| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
23,151 |
20,180 |
$1.05M |
| E0466 |
Home vent non-invasive inter |
2,101 |
1,732 |
$764K |
| E2402 |
Neg press wound therapy pump |
574 |
478 |
$233K |
| E0431 |
Portable gaseous 02 |
18,752 |
15,953 |
$113K |
| E0601 |
Cont airway pressure device |
2,444 |
2,243 |
$95K |
| A7030 |
Cpap full face mask |
839 |
696 |
$43K |
| A6550 |
Neg pres wound ther drsg set |
386 |
242 |
$32K |
| E0261 |
Hosp bed semi-electr w/o mat |
1,331 |
1,157 |
$24K |
| E0570 |
Nebulizer with compression |
2,857 |
2,493 |
$18K |
| A7037 |
Pos airway pressure tubing |
1,614 |
1,381 |
$17K |
| K0001 |
Standard wheelchair |
1,899 |
1,604 |
$17K |
| E0562 |
Humidifier heated used w pap |
352 |
335 |
$14K |
| E0443 |
Portable 02 contents, gas |
458 |
356 |
$9K |
| A7035 |
Pos airway press headgear |
804 |
675 |
$9K |
| A7000 |
Disposable canister for pump |
466 |
301 |
$9K |
| A7038 |
Pos airway pressure filter |
2,294 |
1,761 |
$7K |
| A7034 |
Nasal application device |
144 |
116 |
$5K |
| A7031 |
Replacement facemask interfa |
284 |
166 |
$4K |
| E1392 |
Portable oxygen concentrator |
646 |
588 |
$3K |
| A7039 |
Filter, non disposable w pap |
572 |
464 |
$2K |
| A6252 |
Absorpt drg >16 <=48 w/o bdr |
46 |
38 |
$2K |
| A7046 |
Repl water chamber, pap dev |
156 |
137 |
$1K |
| A7032 |
Replacement nasal cushion |
77 |
39 |
$864.17 |
| E0470 |
Rad w/o backup non-inv intfc |
13 |
12 |
$847.49 |
| A4452 |
Waterproof tape |
34 |
27 |
$392.72 |
| E0143 |
Walker folding wheeled w/o s |
14 |
13 |
$374.56 |
| K0195 |
Elevating whlchair leg rests |
53 |
40 |
$357.28 |
| A6216 |
Non-sterile gauze<=16 sq in |
53 |
42 |
$301.00 |
| A9279 |
Monitoring feature/devicenoc |
44 |
42 |
$0.00 |