| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
26,713 |
24,650 |
$1.02M |
| E0431 |
Portable gaseous 02 |
13,562 |
12,443 |
$365K |
| E0466 |
Home vent non-invasive inter |
1,080 |
970 |
$253K |
| A7030 |
Cpap full face mask |
1,991 |
1,830 |
$106K |
| E0601 |
Cont airway pressure device |
4,275 |
3,893 |
$102K |
| A7031 |
Replacement facemask interfa |
2,742 |
2,480 |
$79K |
| E0562 |
Humidifier heated used w pap |
2,363 |
2,140 |
$52K |
| E0260 |
Hosp bed semi-electr w/ matt |
1,727 |
1,571 |
$47K |
| A7038 |
Pos airway pressure filter |
6,308 |
5,753 |
$29K |
| A7037 |
Pos airway pressure tubing |
2,756 |
2,489 |
$27K |
| A7035 |
Pos airway press headgear |
1,955 |
1,788 |
$24K |
| E0570 |
Nebulizer with compression |
3,771 |
3,480 |
$19K |
| K0001 |
Standard wheelchair |
2,153 |
1,692 |
$16K |
| A7046 |
Repl water chamber, pap dev |
1,290 |
1,193 |
$8K |
| A7034 |
Nasal application device |
324 |
289 |
$7K |
| E1392 |
Portable oxygen concentrator |
703 |
659 |
$5K |
| E0470 |
Rad w/o backup non-inv intfc |
112 |
90 |
$4K |
| J7605 |
Arformoterol non-comp unit |
18 |
15 |
$2K |
| A7039 |
Filter, non disposable w pap |
340 |
319 |
$2K |
| A4604 |
Tubing with heating element |
171 |
150 |
$2K |
| A7003 |
Nebulizer administration set |
1,304 |
1,165 |
$1K |
| Q0513 |
Disp fee inhal drugs/30 days |
129 |
111 |
$1K |
| E0443 |
Portable 02 contents, gas |
78 |
77 |
$839.99 |
| J7626 |
Budesonide non-comp unit |
35 |
30 |
$815.22 |
| A7032 |
Replacement nasal cushion |
26 |
25 |
$724.34 |
| J7620 |
Albuterol ipratrop non-comp |
37 |
30 |
$82.49 |
| J7613 |
Albuterol non-comp unit |
30 |
27 |
$45.24 |