| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
7,022 |
5,588 |
$242K |
| E0570 |
Nebulizer with compression |
2,355 |
1,786 |
$39K |
| E0601 |
Cont airway pressure device |
1,196 |
997 |
$37K |
| E0431 |
Portable gaseous 02 |
3,489 |
2,701 |
$26K |
| K0738 |
Portable gas oxygen system |
1,321 |
1,054 |
$15K |
| E0562 |
Humidifier heated used w pap |
1,239 |
1,076 |
$15K |
| A7030 |
Cpap full face mask |
243 |
189 |
$9K |
| A7031 |
Replacement facemask interfa |
214 |
164 |
$4K |
| A7038 |
Pos airway pressure filter |
1,437 |
1,135 |
$4K |
| A7037 |
Pos airway pressure tubing |
545 |
411 |
$3K |
| A7035 |
Pos airway press headgear |
311 |
243 |
$3K |
| A7005 |
Nondisposable nebulizer set |
216 |
182 |
$2K |
| E1392 |
Portable oxygen concentrator |
178 |
151 |
$2K |
| E0250 |
Hosp bed fixed ht w/ mattres |
163 |
102 |
$2K |
| A4604 |
Tubing with heating element |
40 |
37 |
$1K |
| E0470 |
Rad w/o backup non-inv intfc |
13 |
12 |
$980.88 |
| A7039 |
Filter, non disposable w pap |
214 |
170 |
$649.78 |
| A7034 |
Nasal application device |
15 |
12 |
$610.32 |
| A7046 |
Repl water chamber, pap dev |
12 |
12 |
$115.61 |
| 0013A |
|
14 |
14 |
$0.00 |
| G0008 |
Admin influenza virus vac |
36 |
36 |
$0.00 |
| 90674 |
|
26 |
26 |
$0.00 |