| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
10,563 |
8,233 |
$383K |
| E0601 |
Cont airway pressure device |
5,075 |
4,227 |
$179K |
| A7030 |
Cpap full face mask |
2,677 |
2,178 |
$148K |
| E0570 |
Nebulizer with compression |
3,491 |
2,674 |
$79K |
| A7031 |
Replacement facemask interfa |
2,406 |
1,947 |
$57K |
| E0562 |
Humidifier heated used w pap |
5,278 |
4,429 |
$57K |
| E0431 |
Portable gaseous 02 |
5,891 |
4,592 |
$41K |
| A7037 |
Pos airway pressure tubing |
3,378 |
2,738 |
$32K |
| A7035 |
Pos airway press headgear |
2,221 |
1,841 |
$27K |
| A7034 |
Nasal application device |
429 |
365 |
$17K |
| A7038 |
Pos airway pressure filter |
3,578 |
2,920 |
$12K |
| A7005 |
Nondisposable nebulizer set |
846 |
763 |
$11K |
| A7039 |
Filter, non disposable w pap |
1,954 |
1,608 |
$8K |
| E1392 |
Portable oxygen concentrator |
606 |
518 |
$8K |
| A7046 |
Repl water chamber, pap dev |
758 |
646 |
$6K |
| E1130 |
Whlchr stand fxd arm ft rest |
183 |
177 |
$5K |
| A4604 |
Tubing with heating element |
77 |
74 |
$3K |
| A7032 |
Replacement nasal cushion |
59 |
51 |
$2K |
| A4253 |
Blood glucose/reagent strips |
81 |
49 |
$344.43 |
| E0250 |
Hosp bed fixed ht w/ mattres |
41 |
25 |
$309.48 |
| G0008 |
Admin influenza virus vac |
79 |
76 |
$0.00 |
| 90674 |
|
22 |
22 |
$0.00 |
| 90686 |
|
12 |
12 |
$0.00 |
| 90694 |
|
13 |
12 |
$0.00 |