| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
10,609 |
9,024 |
$555K |
| E0601 |
Cont airway pressure device |
8,004 |
7,228 |
$501K |
| A7030 |
Cpap full face mask |
2,805 |
2,510 |
$234K |
| A7034 |
Nasal application device |
3,700 |
3,349 |
$202K |
| E0562 |
Humidifier heated used w pap |
1,484 |
1,371 |
$196K |
| A4604 |
Tubing with heating element |
5,764 |
5,180 |
$175K |
| A7035 |
Pos airway press headgear |
4,961 |
4,519 |
$96K |
| E0570 |
Nebulizer with compression |
3,196 |
2,618 |
$61K |
| A7031 |
Replacement facemask interfa |
1,982 |
1,790 |
$59K |
| E0431 |
Portable gaseous 02 |
5,073 |
4,304 |
$53K |
| A7038 |
Pos airway pressure filter |
8,141 |
7,366 |
$44K |
| A7032 |
Replacement nasal cushion |
1,386 |
1,276 |
$40K |
| K0001 |
Standard wheelchair |
2,907 |
2,289 |
$38K |
| E1392 |
Portable oxygen concentrator |
2,654 |
2,258 |
$34K |
| E0465 |
Home vent invasive interface |
59 |
36 |
$31K |
| E0471 |
Rad w/backup non inv intrfc |
151 |
132 |
$29K |
| A7046 |
Repl water chamber, pap dev |
3,091 |
2,794 |
$28K |
| E0470 |
Rad w/o backup non-inv intfc |
246 |
231 |
$24K |
| A4927 |
Non-sterile gloves |
2,664 |
2,053 |
$24K |
| A7033 |
Replacement nasal pillows |
1,182 |
1,058 |
$21K |
| E0143 |
Walker folding wheeled w/o s |
392 |
326 |
$14K |
| E0260 |
Hosp bed semi-electr w/ matt |
485 |
409 |
$8K |
| E0294 |
Hosp bed semi-elect w/ mattr |
168 |
162 |
$5K |
| E0600 |
Suction pump portab hom modl |
127 |
112 |
$4K |
| A4606 |
Oxygen probe used w oximeter |
81 |
66 |
$4K |
| A7036 |
Pos airway press chinstrap |
404 |
372 |
$4K |
| A7000 |
Disposable canister for pump |
236 |
223 |
$4K |
| A7002 |
Tubing used w suction pump |
357 |
317 |
$3K |
| A7526 |
Tracheostomy tube collar |
43 |
37 |
$3K |
| A7003 |
Nebulizer administration set |
1,607 |
1,436 |
$3K |
| T4541 |
Large disposable underpad |
91 |
86 |
$2K |
| T4527 |
Adult size pull-on lg |
25 |
25 |
$2K |
| A7005 |
Nondisposable nebulizer set |
44 |
42 |
$928.72 |
| H0020 |
Alcohol and/or drug services |
51 |
39 |
$806.31 |
| A4628 |
Oropharyngeal suction cath |
122 |
84 |
$617.77 |
| E2201 |
Man w/ch acc seat w>=20"<24" |
55 |
37 |
$613.69 |
| A4216 |
Sterile water/saline, 10 ml |
28 |
24 |
$492.90 |
| A7039 |
Filter, non disposable w pap |
14 |
12 |
$113.98 |
| A7015 |
Aerosol mask used w nebulize |
43 |
40 |
$56.09 |