| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
5,640 |
5,307 |
$330K |
| E0466 |
Home vent non-invasive inter |
702 |
654 |
$261K |
| E0601 |
Cont airway pressure device |
2,567 |
2,386 |
$91K |
| E0470 |
Rad w/o backup non-inv intfc |
776 |
728 |
$61K |
| E0431 |
Portable gaseous 02 |
3,264 |
3,052 |
$33K |
| A7030 |
Cpap full face mask |
323 |
287 |
$18K |
| E0562 |
Humidifier heated used w pap |
193 |
171 |
$13K |
| A4604 |
Tubing with heating element |
475 |
414 |
$11K |
| E0260 |
Hosp bed semi-electr w/ matt |
366 |
334 |
$11K |
| A7031 |
Replacement facemask interfa |
419 |
377 |
$8K |
| E0570 |
Nebulizer with compression |
440 |
420 |
$8K |
| K0001 |
Standard wheelchair |
584 |
534 |
$6K |
| A7035 |
Pos airway press headgear |
408 |
360 |
$5K |
| A7038 |
Pos airway pressure filter |
1,270 |
1,135 |
$4K |
| K0003 |
Lightweight wheelchair |
148 |
140 |
$2K |
| A7032 |
Replacement nasal cushion |
66 |
61 |
$2K |
| A7034 |
Nasal application device |
28 |
26 |
$1K |
| A7046 |
Repl water chamber, pap dev |
70 |
67 |
$564.09 |
| A7039 |
Filter, non disposable w pap |
58 |
52 |
$330.29 |