| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
19,698 |
17,758 |
$815K |
| E0466 |
Home vent non-invasive inter |
1,461 |
1,259 |
$415K |
| E0601 |
Cont airway pressure device |
6,683 |
6,232 |
$281K |
| E0470 |
Rad w/o backup non-inv intfc |
1,103 |
1,053 |
$115K |
| E0562 |
Humidifier heated used w pap |
1,491 |
1,351 |
$101K |
| E0431 |
Portable gaseous 02 |
6,697 |
6,010 |
$95K |
| A7030 |
Cpap full face mask |
1,424 |
1,340 |
$61K |
| K0738 |
Portable gas oxygen system |
2,624 |
2,426 |
$48K |
| A6196 |
Alginate dressing <=16 sq in |
364 |
292 |
$34K |
| E0570 |
Nebulizer with compression |
1,659 |
1,537 |
$29K |
| A7035 |
Pos airway press headgear |
1,951 |
1,816 |
$27K |
| A7037 |
Pos airway pressure tubing |
2,662 |
2,474 |
$27K |
| A7034 |
Nasal application device |
759 |
707 |
$19K |
| A6021 |
Collagen dressing <=16 sq in |
111 |
86 |
$15K |
| A7039 |
Filter, non disposable w pap |
1,791 |
1,671 |
$10K |
| A7038 |
Pos airway pressure filter |
4,047 |
3,527 |
$9K |
| A7031 |
Replacement facemask interfa |
659 |
598 |
$8K |
| A6446 |
Conform band s w>=3" <5"/yd |
435 |
371 |
$8K |
| A6402 |
Sterile gauze <= 16 sq in |
784 |
706 |
$7K |
| A6266 |
Impreg gauze no h20/sal/yard |
66 |
37 |
$6K |
| A6252 |
Absorpt drg >16 <=48 w/o bdr |
118 |
95 |
$5K |
| A7032 |
Replacement nasal cushion |
189 |
173 |
$3K |
| A4450 |
Non-waterproof tape |
561 |
502 |
$2K |
| E1392 |
Portable oxygen concentrator |
193 |
178 |
$2K |
| A6222 |
Gauze <=16 in no w/sal w/o b |
62 |
55 |
$2K |
| A7005 |
Nondisposable nebulizer set |
205 |
196 |
$2K |
| E0260 |
Hosp bed semi-electr w/ matt |
41 |
39 |
$2K |
| A7046 |
Repl water chamber, pap dev |
228 |
211 |
$574.14 |
| A7003 |
Nebulizer administration set |
103 |
102 |
$39.15 |
| A9279 |
Monitoring feature/devicenoc |
51 |
48 |
$3.46 |