| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E0601 |
Cont airway pressure device |
4,235 |
3,720 |
$259K |
| E0470 |
Rad w/o backup non-inv intfc |
1,900 |
1,641 |
$206K |
| A7030 |
Cpap full face mask |
2,281 |
1,868 |
$190K |
| A7031 |
Replacement facemask interfa |
2,228 |
1,837 |
$134K |
| E1390 |
Oxygen concentrator |
2,547 |
1,889 |
$123K |
| A4604 |
Tubing with heating element |
3,228 |
2,718 |
$101K |
| A7034 |
Nasal application device |
1,631 |
1,407 |
$96K |
| A7032 |
Replacement nasal cushion |
934 |
793 |
$85K |
| A7038 |
Pos airway pressure filter |
3,999 |
3,369 |
$55K |
| A7035 |
Pos airway press headgear |
2,318 |
1,961 |
$44K |
| K0001 |
Standard wheelchair |
1,347 |
976 |
$21K |
| E0260 |
Hosp bed semi-electr w/ matt |
694 |
450 |
$20K |
| A4927 |
Non-sterile gloves |
1,578 |
1,155 |
$20K |
| E0261 |
Hosp bed semi-electr w/o mat |
422 |
366 |
$14K |
| A7039 |
Filter, non disposable w pap |
1,878 |
1,622 |
$14K |
| T4541 |
Large disposable underpad |
821 |
646 |
$14K |
| T4535 |
Disposable liner/shield/pad |
144 |
131 |
$10K |
| E0562 |
Humidifier heated used w pap |
47 |
42 |
$7K |
| E1392 |
Portable oxygen concentrator |
160 |
157 |
$2K |
| E0570 |
Nebulizer with compression |
49 |
37 |
$1K |
| E0431 |
Portable gaseous 02 |
153 |
120 |
$1K |
| A7037 |
Pos airway pressure tubing |
46 |
39 |
$790.75 |
| A4520 |
Incontinence garment anytype |
407 |
219 |
$0.00 |
| S5161 |
Emer rspns sys serv permonth |
163 |
148 |
$0.00 |