| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E0466 |
Home vent non-invasive inter |
1,458 |
1,342 |
$492K |
| E1390 |
Oxygen concentrator |
18,024 |
14,927 |
$441K |
| A7030 |
Cpap full face mask |
3,354 |
3,165 |
$109K |
| E0431 |
Portable gaseous 02 |
9,138 |
7,072 |
$104K |
| B4035 |
Enteral feed supp pump per d |
1,080 |
930 |
$104K |
| A7031 |
Replacement facemask interfa |
3,688 |
3,497 |
$62K |
| E0601 |
Cont airway pressure device |
3,681 |
3,234 |
$55K |
| A7034 |
Nasal application device |
2,089 |
2,006 |
$37K |
| E1392 |
Portable oxygen concentrator |
3,337 |
2,869 |
$34K |
| E0562 |
Humidifier heated used w pap |
3,854 |
3,216 |
$26K |
| A7035 |
Pos airway press headgear |
3,410 |
3,234 |
$25K |
| A7037 |
Pos airway pressure tubing |
5,239 |
4,834 |
$23K |
| A7032 |
Replacement nasal cushion |
1,139 |
1,095 |
$19K |
| A7038 |
Pos airway pressure filter |
7,019 |
6,610 |
$16K |
| A7046 |
Repl water chamber, pap dev |
3,607 |
3,404 |
$14K |
| E0570 |
Nebulizer with compression |
6,974 |
6,413 |
$12K |
| A7033 |
Replacement nasal pillows |
633 |
599 |
$9K |
| A7003 |
Nebulizer administration set |
3,841 |
3,422 |
$2K |
| A7039 |
Filter, non disposable w pap |
684 |
642 |
$1K |
| A6402 |
Sterile gauze <= 16 sq in |
297 |
258 |
$602.80 |
| E0443 |
Portable 02 contents, gas |
131 |
130 |
$400.84 |
| A7526 |
Tracheostomy tube collar |
18 |
13 |
$298.73 |
| E0260 |
Hosp bed semi-electr w/ matt |
12 |
12 |
$224.03 |
| A4604 |
Tubing with heating element |
24 |
24 |
$149.75 |
| A4213 |
20+ cc syringe only |
12 |
12 |
$149.31 |
| E0600 |
Suction pump portab hom modl |
27 |
25 |
$128.72 |
| A7013 |
Disposable compressor filter |
485 |
454 |
$56.19 |
| E0776 |
Iv pole |
14 |
12 |
$52.60 |
| E0470 |
Rad w/o backup non-inv intfc |
13 |
12 |
$16.40 |
| A7525 |
Tracheostomy mask |
14 |
12 |
$1.84 |