| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
4,221 |
3,440 |
$252K |
| A7030 |
Cpap full face mask |
2,010 |
1,520 |
$123K |
| A4604 |
Tubing with heating element |
2,628 |
2,055 |
$63K |
| E0562 |
Humidifier heated used w pap |
518 |
360 |
$54K |
| E0601 |
Cont airway pressure device |
5,047 |
3,523 |
$53K |
| A7031 |
Replacement facemask interfa |
1,874 |
1,431 |
$43K |
| E0431 |
Portable gaseous 02 |
1,837 |
1,504 |
$34K |
| A7035 |
Pos airway press headgear |
1,941 |
1,447 |
$26K |
| E0570 |
Nebulizer with compression |
3,610 |
2,385 |
$20K |
| E0470 |
Rad w/o backup non-inv intfc |
428 |
378 |
$18K |
| A7038 |
Pos airway pressure filter |
4,483 |
3,524 |
$16K |
| A7034 |
Nasal application device |
315 |
231 |
$13K |
| E0260 |
Hosp bed semi-electr w/ matt |
829 |
499 |
$8K |
| K0001 |
Standard wheelchair |
466 |
370 |
$7K |
| A7046 |
Repl water chamber, pap dev |
1,133 |
875 |
$7K |
| L4361 |
Pneuma/vac walk boot pre ots |
67 |
55 |
$6K |
| A7032 |
Replacement nasal cushion |
135 |
111 |
$2K |
| K0738 |
Portable gas oxygen system |
140 |
126 |
$2K |
| A7003 |
Nebulizer administration set |
254 |
172 |
$437.28 |
| E0143 |
Walker folding wheeled w/o s |
16 |
12 |
$394.77 |
| L3908 |
Who cock-up nonmolde pre ots |
19 |
15 |
$328.36 |
| A7013 |
Disposable compressor filter |
466 |
350 |
$315.56 |
| A4452 |
Waterproof tape |
29 |
12 |
$152.06 |