
64 |
64 |
$8K |
| A7005 |
Nondisposable nebulizer set |
626 |
615 |
$8K |
| A7038 |
Pos airway pressure filter |
1,083 |
1,018 |
$5K |
| A4253 |
Blood glucose/reagent strips |
191 |
188 |
$5K |
| A7034 |
Nasal application device |
96 |
92 |
$4K |
| A7031 |
Replacement facemask interfa |
117 |
110 |
$3K |
| B4087 |
Gastro/jejuno tube, std |
78 |
37 |
$3K |
| E0562 |
Humidifier heated used w pap |
33 |
28 |
$2K |
| E0143 |
Walker folding wheeled w/o s |
49 |
49 |
$2K |
| A5514 |
Mult den insert dir carv/cam |
16 |
12 |
$834.96 |
| A7046 |
Repl water chamber, pap dev |
38 |
38 |
$218.02 |
| A7003 |
Nebulizer administration set |
301 |
298 |
$149.20 |
| A7013 |
Disposable compressor filter |
105 |
102 |
$124.17 |
| A7015 |
Aerosol mask used w nebulize |
12 |
12 |
$11.38 |