| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
24,950 |
19,673 |
$970K |
| E0431 |
Portable gaseous 02 |
15,252 |
11,920 |
$526K |
| A7030 |
Cpap full face mask |
4,096 |
3,450 |
$256K |
| E0601 |
Cont airway pressure device |
7,020 |
5,772 |
$241K |
| A7034 |
Nasal application device |
3,407 |
2,846 |
$140K |
| E0562 |
Humidifier heated used w pap |
5,586 |
4,621 |
$123K |
| A7031 |
Replacement facemask interfa |
4,603 |
3,738 |
$100K |
| A7037 |
Pos airway pressure tubing |
4,446 |
3,828 |
$80K |
| A7035 |
Pos airway press headgear |
5,084 |
4,344 |
$78K |
| E1392 |
Portable oxygen concentrator |
1,928 |
1,540 |
$31K |
| A7038 |
Pos airway pressure filter |
8,641 |
6,962 |
$28K |
| E0471 |
Rad w/backup non inv intrfc |
189 |
161 |
$27K |
| A7032 |
Replacement nasal cushion |
1,933 |
1,503 |
$25K |
| A7033 |
Replacement nasal pillows |
1,532 |
1,281 |
$22K |
| A7046 |
Repl water chamber, pap dev |
3,525 |
3,016 |
$21K |
| E0619 |
Apnea monitor w recorder |
174 |
131 |
$17K |
| K0738 |
Portable gas oxygen system |
3,253 |
2,932 |
$12K |
| E0570 |
Nebulizer with compression |
1,338 |
1,142 |
$11K |
| E0443 |
Portable 02 contents, gas |
250 |
215 |
$11K |
| A4604 |
Tubing with heating element |
2,538 |
2,165 |
$11K |
| E0434 |
Portable liquid 02 |
127 |
117 |
$10K |
| E0439 |
Stationary liquid 02 |
113 |
104 |
$9K |
| E0424 |
Stationary compressed gas 02 |
93 |
68 |
$5K |
| E0260 |
Hosp bed semi-electr w/ matt |
174 |
162 |
$2K |
| A7039 |
Filter, non disposable w pap |
313 |
267 |
$2K |
| E0143 |
Walker folding wheeled w/o s |
66 |
61 |
$1K |
| E0114 |
Crutch underarm pair no wood |
20 |
20 |
$627.02 |
| A7005 |
Nondisposable nebulizer set |
55 |
52 |
$608.59 |
| E0470 |
Rad w/o backup non-inv intfc |
12 |
12 |
$147.13 |
| A7036 |
Pos airway press chinstrap |
14 |
12 |
$81.11 |
| A7003 |
Nebulizer administration set |
15 |
13 |
$7.07 |