| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
13,125 |
11,830 |
$454K |
| E0466 |
Home vent non-invasive inter |
1,564 |
1,246 |
$394K |
| E0601 |
Cont airway pressure device |
12,872 |
11,585 |
$327K |
| E0562 |
Humidifier heated used w pap |
4,514 |
4,034 |
$171K |
| A7030 |
Cpap full face mask |
3,343 |
3,034 |
$165K |
| E0431 |
Portable gaseous 02 |
9,432 |
8,564 |
$128K |
| A7034 |
Nasal application device |
4,091 |
3,667 |
$121K |
| A7038 |
Pos airway pressure filter |
9,072 |
7,316 |
$62K |
| A7031 |
Replacement facemask interfa |
2,931 |
2,561 |
$60K |
| A7032 |
Replacement nasal cushion |
2,441 |
2,041 |
$58K |
| A7035 |
Pos airway press headgear |
4,975 |
4,526 |
$56K |
| A4604 |
Tubing with heating element |
2,968 |
2,727 |
$55K |
| E0470 |
Rad w/o backup non-inv intfc |
791 |
685 |
$37K |
| A7046 |
Repl water chamber, pap dev |
2,175 |
2,000 |
$36K |
| A7037 |
Pos airway pressure tubing |
4,128 |
3,726 |
$35K |
| E1392 |
Portable oxygen concentrator |
1,332 |
1,187 |
$26K |
| A9279 |
Monitoring feature/devicenoc |
2,187 |
1,808 |
$23K |
| A7039 |
Filter, non disposable w pap |
1,783 |
1,610 |
$22K |
| A7033 |
Replacement nasal pillows |
1,073 |
888 |
$19K |
| E0570 |
Nebulizer with compression |
2,127 |
1,969 |
$14K |
| E0261 |
Hosp bed semi-electr w/o mat |
1,209 |
1,099 |
$13K |
| A6196 |
Alginate dressing <=16 sq in |
102 |
84 |
$12K |
| K0001 |
Standard wheelchair |
1,265 |
1,165 |
$12K |
| A6252 |
Absorpt drg >16 <=48 w/o bdr |
120 |
105 |
$5K |
| A6402 |
Sterile gauze <= 16 sq in |
499 |
446 |
$5K |
| A7036 |
Pos airway press chinstrap |
574 |
522 |
$5K |
| E0260 |
Hosp bed semi-electr w/ matt |
324 |
288 |
$2K |
| A6251 |
Absorpt drg <=16 sq in w/o b |
17 |
12 |
$926.93 |
| E0630 |
Patient lift hydraulic |
162 |
147 |
$796.79 |
| A6266 |
Impreg gauze no h20/sal/yard |
19 |
13 |
$648.19 |
| A6446 |
Conform band s w>=3" <5"/yd |
41 |
38 |
$583.60 |
| A4452 |
Waterproof tape |
30 |
27 |
$299.85 |
| K0195 |
Elevating whlchair leg rests |
13 |
13 |
$23.63 |