| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E0466 |
Home vent non-invasive inter |
1,210 |
684 |
$193K |
| E0601 |
Cont airway pressure device |
4,202 |
3,425 |
$168K |
| E1390 |
Oxygen concentrator |
4,677 |
3,115 |
$139K |
| E0470 |
Rad w/o backup non-inv intfc |
512 |
431 |
$50K |
| A7030 |
Cpap full face mask |
704 |
585 |
$45K |
| A7037 |
Pos airway pressure tubing |
1,959 |
1,603 |
$27K |
| A7031 |
Replacement facemask interfa |
1,113 |
799 |
$25K |
| A7034 |
Nasal application device |
595 |
497 |
$22K |
| A7035 |
Pos airway press headgear |
1,090 |
887 |
$14K |
| E0431 |
Portable gaseous 02 |
3,550 |
2,464 |
$14K |
| E0562 |
Humidifier heated used w pap |
126 |
100 |
$12K |
| A7038 |
Pos airway pressure filter |
2,595 |
2,014 |
$10K |
| K0004 |
High strength ltwt whlchr |
491 |
380 |
$9K |
| A7032 |
Replacement nasal cushion |
448 |
359 |
$9K |
| E0260 |
Hosp bed semi-electr w/ matt |
228 |
191 |
$6K |
| E0971 |
Wheelchair anti-tipping devi |
1,749 |
644 |
$6K |
| K0001 |
Standard wheelchair |
294 |
220 |
$2K |
| K0195 |
Elevating whlchair leg rests |
487 |
363 |
$2K |
| E0570 |
Nebulizer with compression |
328 |
274 |
$2K |
| A7039 |
Filter, non disposable w pap |
324 |
269 |
$1K |
| K0003 |
Lightweight wheelchair |
63 |
49 |
$953.57 |
| E0443 |
Portable 02 contents, gas |
107 |
65 |
$356.36 |
| A7046 |
Repl water chamber, pap dev |
28 |
26 |
$80.18 |
| K0052 |
Swingaway detach ftrest repl |
125 |
43 |
$13.28 |