| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
9,636 |
7,994 |
$634K |
| E0601 |
Cont airway pressure device |
3,736 |
3,397 |
$181K |
| E0466 |
Home vent non-invasive inter |
108 |
89 |
$40K |
| E0470 |
Rad w/o backup non-inv intfc |
315 |
278 |
$37K |
| E0431 |
Portable gaseous 02 |
7,498 |
6,178 |
$31K |
| E0562 |
Humidifier heated used w pap |
2,762 |
2,557 |
$26K |
| E0570 |
Nebulizer with compression |
2,103 |
1,644 |
$14K |
| K0003 |
Lightweight wheelchair |
1,460 |
1,247 |
$11K |
| E0260 |
Hosp bed semi-electr w/ matt |
458 |
424 |
$2K |
| E1392 |
Portable oxygen concentrator |
317 |
269 |
$2K |
| E0143 |
Walker folding wheeled w/o s |
14 |
12 |
$333.53 |
| K0001 |
Standard wheelchair |
55 |
39 |
$293.99 |
| A7030 |
Cpap full face mask |
115 |
88 |
$175.83 |
| A7037 |
Pos airway pressure tubing |
303 |
243 |
$90.06 |
| A7003 |
Nebulizer administration set |
22 |
18 |
$62.49 |
| A7038 |
Pos airway pressure filter |
467 |
346 |
$46.76 |
| A7034 |
Nasal application device |
48 |
40 |
$7.94 |
| A7035 |
Pos airway press headgear |
148 |
118 |
$4.64 |
| A7013 |
Disposable compressor filter |
20 |
16 |
$1.70 |
| A7031 |
Replacement facemask interfa |
90 |
68 |
$0.00 |
| A7039 |
Filter, non disposable w pap |
19 |
14 |
$0.00 |
| A7046 |
Repl water chamber, pap dev |
44 |
37 |
$0.00 |