| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
3,861 |
3,586 |
$374K |
| E0601 |
Cont airway pressure device |
3,252 |
2,928 |
$174K |
| K0823 |
Pwc gp 2 std cap chair |
1,114 |
1,091 |
$136K |
| E0562 |
Humidifier heated used w pap |
3,754 |
3,391 |
$73K |
| A7030 |
Cpap full face mask |
571 |
505 |
$60K |
| E0431 |
Portable gaseous 02 |
2,220 |
2,101 |
$32K |
| A4604 |
Tubing with heating element |
982 |
900 |
$30K |
| A7035 |
Pos airway press headgear |
1,051 |
966 |
$23K |
| E0470 |
Rad w/o backup non-inv intfc |
135 |
125 |
$21K |
| E0570 |
Nebulizer with compression |
234 |
207 |
$19K |
| E0973 |
W/ch access det adj armrest |
849 |
514 |
$15K |
| E1028 |
W/c manual swingaway |
116 |
103 |
$8K |
| A7038 |
Pos airway pressure filter |
1,366 |
1,269 |
$8K |
| K0825 |
Pwc gp 2 hd cap chair |
13 |
13 |
$8K |
| A7046 |
Repl water chamber, pap dev |
518 |
462 |
$6K |
| A7034 |
Nasal application device |
76 |
67 |
$5K |
| K0195 |
Elevating whlchair leg rests |
1,439 |
1,413 |
$4K |
| A7003 |
Nebulizer administration set |
762 |
665 |
$3K |
| A4670 |
Automatic bp monitor, dial |
30 |
30 |
$2K |
| A7031 |
Replacement facemask interfa |
14 |
13 |
$391.67 |
| K0739 |
Repair/svc dme non-oxygen eq |
34 |
28 |
$326.65 |
| A7015 |
Aerosol mask used w nebulize |
140 |
127 |
$188.95 |
| A7013 |
Disposable compressor filter |
144 |
121 |
$110.73 |