| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A4520 |
Incontinence garment anytype |
6,664 |
5,796 |
$755K |
| E1390 |
Oxygen concentrator |
9,728 |
8,804 |
$577K |
| E0601 |
Cont airway pressure device |
5,994 |
5,164 |
$243K |
| A7030 |
Cpap full face mask |
1,172 |
1,086 |
$91K |
| E0431 |
Portable gaseous 02 |
4,255 |
3,807 |
$60K |
| E0570 |
Nebulizer with compression |
2,656 |
2,367 |
$56K |
| E0562 |
Humidifier heated used w pap |
585 |
544 |
$47K |
| A7031 |
Replacement facemask interfa |
1,723 |
1,569 |
$41K |
| A4604 |
Tubing with heating element |
1,083 |
993 |
$37K |
| A4554 |
Disposable underpads |
2,283 |
2,008 |
$35K |
| A7035 |
Pos airway press headgear |
1,726 |
1,606 |
$33K |
| A7037 |
Pos airway pressure tubing |
1,563 |
1,438 |
$28K |
| A7032 |
Replacement nasal cushion |
559 |
504 |
$18K |
| A7038 |
Pos airway pressure filter |
3,215 |
2,909 |
$14K |
| K0001 |
Standard wheelchair |
932 |
826 |
$13K |
| A7034 |
Nasal application device |
164 |
147 |
$8K |
| E1392 |
Portable oxygen concentrator |
1,529 |
1,395 |
$6K |
| A7039 |
Filter, non disposable w pap |
484 |
462 |
$6K |
| K0738 |
Portable gas oxygen system |
974 |
899 |
$5K |
| A7003 |
Nebulizer administration set |
1,851 |
1,722 |
$5K |
| E0470 |
Rad w/o backup non-inv intfc |
43 |
39 |
$3K |
| A4239 |
Non-adju cgm supply allow |
14 |
12 |
$2K |
| A7046 |
Repl water chamber, pap dev |
68 |
61 |
$552.71 |
| Q0513 |
Disp fee inhal drugs/30 days |
25 |
24 |
$363.29 |
| A7015 |
Aerosol mask used w nebulize |
98 |
90 |
$108.58 |