| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
24,658 |
17,959 |
$865K |
| A7030 |
Cpap full face mask |
3,148 |
2,262 |
$146K |
| A7031 |
Replacement facemask interfa |
4,665 |
3,595 |
$129K |
| E0601 |
Cont airway pressure device |
4,704 |
3,456 |
$125K |
| E0431 |
Portable gaseous 02 |
12,062 |
8,828 |
$96K |
| A4604 |
Tubing with heating element |
3,425 |
2,534 |
$69K |
| E0562 |
Humidifier heated used w pap |
5,891 |
4,611 |
$56K |
| E0466 |
Home vent non-invasive inter |
242 |
166 |
$52K |
| A7034 |
Nasal application device |
1,470 |
1,075 |
$39K |
| A7032 |
Replacement nasal cushion |
1,058 |
859 |
$35K |
| E0570 |
Nebulizer with compression |
6,907 |
4,838 |
$28K |
| A7035 |
Pos airway press headgear |
2,768 |
2,018 |
$26K |
| A7038 |
Pos airway pressure filter |
7,433 |
5,784 |
$25K |
| E1392 |
Portable oxygen concentrator |
2,494 |
1,727 |
$16K |
| A7033 |
Replacement nasal pillows |
591 |
478 |
$15K |
| A7046 |
Repl water chamber, pap dev |
2,281 |
1,645 |
$12K |
| A7037 |
Pos airway pressure tubing |
1,202 |
868 |
$9K |
| A7003 |
Nebulizer administration set |
2,602 |
1,730 |
$2K |
| E0260 |
Hosp bed semi-electr w/ matt |
190 |
124 |
$1K |
| E0443 |
Portable 02 contents, gas |
210 |
168 |
$322.64 |
| A7039 |
Filter, non disposable w pap |
126 |
79 |
$198.96 |
| A7005 |
Nondisposable nebulizer set |
14 |
12 |
$90.26 |
| B4035 |
Enteral feed supp pump per d |
20 |
13 |
$71.37 |
| A7015 |
Aerosol mask used w nebulize |
53 |
38 |
$28.08 |
| A7013 |
Disposable compressor filter |
19 |
13 |
$4.42 |
| B4152 |
Ef calorie dense>/=1.5kcal |
89 |
75 |
$0.00 |
| K0001 |
Standard wheelchair |
137 |
115 |
$0.00 |