| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
28,174 |
19,346 |
$926K |
| E0431 |
Portable gaseous 02 |
18,496 |
12,785 |
$116K |
| E0601 |
Cont airway pressure device |
2,651 |
1,954 |
$100K |
| A7030 |
Cpap full face mask |
1,823 |
1,303 |
$79K |
| A7034 |
Nasal application device |
1,648 |
1,273 |
$54K |
| A7031 |
Replacement facemask interfa |
2,264 |
1,697 |
$49K |
| A7035 |
Pos airway press headgear |
2,773 |
2,190 |
$37K |
| E0562 |
Humidifier heated used w pap |
1,288 |
947 |
$36K |
| A7038 |
Pos airway pressure filter |
7,460 |
6,300 |
$35K |
| A4604 |
Tubing with heating element |
1,325 |
1,024 |
$26K |
| A7037 |
Pos airway pressure tubing |
2,367 |
1,720 |
$24K |
| E0570 |
Nebulizer with compression |
4,093 |
2,785 |
$23K |
| E1392 |
Portable oxygen concentrator |
2,384 |
1,658 |
$23K |
| A7032 |
Replacement nasal cushion |
1,009 |
779 |
$17K |
| A7046 |
Repl water chamber, pap dev |
2,060 |
1,628 |
$13K |
| A7033 |
Replacement nasal pillows |
334 |
274 |
$4K |
| K0001 |
Standard wheelchair |
270 |
191 |
$3K |
| E0443 |
Portable 02 contents, gas |
284 |
160 |
$1K |
| A7003 |
Nebulizer administration set |
1,721 |
1,085 |
$1K |
| A7039 |
Filter, non disposable w pap |
171 |
139 |
$948.60 |
| K0003 |
Lightweight wheelchair |
33 |
24 |
$165.35 |
| A7005 |
Nondisposable nebulizer set |
13 |
13 |
$150.82 |
| E0255 |
Hospital bed var ht w/ mattr |
18 |
13 |
$148.41 |
| A7002 |
Tubing used w suction pump |
29 |
13 |
$113.27 |