| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
10,456 |
10,361 |
$906K |
| E0601 |
Cont airway pressure device |
3,278 |
3,211 |
$125K |
| E0431 |
Portable gaseous 02 |
7,267 |
7,199 |
$121K |
| A7030 |
Cpap full face mask |
1,801 |
1,765 |
$120K |
| E0466 |
Home vent non-invasive inter |
153 |
152 |
$103K |
| A7031 |
Replacement facemask interfa |
2,464 |
2,389 |
$83K |
| E0562 |
Humidifier heated used w pap |
472 |
467 |
$40K |
| A7034 |
Nasal application device |
711 |
701 |
$35K |
| E0470 |
Rad w/o backup non-inv intfc |
204 |
203 |
$28K |
| A7037 |
Pos airway pressure tubing |
1,568 |
1,542 |
$26K |
| A7032 |
Replacement nasal cushion |
544 |
533 |
$23K |
| A7038 |
Pos airway pressure filter |
4,651 |
4,509 |
$22K |
| A7035 |
Pos airway press headgear |
1,502 |
1,475 |
$20K |
| A7033 |
Replacement nasal pillows |
499 |
478 |
$15K |
| E0570 |
Nebulizer with compression |
1,544 |
1,536 |
$11K |
| K0738 |
Portable gas oxygen system |
267 |
266 |
$9K |
| E0260 |
Hosp bed semi-electr w/ matt |
147 |
147 |
$8K |
| A7046 |
Repl water chamber, pap dev |
810 |
798 |
$5K |
| K0001 |
Standard wheelchair |
232 |
221 |
$5K |
| K0003 |
Lightweight wheelchair |
91 |
88 |
$4K |
| A4604 |
Tubing with heating element |
751 |
740 |
$1K |
| E0443 |
Portable 02 contents, gas |
79 |
79 |
$359.47 |
| E1392 |
Portable oxygen concentrator |
434 |
430 |
$282.27 |
| A7036 |
Pos airway press chinstrap |
50 |
50 |
$247.58 |
| A7005 |
Nondisposable nebulizer set |
12 |
12 |
$152.53 |
| A7015 |
Aerosol mask used w nebulize |
14 |
13 |
$12.49 |