| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
2,234 |
2,131 |
$139K |
| A7030 |
Cpap full face mask |
718 |
686 |
$76K |
| E0601 |
Cont airway pressure device |
937 |
850 |
$49K |
| B4035 |
Enteral feed supp pump per d |
250 |
190 |
$35K |
| A4604 |
Tubing with heating element |
1,065 |
1,025 |
$31K |
| A7031 |
Replacement facemask interfa |
709 |
668 |
$27K |
| E0431 |
Portable gaseous 02 |
1,133 |
1,077 |
$15K |
| A7034 |
Nasal application device |
277 |
261 |
$15K |
| E0562 |
Humidifier heated used w pap |
901 |
841 |
$14K |
| S9500 |
Hit antibiotic q24h diem |
31 |
12 |
$10K |
| A7035 |
Pos airway press headgear |
563 |
540 |
$9K |
| A7038 |
Pos airway pressure filter |
1,299 |
1,183 |
$8K |
| S9342 |
Hit enteral pump diem |
12 |
12 |
$7K |
| E0260 |
Hosp bed semi-electr w/ matt |
259 |
254 |
$7K |
| B4150 |
Ef complet w/intact nutrient |
40 |
26 |
$1K |
| E0570 |
Nebulizer with compression |
128 |
118 |
$481.39 |
| A7032 |
Replacement nasal cushion |
15 |
13 |
$388.55 |
| A7046 |
Repl water chamber, pap dev |
39 |
39 |
$374.07 |
| A7039 |
Filter, non disposable w pap |
71 |
67 |
$366.01 |
| K0001 |
Standard wheelchair |
66 |
62 |
$312.66 |