| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
10,467 |
8,063 |
$399K |
| E0601 |
Cont airway pressure device |
11,544 |
8,643 |
$305K |
| A7030 |
Cpap full face mask |
6,117 |
4,203 |
$251K |
| E0562 |
Humidifier heated used w pap |
1,686 |
1,199 |
$143K |
| A7031 |
Replacement facemask interfa |
6,549 |
4,680 |
$142K |
| A4604 |
Tubing with heating element |
9,024 |
6,228 |
$120K |
| E0470 |
Rad w/o backup non-inv intfc |
1,838 |
1,307 |
$101K |
| A7034 |
Nasal application device |
3,380 |
2,340 |
$79K |
| E0431 |
Portable gaseous 02 |
6,727 |
5,280 |
$66K |
| A7035 |
Pos airway press headgear |
5,885 |
4,185 |
$57K |
| A7038 |
Pos airway pressure filter |
10,983 |
7,874 |
$37K |
| A7032 |
Replacement nasal cushion |
1,571 |
1,149 |
$34K |
| E0570 |
Nebulizer with compression |
2,544 |
1,819 |
$19K |
| A7046 |
Repl water chamber, pap dev |
3,866 |
2,771 |
$18K |
| A7033 |
Replacement nasal pillows |
1,058 |
734 |
$17K |
| E0260 |
Hosp bed semi-electr w/ matt |
300 |
172 |
$9K |
| E1392 |
Portable oxygen concentrator |
1,100 |
903 |
$5K |
| K0001 |
Standard wheelchair |
127 |
107 |
$1K |
| A7037 |
Pos airway pressure tubing |
92 |
70 |
$1K |
| E0143 |
Walker folding wheeled w/o s |
55 |
38 |
$776.30 |
| K0195 |
Elevating whlchair leg rests |
15 |
14 |
$137.16 |
| A7036 |
Pos airway press chinstrap |
37 |
28 |
$88.05 |